LAND USE Initial Application Date: 3 —
2 - </ R t ''y Application # / D 579/ 7i 6 /p 2
YhJ1 CU#
COUNTY OF HARNETT r r ` . . ! SE APPLICATION
Central Permitting 108 E. Front
j
Street, Lillington, NC 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.hamett.org /permits
LANDOWNER: $JU\k% / `'
P ' l kke- - Mailing Address:
v
City: State: Zip: Contact # Email:
APP LICAN7•: /2 004 ° 4^ tilZAP ...1/ Mailing Address: 7/ Es ree'a' ,..3.°� caT
City: State:_ Zip: Contact # Email:
'Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE: �,,, ,, o S Phone # C ? / ,,
PROPERTY LOCATION: Subdivision: h C 1 ' C A-L 1 Lot #: / 7 Lott�Size: • 1.00` Q 1 C—
I
State Road # IS Road Name: r " / `-t-y , '1 e Map � Boo \
Book&Page: V -3
Parcel: b 1` ��S IS bd.-7 ��/� PIN: V, a s S - X 53 - / 7 0 CS •on 1
Zoning: ( F lood Zone: - Waters ed: ADA Deed Book &Page'.) O/ l� Power Company *:
New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIGDIRECTIONS,TO THE PROPERTY FROM LILLINGTON:
2/6 - v c . - . c � � S 70-z Z / - k - i t . To c (7 e ye--- - - /I) 1) "
w ti. t`e-- - 6 - 0 A-.c c-L: . s T,-, + t■ut..) Tv z U C/ •
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
`�
(lyre second floor finished? ( yes 7 ( _ )no Any other S' a built additions? (_) yes ( )no
I L Manufactured Home: , SW DW _ TW (Size 14 x 74 ) # Bedrooms: r °S Garage: (site built ? Deck: (site built ?
/ Duplex: (Size _ x _ ) No. Buildings: No. Bedrooms Per Unit:
O Home Occupation: # Rooms: Use: Hours of Operation: #Employees:
❑ Addition /Accessory/Other: (Size _ x ) Use: Closets in addition? ( yes (
Water Supply: County Existing Well New Well (# of llings 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 fee (500') of tract listed abo es (
Structures (existing or proposed): Single family dwellings: Manufactured Homes: 1 ther spJcci :
Required Residential Property Line Setbacks: ' f l� e& kss: Commments: fK�(� -- - l I \ 1
Front Minimum 3c, Actual 90 k o err() 1r, --1— — ra t ' , ')€.�.A..) e \Qx\'Q
Rear __ 23 \ x u 1Q c-c V l l Y , -e v 1 S
Closest Side ID 46C "\C4 •
Sidestreet/corner lot
Nearest Building
on same lot
If permits are granted I agree to confo o all ordinance and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing stateme 'are accura an rrect to the best of my knowledge. Permit subject o revo tion if false information is provided.
SignatureTof Owner or er's Agent �Oa att
v.. -- /gy
"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
NAME: APPLICATION #: /1 5 ' 2 V IA
•
*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) � / D
910 - 893 -7525 option 1 CONFIRMATION # D
❑ 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.
• Ater 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.
E nvironmental 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 'Iid.back in piece. (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 recordino 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 I_) Innovative (_) Conventional 1 - 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 (_) NO Does the site contain any Jurisdictional Wetlands?
(_ }YES 1_} NO Do you plan to have an irrieation system now or in the future?
{_ }YES {_) NO Does or will the building contain any Jaws? Please explain.
{_(YES I I NO Are there any existing wells, springs, waterlines or Wastewater Systems on this property?
(_)YES (_} NO Is any wastewater going to be generated on the site other than domestic sewage?
(_}YES (_) NO Is the site subject to approval by any other Public Agency?
(_ }YES (_) NO Are there any Easements or Right of Ways on this property?
{_)YES {_} NO Does the site contain any existing water, cable, phone or underground electric lines?
If yes please call No Cuts at 8a0- 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 Property Lines And Come And And Making
The Site Accessible So That A Complete Site Evaluation Can Be Performed. 7 ; / PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATIVIf SIGNATUR (REQUIRED)
10110
How to Properly Mark Property for Soil Evaluation
(MUST MATCH SITE PLAN)
ink _ flag
iron
flag
pink flag —+Ba
1 L 4— I fl
Legend House
iroP
ti arr
}
range flag
Pink
iron > iron
ROAD
PROCEDURES AND GUIDELINES FOR MANUFACTURED HOMES
Replacement & Removal Criteria
I, ` G Vv\—Q V-P.(_[ P , do hereby certify the following:
(Print Name) 3+
1. That I own a tract of land located on SR �n f y in an RA -30 / RA -40 or RA -20R /RA -20M
district which has a functional septic tank;
2. That the existing single/double -wide manufactured home is to be removed or was removed on
. (date)
3. That I am replacing an existing single /double wide manufactured home with a single /double wide
manufactured home, and;
4. That the replacement of this manufactured home creates t residence(s) on this single tract of land,
and; a
5. That there will be 1 manufactured home(s) on this single tract of land and 1 do /do not own
property within 500 feet of this tract that contains a manufactured home.
6. The home must have a pitched roof, for a manufactured home, whether A shaped or rounded, which
has a minimum rise (measured at the center of the home) of twelve (12) inches for every seven (7)
feet of total width of the home. (Example: A home measuring fourteen (14 ft.) in width must have a
twenty four (24) inch rise as measured from the center of the roofline to the baseline of the roof.)
(See Illustrations Below.)
24't 1dImum!" p�5€ dj PIC, >�" MIi'lntunl,> '� r } . ' 6 < , 91, `` 1.04 , x y. r .;
Roof Pitah=Rls ` it , ' red x
} Q�' a p ' t
�a3:.r€F47,,s{t�' . 5 � , Caw , ��Si gShu OOfPIt RI :O ROIL tl @d'�.
yr � t t�
)isrf.. '.sAT ae.V *,
t4 ; �Z �� " a .. F. ;i: c 'al u i : .htii ;.t'■ , ;.G . ' 'x '{
'4 "'fit' r . _ 1 E
* ' xm k ' +� Y r ' 1 r ( ' kit, t.'
{ 1.,i3r'Las∎ el f13 U '. },--:. sae ,.
:-';'-.':,3 '.iu? rit sl fi 2 `�. ` §: 1 ` t _ 5� f �«:, :,
' , Note: Most Rounded Roofs
m, ,, _ ___ 111 t 4 4 Will Not Meet The Roof Pitch
+ f Requirement As Illustrated.
f ��., .1 k � � a I The Measurement From The
tit' e ta yidegtoa � n 5 a � ! Peak Of The Roof To The
�� ' r
Mee 'The Req 1,4 . . , ,Ro.f Base Line Of The Roof Must
pitch ea `��. _ ` Be 12" For Every 7' Of Total,
Width Of The Home. (14'
# , Wide Home = 24" Roof Rise)
If 4 114 e;Agt 11 tiff Lt. M. 4 14 1 0 Ili
7/10
7. The home must be underpinned, the underpinning must be designed for manufactured homes &
installed in good workmanship -like manner along the entire base of a manufactured home, except for
ventilation and crawl space requirements, and consisting of the following: metal with a baked —on
finish of uniform color; a uniform design and color vinyl; or brick, cinder block, and stone masonry as
well as artificial stone masonry.
8. The homes moving apparatus removed, underpinned or landscaped.
9. Select One of the Following Options .Below:
a. The current manufactured home will be removed prior to the Zoning Inspection.
b. The current manufactured home is scheduled to be removed through Project AMPI
c. The current manufactured home will be removed after the final inspection has been performed
and the certificate of occupancy has been issued. (Additional Fees & Requirements Shall Apply)
*see back of form for additional information.
*(Additional Information for Option C) Temporary approval for replacement of a manufactured home is
allowed only under the procedures and limitations stated below.
Please initial next to each item to indicate that you understand and have or will comply as necessary.
1) A valid manufactured home moving permit must be submitted for the removal of the existing home located
on the property.
I 2) A copy of a Bill of Sale or a Title Transfer of the existing home must be submitted.
1 3) Items 1 & 2 must be submitted to Central Permitting prior to your permit issuance.
4) Property owner /agent acknowledges that due to the fact that a second zoning inspection is required, in
order to facilitate this request, a re- inspection fee in the amount of fifty ($50.00) dollars shall be paid
during the permitting process.
1 5) Once the home has met all other zoning requirements, a temporary approval shall be granted in order
to proceed with obtaining a certificate of occupancy. From the date the certificate of occupancy is issued,
the property owner shall have five (5) business days to remove the pre - existing manufactured home.
1 6) Property owner /agent acknowledges that if the pre - existing manufactured home is not removed by the
specified time of five (5) business days that he / or she shall be in direct violation of the Harnett County
Zoning Ordinance. And by creating a violation of the Harnett County Zoning Ordinance shall subject
themselves to enforcement actions, penalties, and fines specified within Article XV, (Administration,
Enforcement, and Penalties) of the Harnett County Zoning Ordinance. Each day the violation continues is
a separate offence and is a misdemeanor punishable by a fine not to exceed one hundred ($100.00) dollars
or imprisonment not to exceed thirty (30) days.
I 7) Property owner /agent acknowledges and affirms that the guidelines, procedures, and requirements
associated with the replacement of a manufactured home and the penalties for creating a violation of the
Harnett County Zoning Ordinance have be- `: xplained and accepts this document as an initial notice of
violation.
3 Z li
1_ ature of Prope , • er Date
*By signing this form th ! owner /agent is stating t : t they have
read and understand th information on this for 1
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41-4 e_ IC IEV SWP:#L E
••= fac:- GENERAL WARRANTY DEED
Parce • nti• - • 10515 0275 and 010515 0274
Mail aft- -.. . L. Holt Pelmet
P. 0. Box 1689, Lillington, NC 27546
This inst n. - -red by L. Nolt relmet WITS= TITLE CFRTQTCATZON
OR =ADVICE
ADVICE
Brief Descrip. • e fo e 0 Iota 162 and 163, Section IIt,
index Anderson Creak Somas Subdivision
AA
THIS DEED made thi - •, 2010, by and between
icela //'''�
Amhara a M Millis �fdolc
Barbr Mite Millis .•: h
CHARLES M I.LIS and
NICHOLS NSITH L?ACB . ,
LARRY E. .7ALRSOS
446 Finley Drive
Spring Late, North can:L na 28390 r,
Ofinnlif
MARIA ROSARID VE2Z ALLEs
7652 Smithfield Road
Godwin, North Carolina 28344
The designation Grantor and Grantee a- > h_.ein shall include said
parties, their heirs, successors, and a -.d shall include singular,
plural, masculine, feminine or neuter re., a context.
WITNESSETH, that the Grantor, for a valuab - *ens • paid by the
Grantee, the receipt of which is hereby ace • 1 =.. -•, as and by these
presents does grant, bargain, sell and con - I to - Grantee in fee
simple, all that certain lot or parcel of la _. the City of ,
Anderson Creek Township, Harnett County, or .ro •na and more
particularly described as follows:
Lots 162 and 163, Section III, • -- -
Subdivision, as shown by a plat Premed by Pt-. - .,
Company, dated August 6, 1974, and recorded �' ` .
11, Barnett Canty Registry, to which map ref- -
made for a full and oaaplete description of -. .,
This conveyance is made subject to alt ents
may Station said map and also alt of those terms, -. . ,
m
covenants and conditions set forth in restrictive ., to
dated August 8, 1974, and recorded in Hook 611, 97,
Harnett County Registry, which restrictive covenants -• \JJ
reference incorporated in and made a part of this can. -
Pursuant to N.C.G.S.$ 105 - 317.2, the above described - --
does not include the primary residence of Grantors.
41
•
e property hereinabove described was acquired by Grantors by inheritance
the Last will and Testament of Garland H. White probated in Harnett
Estate File 2009 -E -567. For further reference see instrument
• d in Book 1971, Pages 73 -76, Harnett County Registry.
• - .s howing the above described property is recorded in Book 20, Page 11.
r , AN' TO HOLD the aforesaid lot or parcel of land and all privileges
a i apofkt -noes thereto belonging to the Grantee in fee simple.
. • d G - • c. enants with the Grantee, that Grantor is seized of the
p >I r fe- .41e, has the right to convey the same in fee simple,
tha t - is .,. -.le and free and clear of all encumbrances, and that
Granto. wi nt .. d defend the title against the lawful claims of all
•
• perso - oms•.ver -0t for the exceptions hereinafter stated.
Title to - - ..z 1 0‘ereinabove described is subject to the following
exceptio -:
IN WITNESS a - e , the Grantor has hereunto set his hand and seal, or
if corporat=, is ...- this instrument to be signed in its corporate
name by its du y . thvri edpf+{leers and its seal to be hereunto affixed
by authority .2 t " - & irectors, the day and year first above
written.
i ii _
By: . -- 82)11; AC 4Lh ;/, t. / /.e (SEAL)
President . •/• Nhita /
ATTEST: Aar (SEAL)
Charles .., is
Secretary 0 ',Lb b -1 ,r ka'- (SEAL)
. -•• White J 1
(Corporate Seal) — (SEAL)
SEAL-STANP B31TE CAROLINA, Co y.
I, the undersigned, a Nail, ' of the County I
of Sampson and Stage .re .id, certify that
..- -.. :.. � - .__._ ._ ..__.-ter`' --. .. -�•_
a.,.:-. _ -T !,' canto s, personally
appeared before me this .:-. -c• owledged the
execution of the foregoing i -tr t. Witn-ss my
hand and official stamp •r --al, As .4.. - of
gaoember, 2010. //
//'f OFFICIAL SEAL " �, :fr. .t /1'. l ••• 1 . D
� mom, PJallc Nat• cvOb. • iC
r.W.•re Paw ••••
� GR ILL MC�� M
ny„ N• y courdssion expires: Nov 11, '
SBAL -STAle NOmB amnia ik R c cx; r qq c County.
I, the undersigned, a Notary Public - •un
of - '4,.,.w,%n�y Ae \ and State aforesaid, :rt• y th-
charlae Nellie Grantor, personally a••.; •4f• e
,,,,,,,,, me this day and acknowledged the execu o ,
,,,otA4 P,6i,,, foregoing instrument. Witness my hand : • o ' ial
SO ,�8 � stamp or seal, this day of Deoaaber9201'. 9
■
Notary Pub V ■
T. n A wSL1 6 0�3
? � y A My commission
mission expires: ne 9 no 1 •i
. • , 41A co■Ao e,i
- .-'(n opilliH. ; R N Kflt T c
' ' i It 1 + c ` ce-41.7 Si
l e
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1 ti •
BERLY S. HARGROVE
1' s - DEEDS, HARNETT
• O' E LIUS HARNETT BLVD
ITE 200
l H N, C 27546
\IY\ \O \n\ MINHRn \M\n\nnnn nMIM\N\ a \I . . \N \tl \M \M \N \N \MM \M \ \f\N \M \M \f\H\
Filed For Reglstratlon: 02/ ' I . � I • M
Book: RE
100, . , . o: 838837
Document No.: 2011002185
DEED 3PGS 2 �0
NC REAL ESTATE EXCISE TAX: $38.00
Recorder: MARY ANNE WOO r
0
State of North Carolina, County of Hamett
KIMBERLY S. HARGROVE , REGISTER OF DEEDS CIO
DO NOT DISCARD 11
i0
0, 2011002185