LAND USE Initial Appl cat on Date ./ F! Application 1/ / ✓ ✓ CA) ,/ O a_
DRB# CU#
COMMERCIAL
COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting 108 E Street Llllingtto NC 27546 Phone (910) 893 7525 Fax (910) 893 2793 www harnett orglperm is
LANDOWNER Par ,4 /' "" ^'s /T I o r 5 Ma ling Address 2ZZ V / 2/ SP b 1 / ec 9 2mA' Aje 2&'5C D
C ty S,Jrrb Za-Ae State �� Zip £t74 Contact # 7�6 2 f6 3 Email pas' 14, et 7 4 G / /nah o y
APPLICANT /Wan A r 6 -epc y Malting Address /22 7f/ //r....y /
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y At � State Z p erS d Contact # Em / ail i '
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CONTACT NAME APPLYING IN OFFICE � / ", r7 art7rt ' Phone # /�Q Z & t( 5-TT Q V' '
PROPERTY LOCATION Subdivision { ( p /6f a /�/ Lot # Lott 8 e bit
State Road # State Road N ame /U 2 / [[ " Map Book &Page /2 /y /
Parcel 0/ &1/2---i, 2 A III / /yr PIN 05- / — / a / 7 � 79 2/ ✓�Oj�
Zon ng fig Z`' FIood Zone Watershed f t� Deed Book &Page Z9117 y(G'l Powe Company
New structures with Progress Energy as ser ce pro der eed to supply premise number from Progress Energy
SPECIFIC DIRECTIONS TO THE PROPERTY OPERTY FROM LIILLINGTON 72 ryw, y 2/ S / / a„,,trd �i7,i 4c4
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CO .f C6 6 x /e/ 4. T 6 rick I� N[ / N S 6
PROPOSED USE
❑ Multi Family Dwelling No Units No Bedrooms /Unit
❑ Business Sq Ft Retail Space Type # Employees Ho rs of Operat on
❑ Daycare # Preschoolers # Afterschoolers # Employees Hours of Operation
❑ Industry Sq Ft Type # Employees Hours of Operation
❑ Ch rch Seat ng Capac ty # Bath oomms // K tche
CI (d 3L 4
Accessory/Add t on /Other (Size ) Use .SA c' r .5 /0 /as
Water Supply County Existing Well New W II (# of dwellings using well ) MUST have operable water before final
Sewage Supply New Septic Tank (Complete Checklist) Existing Septic Tank (Complete Check! st) _ County Sewe
Comments
If permits are granted I agree to conform to all ordinances and laws of the State of North Carol na regulat ng such work a d the spec fcat ons of plans s bm tted
I hereby state that foregoing statements are accurate and correct to the best of my knowledge Permit subject to revocation if false informatio s p o ded
it . t492 2Z .tea i/
S g ature of of wner s Agent Date
This applic Iron expires 6 months from the n t al date If permits have not been In ed'
A RECORDED SURVEY MAP RECORDED DEED (OR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION
Commercial Land Use Appl cat on Page 1 of 1 08110
/ Proposed
25 X16 Shed
(400 sq)
III
1
Pre Lab
bldgs 150
• Septic tank
ChnrchButldang 1 5
_ 100 1
Parking lot
Teach All Nations Ministries Shed building Site Plan
12254 Hwy 210 South Spnng Lake NC 28390
POC Pastor Marvin Gregory 910 286 5345
Elder Barry Merritt 910 580 1147
� 1Ti C Xd cc kati
Proposed v
25 X16 Shed )S ---ram t-c e car rt, S re
(400 sq) AS ye-,-- �a� `ter Cczo or1 6)
1
Pre fab
bldgs 150
Septic tank
Site Plan Approval
The Harnett County Planning Department
nereby approves this site Ian
Church 10,104 n% 3hy1
I ° ate Ha t County Planning Dent
� l0
Parking lot
Teach All Nations Ministries Shed building Site Plan
12254 Hwy 210 South Spring Lake NC 28390
POC Pastor Marvin Gregory 910 286 5345
Elder Barry Merritt 910 580 1147
NAME APPLICATION # 11 5-VP 7.‘ 5,2
*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 month or without expuan n
depend ng pon doe mental on submitted (C mpl to it pia = 60 months Complete plat = without expiration) / / c- 7� 3
910 893 7525 option 1 CONFIRMATION #
❑ Environmental Health New Septic SystemCode 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
X 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
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 Ild back in place (Unless inspection is for a septic tank in a mobile home park)
,tDO 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 tor authoriz Ai m to construct please indicate desired system type(s) can be ranked in order of preference must choose one
{ Accepted { innovative { Conventional {_1 Any
1 Alternative {_} Other
The applicant sh ill 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 1 NO Does the site contain any Jurisdictional Wetlands?
{_)YES { NO Do you plan to have an mg ini sn system system now or in the future
{_)YES {_) NO Does or will the building contain any drains' Please explain
{_)YES II NO Are there any existing wells springs waterlines or Wastewater Systems on this property
{_)YES {_1 NO Is any wastewater going to be generated on the site other than domestic sewage
{_)YES f_} NO Is the site subject to approval by any other Public Agency
{_IVES {} NO Are there any Easements or Right of Ways on this property
{ f1 NO Does the site contain any existing water cable phone or underground electric hnesn
If yes please call No Cuts at 800 632 4949 to locate the lines This is a free service
I Ha e Read Th s Application And Certify That The Inf minion Provided Herein Is True Complete And Correct Authorized 0 unty And
State Officials Are Granted Right Of Entry To C nduet Necessary Inspections To Determine Compl ante With Applicable Laws And Rules
I Understand That I Am Solely Responsible For The Proper Identification And Labeling Of All Property L nes And Corners And Making
The Site : we ible So hat A C mplete Sit Ev Iuation Can Be Performed ^ 3
-- s
P' 0 RTY 0 NERS WNERS LECAL REPRESENTATIVE SIGNATURE (REQUIRED) DATF
10 /10
DIAGRAM •" A TYPIC • S - u • :. ,
tat II
Ns
• UTI.E'I' LID
0
I
POSSIBLE POSSIBLE;
HOUSE HOUSE
CONNECTION
1111 CONNECTION
POSSIBLE
HOUSE
CONNECTION
POSSIBLE LID SHAPES
I 1 SQUARE (SHOWN ON DIAGRAM)
I RECTANGLE (OLDER TANKS) R OUND