LAND USE Initial Application Date 1, e l ti -` 1 Applicat on # ` / ✓ " P 2‘ 323
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 harnett org /permits
C S MLIL n Ma In Address EIS J
City " I State � Z ip P1 SOS Conte # `� I (o Email
APPLICANT SA.) 114 k icl t3vl I Mail ng Address )-e) (uIMAaJ( r
City can4If State NC Zip 31 ',30 Contact # 9H 3 C3 °i I J. E apt O "' - Jshhr...,
PI fII out pplica 11 fom t nIfdff tth 1 d wn
CONTACT NAME APPLYING IN OFFICE
'+ JISMr^+ SM Phone # r� 3 S 3 -6t112
PROPERTY LOCATION Subdivision \ 1 unapt r. (1 - r. tI S Lot# 7 Lot Spzee __ C
State Road # 11). State Road Name L 4 I./(a'1cE, 0.a Map Book&Page C 0 G VI
Parcel 13 0o i fit el `0 PIN ^ I l-4 -- 7 cXX
Zoning j� Flood Zone K Watershed J� Deed Book &PageoWd 1 -Q!/ l ,2) Power Company
New structures with Progress Energy as service provider need to supply prem se number 1 I f om Progress Energy
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON us 41t S (NM O 4 1 Arl Qcrrcan ra
/--t4 s er. 3 c cLa2. rJ 4 :60, 1-1.11,4 0.1 IT o- I. tautening., Q-s
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PROPOSED USE
M I th
❑ SFD (Size x_ # Bedrooms _ # Baths _ Basement(wlwo bath) _ Garage _ Deck _ Crawl Space _ Slab _ Slab
(Is the bonus room fnished? ( yes ( w/ a closet? ( yes (ono Of yes add in w th # 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 bu Ito
❑ Duplex (Size _ x _ ) No Buildings No Bedrooms Per Un t
e Occupation # Rooms /, / , Use Hours of Operation #Employees
Addition/Accessory/Other (Size )4 x 74) Use Apt 710 r Closets in addition? ( yes o
Water Supply t! County _ Existing Well New Well rot dwellings us ng 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 manuf,tred home within five hundred feet (500) of tract listed abo e ( yes (! )no
Structures (existing or proposed) Single family dwellings Manufactured Homes Other (specify)
Required Residential Property Line Setbacks Comments
Front Minimum IC Actual "AO
Rear 0`C ?7()
Closest Side I0 IC
Sidestreet/corner lot )'v
Nearest Bu (ding
IIA
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 stateme, and correct to the best of my knowledge Permit subject to revocation if false information is provided
� 1 3 -21-f-I I
Signature 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 5 hgt- lt,A44ol Uultd.f APPLICATION#
*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 month Complete plat = without expiration)
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 sod
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 hd, 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
4
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 lid back in (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 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
{} • ccepted {_} Innovative {_} Conventional _ An
{__} Alternative {_} Other
The applicant shall notify the local health department upon submittal of this .pphcation If any of th- ollowing apply to the property in
questi.n If the answer is yes applicant MUST ATTACH SUPPORTI 'G DOCUMENTATIO
{_ }Y: S {} NO Does the site contain any Jurisdictional Wetlan..
{_ } YE. {} NO Do you plan to have an imaation system now o in the future?
{_ }YE' { } NO Doe or will t - , tiding contain any id:a 111s P -ase explain
{_}YES {} NO Ar • there any existing s springs waterline. or Wastewater Systems on this property?
{_ }YES {} NO Is i y wastewater going to be g- - . ted on t site other than domestic sewage
{_ }YES {_} NO Is the site subject to approval by any other Public Agency
{_ }YES {} NO • e there any Easements or Right of Ways on this property?
{ }YES {_} NO D. es the site contain any existing water cable phone or underground electric mes
If , es please call No Cuts at 800 632 -4949 to locate the lines This is a free s-rvtce
I Have Read T is Application • nd Certify That The Information Provided Herein Is True Complete And Co rect Authorized C I my And
State Officials A • Granted RI iht Of Entry To Conduct Necessary Inspections To Determine Compliance Wit Applicable Law. And Rules
I Understand That + m 5 . • y Responsible For The Proper Identification And Labeling Of All Property Lines • • , Corn . And Malting
The Site Access Complete Site Evaluation Can Be Performed
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PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE
10 /10
t
DIAGRAM OF d • TANK
or _agi
• : LID
POSSIBLE POSSIBL
HOUSE HOUSE
CONNECTION CONNECTION
-r
POSSIBLE
HOUSE
CONNECTION
r POSSIBLE LID SHAPES
1 , I SQUARE (SHOWN ON DIAGRAM)
I RECTANGLE (OLDER TANKS) —_ ROUND
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BK 2669 PG 499.496 FEE n N
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Erase Tat v' • ''ITS 1r v Do NOT write above MID One Recording Thus Book and Page
N � y - iti nor General Warranty Deed
pi aWmm prep ,. • Au • en Atfom at Law
Brief desorption for iM l
This Deed made this 9th Al day of Belnentbtt 2 0 by and batmen Grantor end Grantee
Enter in appropriate black'. pa Na addren county state nd N appropriate entity lie corporation partnership) TM
dalgmtlon Grantor and r In Me l•�� u ^y ell palm SIr MIm s censors nd a lira and Malt Include angular
Plural, maadm, faranIns 01a• • • e 0m114
Grantor
THOMAS PROPERTIES OF H ' E 4LL LLC 3560 McArthur Rd
Bra dway NC 27505
Grantee
CHRISTOPHERR MCLEAN and wt 72 Elai Buchanan La e
MARY ELISABETH GRIFFIN MCLEA Broadway NC 27505
Transfer of Ownership Grantor ror a value. - • I ., • • Gre lea the receipt of h h s hereby ackaa /MOW convey to crease
le Imply the Property described below
Property city of 1
Tonkin of Upper Little Rwa' North Camino
The property was acquired by Gra tor by a Mum 1 worded n B 617 - age 341 Hamel North
A map showing the properly b raw ded in PI I Book Art • Num • ^ ' '
tS Pepe - Harnett County
The legal doatMon Mthe Proctor Ile
BEING ALL OF LOT #7 containing 079 acre as shown o. • au 41 0 re amore Hill Subdivision dated October 21 2008 by
Mkkey R Bennett, PIS, and recorded in Map Nlmtber 200. ' ; • H., -, • ,. Registry Reference to aid map to her by made
for grata certainty of desorption
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C it donP g 2 1.—)Ab
After recording mall to Te Lot No _
Mr & Mn Christopher McLean Parcel Identifier N
72 Blaie Buchanan L a Venhed By as
B dray, NC 27505 on the day of r� e
BY V
Form SS I301 a
012002 by JmelMNamaBCo inc wow Jm
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