LAND USE Iv ' 1 l 1/ Z , 9 , ?fit qn
Initial Application Date: L- r I g ' I 1 Application # 1/ 5 .4,(7 (_ K/ G 5t O
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.hamett.orglpermits
IV LANDOWNER: 6-, pnnr / / /U Mailing Address: Di En /4761e 07 in 6, Or27rv/
City: /1 N6( P / r State: Vic Zip: ) 7S' /Contact # / 62677 Email:
APPLICANT': n /1/41..4:t Mailing Address:
City: • State::_ Zip: Contact # Email:
*Please fill out applicant Information if different than landowner
CONTACT NAME APPLYING IN OFFICE: ( Phone #
PROPERTY LOCATION: Subdivision: / �1
=�1� 2�_ r,_�I-IEn., & ♦ 1 Lot #: I LSiize: � � Q
State Road �# 1 J✓ State ad Name: fi / nal '7 Map Book&Page:( o ot 0O 1 ( 2_
/
Parcel: 1Qn /,Flood C ' 0 (O1 r cc LEA a r PIN: � 11 14. 2_0. I lb I
F
Zoning: / ,Flood Zone: X Watershed: ) V Deed Book &Page:L lqJ 1 I / 4 1 Power Company*:
`New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
I SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: HA, y ;/ o fn rd 4 Gi x.P/ 4204 j
/r.y A 3 6 n '10 ,Rrtr.e. / 7W0 r( 5 frcJ toIv7 )en /i
C0-1-2-- 3 hl�,.P )7 if o periy nn I j� y h1 -
4 7 l/ p
PRQPOSED USE: s - )g°"` l L ' _ OL
�/ ) I r , l /� (yy f p „ ,p Monolithic
SFD: (Size x ) # Bedroomst '7 � # Baths �sement(w /wo bath): G
arage: V DA2Y r w l'Space: Slab _ Slab:
_ _
(Is the bonus room finished? ( ) yes ()no w/ a closet? (_) yes ( )no (if yes add in with # b drooms)
❑ Mod: (Size x) # Bedrooms_ # Baths_ Basement (w /wo bath) Garage:_ Site Built Deck:_ On Frame_ Off Frame_
(Is the second floor finished? (_) yes (_)no Any other site built additions? (_) yes (_)no
❑ Manufactured Home: _SW _DW _TW (Size x_) # Bedrooms: _ Garage: (site built ?_) Deck: (site built ?_)
❑ Duplex: (Size _x_) No. Buildings: No. Bedrooms Per Unit:
❑ Home Occupation: # Rooms: Use: Hours of Operation: #Employees:
❑ Addition /Access ry/Other: (Size _x_) Use: / Closets in addition? (_) yes (_)no
Water Supply: C my Existing Well V New Well at of dwellings using well ) *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
Structures (existing or proposed): Single family dwellings: nufactured Homes: '--- Other (specify : 1 i 11*
Required Residential 7 Pro arty Line Setbacks: !J" 4r *I ,l Ali ytn /! QT')
Front Minimum J� Actual ➢ c-, p 1 r - j^ -. /�XC �7� `- / p `' / air / , t a l
Rear 2 2 I,i '^ y� � �( .( , 1y, 4 1I (,( (2 be ,i7 , C.f(L L(L JX fin ( , 'J r '
Closest Side r ' ` ( Ll9 t
Sidestreet/comer lot �/
Nearest Building In 10
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 tements are accurate and correct to the best of my knowledge. Permit subject to revog lion if false information is provided.
I gnature of Owner or er'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: APPLICATION #:
*This application to be filled out when applying for a septk 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 mo ths or without expiration
depending upon documentation submitted. (Complete site plan = 60 months; Complete plat = without expiration) / / L/ 72a // 7 L / 72/
910 - 893 - 7525 option 1 CONFIRMATION # / JJ `
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 trio fee may be incurred
for failure to uncover outlet lid. mark house corners and property lines. etc. once lot confirmed readv.
• 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.
• Use Click2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
❑ Environmental Health Existlno 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'lld back_hiplace. (Unless inspection is for a septic tank in a mobile home park)
•• 00 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 de i system type(s): can be ranked in order of preference, must choose one.
{_) Accepted (_} Innovative ( ) Conventional {_} 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:
(AYES (_) NO Does the site contain any Jurisdictional Wetlands?
O YES I_) NQ Do you plan to have an gation _syslepl now or in the future?
i_)YES {_ NO Does or will the building contain any drains? Please explain.
(_(YES I KNO Are there any existing wells, springs, waterlines or Wastewater Systems on this property?
{_)YES (O Is any wastewater going to be generated on the site other than domestic sewage?
(_I YES {_) NO Is the site subject to approval by any other Public Agency?
{_}YES (±? Are there any Easements or Right of Ways on this property?
{_IVES (✓} NO Does the site contain any existing water, cable, phone or underground electric lines?
If yes please call No Cuts at 8d0- 632 -4949 to locate the lines. This is a free service.
1 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.
1 Understand That I Ant Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site Accessible So That A Com , P--7/4 Site Evaluations Can Be Performed. O �/
PROPERTY OWNERS OIVRRS LE GAL RERESEDVIATIVE SIGNATURE (REQUIRED) DATE
le •
10/10
How to Properly Mark Property for Soil Evaluation
(MUST MATCH SITE PLAN)
■
sink flag
(. iron
range _, ge flag
pink 1 L nk flag
u8 .. House
flag
ire
t ge flag/
pink
Iron iron
ROAD
1 iii i 117711 nisi 11111 iuii a u� lull 7777 uii
2010015113
HARNETT COUNTY TAX ID# FOR "KingEii D s" REGI VE OF DEEDS
NPpNETT CDUNTY� ND
2010 OCT 20 11:37:26 AK
-1312 - - D BK:2797 PG:741 -743 FEE:$22,00
INSIR1NI # 2010016113
)O •'fQO /cY BY . 0
Parcel #
Excise Tax: -0- Recording Time, Book & Page:
Prepared by: Mail after recording to
NAYES, WILLIAMS, TURNER & DAUGHTRY, P.A. Grantees
804 West Broad Street
Dunn, North Carolina 28334
File #: 2010 -348
NORTH CAROLINA GENERAL WARRANTY DEED
NO TITLE CERTIFICATION
This deed made this 20th day of October, 2010, by and between:
GRANTOR: GRANTEE:
LYNWOOD HARE and wife, GASPAR NUNEZ, unmarried
FRANCES HARE 19690 Hwy 210
980 Purfoy Road Angier, North Carolina 27501
Fuquay Varina, North Carolina 27526
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall
include singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH: That the Grantor, for a valuable consideration paid by Grantee, the receipt of
which is hereby acknowledged, has bargained and sold, and by these presents doth grant,
bargain, sell and convey unto the Grantee, in fee simple, all those certain tracts or parcels of land
lying and being in Black River Township, Harnett County, North Carolina, and more
particularly described as follows:
BEING all of LOT 1 containing 1.40 acres and LOT 2 containing 1.39 acres on map
entitled "RECOMBINATION AND MINOR SUBDIVISION FOR: IOLA MCLEOD HARE
ESTATE ", as shown on a plat prepared by Joyner Piedmont Surveying dated September 8, 2010
and recorded on October 1 I, 2010 in Plat Book 2010, Pages 721 -722, Harnett County Registry.
Reference to said map is herby made for a greater certainty of description.
The property herinabove described was acquired by Grantor by instrument recorded in Book
2797, Pages 532 -534 on October 19, 2010, Hamett County Registry.
TO HAVE AND TO HOLD the aforesaid tracts or parcels of land and all privileges and
appurtenances thereto belonging to the Grantee in fee simple.
And the Grantor, covenants with the Grantee, that Grantor is seized of said premises in fee
simple, has right to convey the same in fee simple, that title is marketable and free and clear of
all encumbrances, and that Grantor will warrant and will forever defend the said title against the
lawful claims of all persons whomsoever, except the following.
Title to the property hereinabove described is subject to the following exceptions:
1) Easements, restrictions and rights of way of record.
IN TESTIMONY WHEREOF, the Grantors have hereunto set their hands and seals, the day and
year first above written.
IN WITNESS WHEREOF, the Grantor has hereunto set their hands and seals, the day and year
first above written.
.1 L i yCo 2 EAL)
`,O T A Y LY OOD HARE
; ■ (SEAL)
'y PUMA .i
�? FRANCES HARE
F>?, COUt •..
NORTH CAROLINA,
HARNETT COUNTY
1, Cheri L. 1Ne61' a Notary Public of the County and State aforesaid, hereby
certify that LYNWOOD HARE and FRANCES HARE each personally appeared before me
this day and acknowledged the due execution of the foregoing Deed of Conveyance.
Witness my hand and notarial seal, this 2 1 day of October, 2010.
NOTARY PUBLIC
MY COMMISSION EXPIRES 5 _ _a-O 1 I