DOCUMENTS Initial Application Date: I t�I (1 Application# 1 SOD Y) 4 110
Cut!
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street,Lillington,NC 27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.harnett.org/permits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER: SpMIAEL vt SAeI UR AC-Au(LP4Z Mailing Address: V 3 b Co k:6SBLe.QY PA2t L-N1
City: FUQIAA`/ VA-Q1 NA State:NC- Zip:27S,71-,Contact No: Email:
APPLICANT': SA111 Mailing Address:
City: State: Zip: Contact No: Email:
'Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE: I - Phone# .�1k
PROPERTY LOCATION:
-Subdivision: C \C�V --02-4.r'/ RQ Ck _ Lot#: 1 Lot'TSize:Si ,SS
State Road# D 3,./Vl�/� State Road Name: L'IID' 1�CG.�a l0 1 1 'ege`& Map
BB000kk&P-aTge QC)j`3/ / / y
Parcel:
�(O S d o3 S CJ 2 4 Lko PIN: LPS S - S51 ' Tl 9 \ d ()CAM
Zoning.lFldod Zone: \: Watershed/LA; Deed Book&Page: 74i 3Ise Power Company':
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
Monolithic
❑ SFD:(Size x )#Bedrooms: #Baths: Basement(wlwo bath): Garage: Deck: Crawl Space:_Slab:_Slab:_
(Is the bonus room finished?(_)yes (_)no w/a closet?(_)yes (_)no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms #Baths Basement(w/wo bath)_Garage:_Site Built Deck:_ On Frame_OR Frame_
(Is the second floor finished?(_)yes (_)no Any other site built additions?(_)yes ( )no
❑ Manufactured Home. SW DW TW(Size x )it Bedrooms:_Garage: (site built?_)Deck:_(site built? )
❑ Duplex:(Size x )No.Buildings: No.Bedrooms Per Unit:
❑ Home Occupation:#Rooms: Use: y/ �x m� _ - Hours of Operation: 1- I #Employees: ,,//_
( 6 Addition/Accessory/Other:(Size'C� x ` S )Use: [ 1tiarC2J�Ji/ V�/m+—G{.f Closets in addition?( )yes (A+)no
C(lf Ou f „ C'Il�' (A
Water Supply: County Existing Well New Well(#of dwellings using well UJ* )*Must have operable water before final
Sewage Supply: New Septic Tank(Complete Checklist) Existing Septic Tank(Complete Checklist) County Sewer
Does owner of this tract of land,own land that contains a manufactured home within five hundred feet(500')of tract listed above?( )yes ( )no
Does the property contain any easements whether underground or overhead� (_)yes ( )no
Structures(existing or proposed):Single family dwellings: EuxT/ Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum AS Actual r�
Rear -rDDO•g
Closest Side I L� AUL I
NieesVteVcorngr lot
Nearest
onn same lot '
Residential Land Use Application Page 1 oft 03111
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
If permits are granted I agree to conform to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing statements are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
Apr- 14l- 7 2 1
Signature of Owner or Owner's Agent Da e
"It is the owner/applicants responsibility to provide the county withany applicable information about the subjeft property,including but not limited
to:boundary information,house location,underground or overhead easements,etc.The county or Its employees are not responsible for any
incorrect or missing Information that is contained within these applications."
"This application expires 6 months from the initial date if permits have not been issued"
•
Residential Land Use Application Page 2 of 2 03/11
•
MO Iwr a CURVE RADIUS LENGTH DELTA CHORD CH.BEARING
C-1 200.00' 71.53' 20'29'30• 71.15' S 4702'25'W
COMPS
War u.
NOTES
it UNUSABLE , NOT AN ACTUAL SURVEY
II
I SOILS
AREA BY COORDINATES
I1 1
1 I I REI PIND/00 635-58-892000
VICINITY MAP NT' 1 1 1 1 Ii I I
1 1� 1 1 I I THIS N A FLOOD FLO Hrf IS NOT HAZARD AREA PERS
71 I 1 I I I J. F.E.M.A. MAP /3720062400
TEFF. DATE: 10/3/2006 ZONE X
DUNCAN DEVELOPMENT LL� iY� I I I
/ /dr
¢,333{��� D.B. 2229 PG. 131 89 41 i `I 1 SEn3A.CK5
//r- 0•E \ � ^ I SI�DONTE 10 5
REAR - 25'
N / 2./^/Ow / \ \\\` \
/ / /// `\\\..)\)/R4\N
O`/` / 24,594 S.F. _ N
C04,
8J
.� / rn \ , DUNCAN DEVELOPMENT
( #. . o. \ \in\ D.B. 2229 PG. 131
/ \N W
\\ \\\\ ROPOSED / DECK \\\K' \\ p S
\ \ HOUSE (s9'I / � d
e
%\ \ Q.
\` _ \
�\ \ J I- p
85 'i+\ \ . \ Fr Er
F F o m
DUNCAN DEVELOPMENT LLC O/• \\ $ �' �•'�• ' CO C a o
D.B. 2229 PG. 131 \ \ (0 \
.- y.-
IMPERVIOUS CALCULATIONS \ .e�
•
PROPOSED HOUSE - 1,850 SF
PROPOSED DRIVE - 1,132 SF
TOTAL PROPOSED - 2,982 SF,500 SF �'�VqQ E
518AU_0 SF UNDER WABLE - 3ALLOWABLE
\y ,„•[ valyl
/ yr e\• /i_
�/ �o '° ���
tNl
'0 ,y .n4�9y���il "ti,j/ PROPOSED PLOT PN FOR:
`! WS I o ' U
STANCIL BUILDERS. INC.
U 6,-e / 836 COKESBURY PARK LANE
.L�0412 tel y / FUOUAY-VARINA NC 27526
,,�.M.f.. - a .V// I M RA rniersnuRY PARK — PHACF III
NAME: APPLICATION#:
*This application to be filled out when applying for a septic system inspection.*
County Health Department Application for Improvement Permit and/or Authorization to Construct
IF THE INFORMATION IN THIS APPLICATION IS FALSIFIED,CHANGED,OR THE SITE IS ALTERED,THEN THE IMPROVEMENT
PERMIT OR AUTHORIZATION TO CONSTRUCT SHALL BECOME INVALID. The permit is valid for either 60 months or without expiration
depending upon documentation submitted. (Complete site plan=60 months:Complete plat=without expiration)
910-893-7525 option 1 CONFIRMATION#
Environmental Health New Septic SvstemCode 800
• All property Irons must be made visible. Place "pink property flags' on each corner iron of lot. All property
lines must be clearly flagged approximately every 50 feet between corners.
• Place "orange house corner flags'at each corner of the proposed structure. Also flag driveways, garages,decks,
out buildings, swimming pools, etc. Place flags per site plan developed at/for Central Permitting.
• Place orange Environmental Health card in location that is easily viewed from road to assist in locating property.
• If property is thickly wooded, Environmental Health requires that you clean out the undergrowth to allow the soil
evaluation to be performed. Inspectors should be able to walk freely around site. Do not grade property.
• All lots to be addressed within 10 business days after confirmation. $25.00 return trip fee may be incurred
for failure to uncover outlet lid,mark house corners and property lines.etc. once lot confirmed ready.
• After preparing proposed site call the voice permitting system at 910-893-7525 option 1 to schedule and use code
800 (after selecting notification permit if multiple permits exist) for Environmental Health inspection. Please note
confirmation number given at end of recording for proof of request.
`A • Use Click2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
r Environmental Health Existina Tank Inspections Code 800
• Follow above instructions for placing flags and card on property.
• Prepare for inspection by removing soil over outlet end of tank as diagram indicates, and lift lid straight up (if
possible) and then put lid back In place. (Unless inspection is for a septic tank in a mobile home park)
• DO NOT LEAVE LIDS OFF OF SEPTIC TANK
• After uncovering outlet end call the voice permitting system at 910-893-7525 option 1 &select notification permit
if multiple permits, then use code 800 for Environmental Health inspection. Please note confirmation number
given at end of recording for proof of request.
• Use Click2Gov or IVR to hear results.Once approved, proceed to Central Permitting for remaining permits.
SEPTIC
If applying for authorization to conswuct please indicate desired system type(s): can be ranked in order of preference,must choose one.
Accepted {_I Innovative I—I Conventional I Any
Alternative {_f Other
The pplicant shall notify the local health de 11 ment upon submittal of this application if any of the following apply to the property in
clues on. If the answer is"yes",applicant r ST ATTACH SUPPORTING DOCUMENTA ION:
(_ ES { I NO Does the site c L in any Jurisdictional Wetlands? N
{_ NO Do you plan r ha - an irrigation system now or in the future?
S ( I NO - Does or wi. the bu Iding contain any drains?Please explain.
1I I—I NO Are they- any existi g wells,springs,waterlines or Wastewatery ems on this property?
{_} S { I NO Is any astewater ging to be generated on the site other th, dom.stic sewage?
I I {_} NO Is t site subject to pproval by any other Public Age ?
{_}YE' ( } NO • there any Easem• is or Right of Ways on this operty?
{_IYES (_) NO roes the site contain a • existing water,cable,phone or undergroum electric lines?
If yes please call No Cuts : 800-632-' •9 to locate the lines. This is + free service.
I Have Read T s Ap. cation And Certify That The Information Provided Herein Is True,Complete A • Correct. A orized County And
State Officials Are Granted Right Of Entry To Conduct Necessary Inspections To Determine Compliance t i pplicable Laws And Rules.
I Understand That I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site Accessible So That A Complete Site Evaluation Can Be Performed.
j A*AA of 1 2 1 SS
PROPERTY OWNERS UR OWNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) AT
10/10
°C uv u CURVE RADIUS LENGTH DELTA CHORD CH.BEARING
C-1 200.00' 71.53' 20'29'30' 71.15' S 42'02'25'W
--
n u
NOTES
UNUSABLE NOT AN ACTUAL SURVEY
I
I I 1 SOILS AREA BY COORDINATES
I I PIN X0835-58-8952.000
I 1 I 1 REID /0085798
VICINITY MAP NTS I N J 1 1I I I THIS PROPOERTY IS NOT LOCATED
1 1 T..," 1 1 I INA FLOOD HAZARD AREA PER
"1:.........;,..7.15 I I I ~' J. F.E.MAMA /37262/ I I JEFF. DATE: 10/3/2006 ZONE %
DUNCANLOPMENT LLC ...4 IIIeD.B. 2PG. 13894j \11SETBACKS
no
\ I,¢ / /� E \ SIDE -REARM- 10'
25'
t /Oki/ / /r' -\c
A.2 \ \\ \
Y +/^e /1
\ q",y� \\�'L
// // / ® \ ` , \\\N
O/ // 24,594 S.F. _ w \ 'CJS \ "',{ 83
[ / m \? m DUNCAN DEVELOPMENT
/ v C A. 5 lo. \ \u, D.B. 2229 PG. 131 ` ,
N W fa
W
\ \\ PROPOSED D/ECK \\ p S
N \\ HOUSE CL
4\ Sri,
\ CC
'L\ \\ \ nil A.' p9 \\ \ \\ a •
\ \ \\ z.
�s?' \ a 8• \ °' CO
Q
•
\\ \\ Q.. \ a EE cr
\ 'S O
DUNCAN DEVELOPMENT LLC q\\\ 4. �6 " \ CO S
D.B. 2229 PG. 131 N. +°
IT y_—
IMPERVIOUS CALCULATIONS \ .ems
•
PROPOSED HOUSE - 1,850 SF \ T(`
PROPOSED DRIVE - 1,132 SF
TOTAL PROPOSED - 2,982 SF \ Ieball��
ALLOWABLE - 3,500 SF
518 SF UNDER ALLOWABLE y 0.`l 4 es
// GOest \OP
5°
k •ktN GAtgpi��i�� i s ��
terata k4
491.3, C,'�,,t��4�PR/ PROPOSED PLOT PLAN FOR:
:te* 19
>I ti\j��// STANCIL BUILDERS, INC.
1n g 4,....91-, 836 COKESBURY PARK LANE
S.1:9,,..02b C - it 1 y ,c4, G/ FUOUAY-VARINA, NC 27528
OUId" 5 /
%p,7ON,N,Q,d�� / LOT 84 COKESBURY PARK - PHASE HI
grE#`. -�. 2efl Harnett County Department of Public Health
PERMIT # Zn a z Operation Permit 22491
2"New Installation ["Septic Tank Eriiitrification Line 0 Repair 0 Expansion
PROPERTY LOCATION: ePia 3 Cthrnhw.-y e-d)
Name: (owner) ST/ T$`'..i./ ,3t.--leb..o SUBDIVISION r'.a n...40.7 642- / LOT # 14
System Installer. ?fkmdct l Sc.Jd'z_. Registration #
Basement with plumbing: 0 Garage C Humber of Bedrooms 3
Type of Water Supply: ❑ Community LJ Public 0 Wel Dismnre from well feet
System Type: ,ro`ti2 , Lli-6C1.-fit— ..s.- i.�unt/3 Types 9 and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with amicable Nob Conlin General Statt..Ides Sr Swage Tasman and ksprnb red ill conditions of me!nativism Parent and Cauwninn Authorization4a✓g.--, 1,1
9-M\
T\ 4
\� \
V t •
• t
sex \
4 1. th I�
co..61 en 11#9.42-4
PERMIT CONDITIONS:
I. Perloonance: System shag perform in accordance with Rule .1961.
II. Monitoring As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other
Subsurface system operator required?Yes 0 No 0
M yes. see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
Y. Other
❑ D-Box ❑ Pump ❑ Alarm 0 N201.ine 0 MR Line
Following are the specifications for the sewage disposal system on The above captioned propem.
Type of system: 0 Conventional 9' Other p1 k 75,..o aneofh—s Septic Tank ;Cob gallons Pump Tank 1 9'0 0 gallons
Subsurface No. of exact length width of 2 depth of
Drainage Field ditches 3 of each ditch 'ta leet ditches 1 feet ditches 1'! IS inches
French Drain Required: Linear feet
Authorized State Agents✓-,, I )1A1 - Date 'L - l y — 15
1Nk ot-S, • MI
II
12-5-29082(1) 12-5-29082(2) 12-5-29082(3) 12-5-29082(4) 125-29082(5)
,0 1 .
a
12-5-29082(8) 12-5-29082(7) 12-5.29082(8) 12-5-29082(9) 12-5-29082(10)
12-5-29082(11) 12-5-29082(12) 12-5-29082(13) 12-5-29082(14) 125-29082(15)
125-29082(16)
HARNETI COUNTY RASH RECEIPTS
*** CUSTOMER RECEIPT ***
User: J3ROiK Tyne: LP Drawer: 1
Date: 7/02/16 52 Receipt no: 368
Year Number Amount
2016 50044401
91749 TECH
LILLINGTON, NC 27546
Ea Ba - ENV HEALT.
EXT TANK. �74109.00
SHEILA AGUILAR
Tender detail
CK CHECK PAYMEN 3105 $168.96
Total tendered *169.06
Total payment 1100.90
Trans date: 7/0E418 Time: 11:19:34
** THANK YOU FOR YOUR PAYMENT **