LAND USE •
Initial Application Date: ;/ M- /L Application # 115 5I7D Z h 2 4 ' .7
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. Front Street, Lillingten,,NC 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.harnett.org /permits
LANDOWNER: W r i lla 1irn '+ 1 t te \ � g� ' Mailing Address: 7 QG give,- ledd
City: r4/ flp ^ Ir l a, State: VC. Zip: .47J ontact # Email: f h /�
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APPLICANT': Vr in
Address: /i �/
City: State:_ Zip: Contact # LOP 5 3 X ...di
'Please fill out applicant information if different than Q landow , / , f
CONTACT NAME APPLYING IN / OFFICE: � `/ J , I 1 . ?nn J OV +' n uQ1 Phone # `7 j '1 /� b — 5 Z — 6 4 �j i` ,c'vq/
PROPERTY LOC A , IION9: Subdivision: W /y'd ✓L, �
f /c . Lot #: 2_ Lot Size , it
State Road # J [ State Road Name: f b'Ar LI ,n ' / Map Book &Page: ZOO 1 ) `7 74--
Parcel: Co /Q(oz/ &o�, 102. PIN: 0� ''(� -.? y- IZ 66 000
Zoning��-A 3O Flood Zone: Watershed: Deed Book&Page:2 / 7l1 272 Power Company *:
New structures with Progress Energy as service provider need to supply number from Progress Energy. /�
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 70/ A)• -4 &DA ,, AU Y R9/
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PROPOSED USE:
_ Monolithic
❑ SFD: (Size 50 x 20) # Bedrooms:1 # Baths: Basement(w /ebath): _ 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 (wiwo 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 /Accessory/Other: (Size x) Use: Closets in addition? (_) yes (_)no
Water Supply: ✓County _ Existing Well New Well (# 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 (X)no
� Structures (existing or proposed): Single family dwellings: / , Manufactured Homes: Other (specify): J�49 b"1d Z,
Required Residential Property Line Setbacks: Comments:
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A ' 1
Front Minimum J3 Actual
Rear
Closest Side / 0
SidestreeUcorner lot
Nearest Building /00 t
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 statements are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
S hure 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: APPLICATION #: 1/ 5 --a° 2 CA L /
*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) / Z
910 - 893 -7525 option 1 CONFIRMATION # ! / C 39)
❑ 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.
• 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 hd backanpiace. (Unless inspection is for a septic tank in a mobile home park)
'LDb 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 construct please indicate desired system type(s): can be ranked in order of preference, must choose one.
{A} Accepted {_} Innovative {1 Conventional {_} Any
{_} Alternative {1 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 {X} NO Do you plan to have an irrigatisn system now or in the future?
{ % }YES {} NO Does or will the building contain any drains? Please explain. BdSCth tied- r Ln
{_}YES { X} NO Are there any existing wells, springs, waterlines or Wastewater Systems on this property?
{_}YES {4} NO Is any wastewater going to be generated on the site other than domestic sewage?
{_ }YES {X} NO Is the site subject to approval by any other Public Agency?
{_ }YES {X} NO Are there any Easements or Right of Ways on this property?
{ }YES {X} 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.
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.
I Understand That I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Sitt,:/'q /ssibble So That A Complete Site Evaluation Can Be Performed.
PROPERT OWNERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE
10 /10
Thomas J. Boyce
P.O. Box 81
Pittsboro, NC 27312
9194684135
NC Licensed Soil Scientist # 1241
NC Registered Sanitarian # 1353
Wynn G. Townsley II
6340 Dwight Rowland Road
Fuquay - Varina, NC 27526
Re: Lots 1 & 2, River Road, Harnett County
Dear Mr. Townsley,
A final soils evaluation was completed on the above referenced property on May 14, 2009. The
purpose of the evaluation was to determine the ability of the soils to support a subsurface waste
disposal system. All ratings and determinations were made in accordance with "Laws and Rules
for Sewage Treatment and Disposal Systems, 15A NCAC 18A .1900 ".
The tract was evaluated by auger borings and landscape position The typical usable soils were a
gravelly sandy loam over clay to thirty or more inches. Provisionally suitable soils were
identified and are shown on the enclosed map. The long tent acceptance rate will probably be .3
gpd/sqft. Adequate area exists for repair for the existing three bedroom house on lot 1. Lot 2
contains adequate area for the initial and repair of a typical three bedroom house (40 X 60 ).
Systems may be conventional, accepted, alternative or innovative. Systems may also require the
use of a pump, fill, or additional cover. Surface and/or subsurface drainage may be recommended
for the site.
This report does not guarantee or represent approval or issuance of permits as needed by the
local health department. This report only represents my opinion as a licensed soil scientist. Lot
clearing or grading may make the site unsuitable and is not advised until approval from the health
department. I trust this is the information that you require at this time. If you have any questions
or need assistance, please call.
y
Sincerely,
T 5 TT is
Thomas J. yce t'
}
HIM 11111IU 1111111111111 11111
HA CO T 2010010834
CS S 1 • 091 ' FOR P REGIST of DEEDS
KIMBER 5 H
HRRNE COUNTY H
2010 AUG 03 09 :54:46 A5
BK:2170 P G :272-21 F EE,S22.00
1N 10
North Carolina
General Warranty Deed
Mail after recording to: William T Prough, 8907 E Albany St, Mesa, AZ 85207
This instrument was prepared by: Terry Sobotka
THIS DEED made this 2nd day of August, 2010 by and between
Wynn C Tousley II, unmarried, 30 Devonshire Road, North Syracuse, NY 13212 of the County of
Onondaga and State of New York (the "Grantor(s)") to William T Prough and Mary C Prough, his wife,
8907 E Albany Street, Mesa, AZ 85207 of the County of Maricopa, and State of Arizona (the
"Grantee(s) ").
Grantor, For a valuable consideration paid by Grantee, the receipt of which is here acknowledged, has
by these presents does grant, bargain, sell and convey unto Grantee in fee simple, a tract or parcel of land in
the County of Harnett and State of North Carolina, in Buckhom Township, and more particularly described
as follows:
BEING all of Lot 2, of the "Minor Subdivision Survey for Wynn C Tousley, II" as recorded July 9,.
2009, in Book 2009, Page 475 -476, Instmment No 2009010644, Harnett County Registry.
All or a portion of the property hereinabove described was acquired by Grantor by instrument recorded
in Book 1598, Page 521 -525, Harnett County Registry.
A map showing the above described property is recorded in Book 2009, Page.475 -476, and reference
within this instrument.