LAND USE Initial Application Date ✓ _ 25 - `/ Application # 1/ 5 24,5/4
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION CU#
Central Permitting 108 E Front Street Lillington NC 27546 Phone (910) 893 -7525 ext 2 Fax (910) 893 2793 www hamett org /penults
"A RECORDED
//yy SURVEY MAP RECORDED DEED (OR OFFER TO PURCHASE) & SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER // / ) c_.¢ J7 4 / -v; b Mailing Address ,- e�j/cjl g -....4 /v
City L-- lato / (, / J 7/ Alen, State V/ Zip i , ,Contact No 9/0 J es/eye.- r'y l7 j Email
APPLICANT* / �' ) . s Mailing Address ,...7-1,7 ,
7 j4 Lam,
City ./?.9't/ State 6'L` Zipantact No 9l8 1 : 7 .iOa 7 Emad
'Please ut pplicant I format) f differe t th landowne .a,u.�'
CONTACT NAME APPLYING IN OFFICE ) �/' l/C Phone # 7�C �� -- 7d0
PROPERTY LOCATION Subdiwsion I! LI / , 4;141 Lot # Lot Size 2 7 4 ~ 2
State Road # / 10 3 / State Road
N Name ') 1.— A Pr Y/9 / !� Map Book & Page //,7 /
Parcel 9 9 ti -4 C d/ 57 07 PIN 7 L ` 1_� _ Z i5 ! s 7, &co
Zoning R4 2 '4Iood Zone /z Watershed 11Q///_ Deed Book & Page 0 471 / Power Company
New structures with Progress Energy as service provider need to supply premise number from Progress Energy
PROPOSED USE
❑ SFD (Size x ) # Bedrooms _ # Baths _ Basement(w/wo bath) _ Garage _ Deck _ Crawl Space Slab _ Slab Hue
(Is the bonus room finished? (_) yes (_) no w/ a closet? ( ) yes (_) no (d yes add in with # bedrooms)
❑ 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 72- x 70) # Bedrooms 7— 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 Fasting Well , _ New Well (# of dwellings using wel ) Must have operable water before final
Sewage Supply !/ N 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 (
Does the property contain any easements whether underground or d er (_) yes ( n [ f
Structures (existing or proposed) Single family dwellings J irr j �ttP' N( anufactured Homes ��r flier (specify) L. l / I'74f°,,,
y
1 y/' /1
Required Residential Property Line Setbacks Comments _ �` / /,Q/btt, / ,r / fir 77 L v �
Front Minimum ✓ c� Actual 0 ,°
Rear Z (0
Closest Side / D 2. 40
Sidestreet/comer lot
Vearest Building
to same lot
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON ✓ , . C. T 7t0
---‘ f 4n'9aq/ , > /, >I- , 2 O ' / /-4# y v - .47, J)s
/fir / 7 cur, f - i /.r `?- ?In) 2 i ri/r i6'f
9 0 )/t9 M, 2< �,� arfil w L e v
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If permits are granted 1 agree to conform all rdinances and aws of the State of North Carolina regulating such work and the speaflcatlons of plans submitted
I hereby state that foregoing statement re rate and • to the best of my knowledge Permit subject t revoca n if false information is provided
Signature of Own o r Owner's Agent Da e
"'It Is the owner/applicants responsibility to provide the county with any applicable Information about the subject property Including but not limited
to boundary Information house location underground or overhead easements etc The county or Its employees are not responsible for any
incorrect or missing Information that Is contained within these applications "'
This application expires 6 months from the Initial date If permits have not been Issued"
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NAME 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 1S ALTERED THEN THE IMPROVEMENT
PERMIT OR AUTHORIZATION TO CONSTRUCT SHALL BECOME INVALID The perm t is and for e Cher 60 month r with it pat on
epen ng upon documentation ubm ued (C mplete to plan = 60 months C mplete plat = with ut e p 1 n) 9 i f % / / /
910 893 7525 option I CONFIRMATION # 7 �(
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
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 Existino 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)
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 tpplying for auth rization t construct plea e and cate de ired ystem type(s) can be ranked in order if preference must eh o e one
{ Accepted 1 — ) Innosative 1 — ) Conventional 1 - Any
1_) 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 ye applicant MUST ATTACH SUPPORTINC DOCUMENTATION
YES {_ NO Does the site contain any Jurisdictional Wetlandsv
1 {) 'y.0 Do you plan to have an imgano i syste now or in the future
{ {) NO Does or will the building contain any drams'? Plei e explain
1_)YES { 943 Are there any existing wells spnngs waterlines or Wastewater Systems on this property?
{_)YES 1 ,/ ISO Is any wastewater going to be generated on the site other than domestic sewage
{ { ,I/NO
Is the site subject to approval by any other Public Agency
( 1 j4O Are there any Easements or Right of Ways on thi property
1 YES { ✓) NO Does the site contain any existing water cable phone or underground electric hnes
It yes please call No Cut at 800 632 4949 to lo ate the lines This is a free service
I Ha e Read This Apphcat n And Calif) That The Information Pro ided Herei Is True C implet And C rrect Authonied C my And
State Officials Are Cranted Right Of Entry T Conduct Nccessar Inspections To Determine Compliance N ith Applicable Laws And Rules
I Understand That 1 Am S lely Responsible For The Proper Identification And Labeling Of All Property I Ines And C rners And Malang
The Site Accessible So That A Complete Site F aluation Can ! Pyrj'orme /) >
PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATIVE SICNATURE (REQUIRED) DAT
10/10
3
92
rjrr55tiED ,L/35
Reai Es a r MbP 25 2 41 PH'8B
E�dp�ly ,q r ExclseTnx CI r 1LDER
m 1 a� -. - 3 1 ..0 = i ILA II 'LIN y DEEDS
Re
is 7� i— 1 f N Y g�
P 9 Wm
Re ceding Time Hook and Page
Tan Lot No. — 1 1 lde tdfler N Q99565 013
Vended by li r 0 County on the d y of 19
by... ._._
Ale Mall after r•eording to ir Dd3d5 27#C laMeE be FOr nxu..ud AC .2 ra/
Tbismatrument was prepar d S :a. M y .a ndel s m •••••
En f desenptl n for th Index V }
NORTH CA 0 4 • ENERAL WARRANTY DEED
MISDEED made Ws 22n51 day f it: 19 $$ by nd between
GRANTOR GRANTER
JAMES E JOHNSON AN.'
IRENE H JOHNSON and .ICHAEL A DAVIS AND WIFE
C H BI OE AND WIFE 'ENDA C' DAVIS
DORIS T BLUE •
4011111111
,:. 92
E to I ppnpbda II ale t saes party name, ddrw, nd if appro. - -. f nifty eq sore nab or partneeaeia
The designation Grantor a d Grants ed her in shall m ! • es • eh- heirs e e essors ltd a Igoe and
shall include singular plu 1. maseul no 1 nd ne t re.. • . e•nt- •
WITNESSET$ tb t the Grantor for a caluabl nsiderati paid by .e r • • tee the receipt f which is hereby
admowledged, has and by these p wants do gra t, barge 11 d • ay • • h G antee an tee annals, 11 that
certa lot parcel of land situ ted in th City f ohnaonville T w hip
Harnett Co my N rth Carelina and more pert] 1 ly • • ed . f w
A certain tract of land located about four miles east of - A. of Cameron about
six hundred yards south of Highway #27 fronting on the wes s..• of : : e Road #1103
adwinitg the lands of W 0 Herrings and others described oll•-
BFOINNI12 at a P K nail in the center of the pavement of - ••- •1103 said
nail being a southeast corner of the J E Johnson & C H B1 • -c 1: - - tract that
is recorded in Deed Book 644 Page 550 in the Harnett County Reg -id citnung
nail being in the W 0 Henning line and also being located about 3.' 71 ee. south
west frail the intersection of the center lines of Road #1103 and Alai., • 7 ... measured •
along the center of Road 41103 running thence from the beginning - of the 138 18
acre tract N 80 19 W 1031 83 feet to an iron pipe with black gem po n s • : - corner of
a field a corner of the 138 18 acre tract thence with thh_line of 1: : acre • act
N 48 1.1. 872 96 feet to an iron pipe in the southeast line of the Ben-: •t 21M a -- tract
thence with the Benedict line N 46°26 E 620 00 feet to the west corner •f ..' : tic : •
Korn 2k acre tract thence with the south line of Korn S 66 33 E 1589 42 0 = .•
spike in the center of the pav t of State Road #1103, Korn s corner t, = road
S 23 32 14 600 00 feet to the BEGUN= containing 28 52 acres more or \ ' ma y _
portion of the J E Johnson and C H Blue 138 18 acre Cotart tract that is - -r
Deed Book 644 at Page 550 in the Office of Register of Deeds for Harnett • n , • e
N Caw Mx.F INN 301971 Rabad01977 :•awe c.- we-on rams ...Kt.
nw- w -•wa—m W I.w. we
LANDOWNER //i1 Cot ( L' 3,
MAILING ADDRESS A.// rh 1'044 k"- 4 Arc-'
CITY ( i STATE 4/C ZIP 2 PHONE jl7,c3 /�O
APPLICATION DATE
5-- 77- 1/ APPLICATION # ! l CP" 2
APPLICANT c 5, - ) nii
MAILING ADDRESS
CITY STATE ZIP PHONE
PROPERTY LOCATION SR# 1! 0 7 SR NAME t m
PARCEL# ' 'C - 0 {J PIN # ' - — 0 — 'L ov6
ACREAGE
p ' FARM NUMBER of Altfiarat Tqy
V) R1FI ON OF LAND USE PROGRAM BY TAX OFFICE 2 _ 2 y_
SIGNA / CENTRAL PERMITTING TECHNICIAN DATE
I (we) have read and understand the requirements to quahfy for a farm exemption I (we)
hereby claim such exemption because I (we) operate a bona fide farm which has a valid faun
senal number and is currently enrolled in Harnett County s Land Use Program Within the
Land Use Program I (we) participate in
Agriculture ( ) Horticulture ( ) Forestry ( )
NOTE Check each category that applies
AFFIRMATION I (we) the undersigned declare under penalties of law that the information
contamed in this application has been examined by me (us) and to the best of my (our)
knowledge and belief is (are) true and correct Additionally I (we) fully understand that
falsification of information supplied by me (us) herein shall cause any permit issued relying
on such information to be automatically revoked and all work shall immediately cease
/ Signature(s) of Owner(s) / — - Date 5/ 0 r
Date
FOR OFFICE USE ONLY L
/�� -I et t, PERMIT# ✓ �g 4
APPROVED BY,,F}„ DATE
DENIED BY DATE
REASON FOR DENIAL
2
REALMNT1 MASTER REAL PROPERTY MAINTENANCE MAR 28 2011 3 40 PM
TP MAP SB BK -LOT DV UD CC (A C D I R S CF) UPDATE ABST(Y /N) NBH
09 9565 0137 03 ACTION I Y 2011 013940
ACCOUNT 000902534000 PROPERTY VALUES BUILDING 174040
OWNER DAVIS MICHAEL A & BRENDA G OBXF 5000
211 CHICKEN SCRATCH LANE LAND 100000
MARKET 279040
ASSESSED 279040
CAMERON NC 28326 0000 DEFERRED
PRIOR OWNER UNKNOWN
USE 01 SINGLE FAMILY RESIDENTIAL NBH 00920 SETHWOOD SUBDIVISION
MODEL 01 SFR CONSTRUCTION CARDS 1 NEW NOTICE CODE
BUILDING KEY
SALE' T/S BOOK /PAGE DEED DATE INST STAMPS UNQUAL ABBREVIATED LEGAL DESCR
0853 0434 03/25/1988 WD 31 50 28 52AC J E JOHNSON
28 52 AC
NUMBER UNIT DIR STREET NAME TYPE STREET SUFFIX MUNI
1103 NC SR
TWNSHIP 09 CITY EXEMPT EXEMPT DATE
CTY U/M 5001 UPD 05/31/2002 11 03 WESLEYK TAXBILL