LAND USE Initial Application Date: ° / 2 /1 Application # /1 C ° ` 9 2 ,9,V
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893 -7525 Fax: (910) 8993 -2793 / www.hamett.orglpermits
LANDOWNER: 1204_x1 I- 1 8,z t/�- Mailing Address: a/5
O / /$ /i/8' e `n
City: `t I /inr 1-0/1/ ' State: /LC Zip: 27S%contact # / r Email ge - i t 9 V4t 0402 ro ^
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APPLICANT *: /' -1 /" 7 L / Ale / /er Mailing Address: (tJ � wOrd d or4 L.-
City: L, /Al n9'441 State/ Zip: Contact# Email:a/Zeit / it) 944 ot'eo
* Please fill out applicant information if different than landowner LA q G /
CONTACT NAME APPLYING IN OFFICE: 1 -f�� J ' / /'-f r Phone */ //O r o /C /
PROPERTYLO N G : Subdivision: Zia NiGik Pa/ 'eC - �� Lot #: yti 0 Lott Size: 3
State Road # f / 1 0; State Road Name: 465 AT / Ma9ookk &Page:it I �J/ l
Parcel: r3 9507 OZ /5 ^ 2 PIN: �S(/ (.i -74,57 B — O$ - av
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Zoning: Il 4 Z8 �Flood Zone:.-Watershed: / g Deed Book &Page: 2 54/ 'Y Yo Power Company`:
*New structures with Progress Energy as service provider need to supply premise number - n' n f / rom Progress Energy.
SPECIFIC DIRECTIONS TO / G THE PROPERTY FROM LILLINGTON: / fiw 2. I / W / �Sf T Po C / 5 d A- / Lit" L - JJM
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PROPOSED USE:
Monolithic
❑ SFD: (Size x # Bedrooms: # Baths: Basement(w /wo bath): Garage: Deck: Crawl Space: Slab: Slab:
(Is the bonus room finished? ( yes ( 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 Off Frame
(Is the second floor finished? ( yes ( Any other site built additions? ( yes (
❑ Manufactured Home: SW _ DW TW (Size x) # Bedrooms: _ Garage: (site built ? Deck: (site built ?
❑ Duplex: (Size x) No. Buildings: No. Bedrooms Per Unit:
X me Occupation: #Rooms: 1 Use: Hours of Operation: //Employees:
r� ( //II/ > 3. () dition /ACCesso !Other: (Size `J(/ x * /i/ Use: I/C�/ lint. /7 2 Closets in addition? ( yes no
Water Supply: X County Existing Well New Well (# of dwellings using well ) *MUST have operable water before final
Sewage Supply: New Septic Tank (Complete Checklist) t< 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
Structures (existing or proposed): Single family dwellings: / Manufactured Homes: Other (specify):
Required Residential Property Line Setbacks: Comments:
7 /
Front Minimum 7y Actual /J
Rear Zr
Closest Side /0 0
Sidestreet/corner lot
Nearest Building
on same lot
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 s ement are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
/ -1 9 - 201/
Si ature of Owner or Owner's Agent Date
* *This application expires 6 months from the initial date if permits have not been issued **
A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION
Residential Land Use Application Page 1 of 1 07/10
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NAME: l ?0 r,.0 v- L Aid l/-er APPLICATION #: / � f'r 2 ? v 9
*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) 1 (
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 lld, 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 recordina for proof of request.
• Use Click2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
❑ Environmental Health Existing 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 Ild 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 recordina 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 construct please indicate desired system type(s): can be ranked in order of preference, must choose one.
(_} Accepted {_} Innovative (_) Conventional {_J Any
{_} Alternative )_} Other
The applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in
question. If the answer is "yes ", applicant MUST ATTACH SUPPORTING DOCUMENTATION:
)_}YES {ZINO Does the site contain any Jurisdictional Wetlands?
(_DYES Ik) NO Do you plan to have an irrieation syste now or in the future?
{_ } YES ( NO Does or will the building contain any drains? Please explain.
I f — NO Are there any existing wells, springs, waterlines or Wastewater Systems on this property?
{_l YES {k,L) NO Is any wastewater going to be generated on the site other than domestic sewage?
{_) YES {Y} NO Is the site subject to approval by any other Public Agency?
(_DYES {X) NO Are there any Easements or Right of Ways on this property?
)_}YES Pc) NO Does the site contain any existing water, cable, phone or underground electric lines?
If yes please call No Cuts at 800- 632 -4949 to locate the lines. This is a free service.
I Have Read This Application And Certify That The Information Provided Herein Is True, Complete And Correct. Authorized County And
State Officials Are Granted Right Of Entry To Conduct Necessary Inspections To Determine Compliance With Applicable 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 an Be Performed.
PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE
10 /10
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DIAG : SEPTIC A A
Warall "
II • UTLET LID
0
POSSIBLE POSSIBLE
HOUSE HOUSE
CONNECTION _ CONNECTION
-r 4
POSSIBLE
HOUSE
CONNECTION
POSSIBLE LTD SHAPES
11 SQUARE (SHOWN ON DIAGRAM)
•
II RECI ANGLE (OLDER TANKS)
0 ROUND
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,9
ETT COUNTY TAX ID#
FOR NMI a "'WS
• 1 12: x:71 Pll
glee :2 P $34. .V>0
ii E C REV 's' t
Prepared • ' ty ' • • . ( at law; 406 W. Broad St-: Mom, N.C. 20334
IP
STATE OF , 0'' ' ti` A
COUNTY 0' illy"
Parcel ID No.: 030507 0215 21
6) HSIONER'S DEED
This deed, s ' , :y of May, 2008, by BILLY R. GODWIN, JR.,
COMMISSIONER,406 • . d; —, ., Du nn, NC28334to ROBERT L.MILLERandwIfe,
JOHANNA M. MILLE T p • % h p ' Lane, LMington, NC 27546.
That whereas Billy R.God •r . intedCommissionerunderanorderoftheGeneral
Court of Justice of Harnett Coun Carolina, ' • , tax foreclosure proceeding entitled
,• , _ _ .:, .: I .. : 1 . A. e # 07CVD 02385) ;and was directed
by the order as Commissioner to sell the 1 . -. , described at public sale after due
advertisement according to law; and
Whereas said Commissioner, did on .1 I pril, 2008, offer the land hereinafter
described at a public sale at the Harnett C. • 4 .r, , in Lillington, N.C., and the land
herein was sold and a Report of Sale flied the same d ten days have elapsed without
additional advanced or upset bids being offered for y ' and at which time, Robert L.
Miller, became the last and highest bidder for the :. • ` • 7 ' ' ' .00, and the Commissioner,
having been ordered to execute a deed to the p ._ ent • f the purchase money;
Now, in consideration of the premises and the sum o P $I • ,000.' 0 - - ipt of which is hereby
acknowledged, Billy R. Codwin, Jr., Commissioner, does, . it p ., . hereby bargain, sell,
grant, and convey to Robert L.Mllkr and wife, Johanna M. 1 pp : •• mots, assigns, ii r 4
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