Initial Application Date:______________ Application# 
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATIONCentral Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893-7525 ext:2 Fax: (910) 893-2793 www.harnett.org/permits 
**A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) & SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION** 
LANDOWNER:MailingAddress:
City: State: Zip: Contact No: Email: 
APPLICANT*: Mailing Address: 
City: State: Zip: Contact No: Email: 
*Pleasefill out applicant information if different than landownerADDRESS:_______________________________________________________PIN:_____________________________________________________ 
Zoning:__________ Flood:___________ Watershed:_________ Deed Book / Page: __________ 
Setbacks – Front:________ Back:________ Side:________ Corner:________
PROPOSED USE:
Monolithic 
SFD: (Size x ) # Bedrooms: # Baths: Basement(w/wo bath): Garage: Deck: Crawl Space: Slab: Slab: 
TOTAL HTD SQ FT______GARAGE SQ FT______ (Is the bonus room finished? ( ) yes ( ) no w/ a closet? ( ) yes ( ) no (if yes add in with # bedrooms)
Modular: (Size x ) # Bedrooms # Baths Basement (w/wo bath) Garage: Site Built Deck: On Frame Off Frame 
TOTAL HTD SQ FT___________________ (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. BedroomsPer Unit: TOTAL HTD SQ FT______________
Home Occupation: # Rooms: Use: Hours of Operation:#Employees:
Addition/Accessory/Other: (Size x ) Use: Closets in addition? ( ) yes ( ) noTOTAL HTD SQ FT_____________ GARAGE_________________
Water Supply: County Existing Well New Well (# of dwellings using well ) *Musthave operable water before final(Need to Complete New Well Application at the same time as New Tank) 
Sewage Supply: New Septic Tank ____ Expansion ____ Relocation Existing Septic Tank County Sewer 
(Complete Environmental Health Checklist on other side of application if Septic) 
Does owner of this tract of land, own land that contains a manufactured home within five hundred feet (500’) of tract listed above? ( ) yes ( ) noDoes the property contain any easements whether underground oroverhead ( ) yes ( ) noStructures (existing or proposed): Single family dwellings: Manufactured Homes: Other (specify): 
If permits are granted I agree to conform to all ordinances andlaws 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. 
Signature of Owner or Owner’s AgentDate***It is the owner/applicants responsibility to provide the county with any applicable information about the subject property, including but not limited 
NVR INC DBA RYAN HOMESRALEIGHNC276075734 TRINITY ROAD, SUITE 200919-987-1930msweitze@nvrinc.comMEREDITH SWEITZER5734 TRINITY ROAD, SUITE 200RALEIGHNC27607919-987-1930msweitze@nvrinc.comRA-30N/AWS-IV30'20'10'20'14042.510/20/20156 BELLA VITA WAY 0652-92-1863.0003635 : 0823 28190339710/20/20 
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATIONCentral Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893-7525 ext:2 Fax: (910) 893-2793 www.harnett.org/permits 
**A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) & SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION** 
LANDOWNER:MailingAddress:
City: State: Zip: Contact No: Email: 
APPLICANT*: Mailing Address: 
City: State: Zip: Contact No: Email: 
*Pleasefill out applicant information if different than landownerADDRESS:_______________________________________________________PIN:_____________________________________________________ 
Zoning:__________ Flood:___________ Watershed:_________ Deed Book / Page: __________ 
Setbacks – Front:________ Back:________ Side:________ Corner:________
PROPOSED USE:
Monolithic 
SFD: (Size x ) # Bedrooms: # Baths: Basement(w/wo bath): Garage: Deck: Crawl Space: Slab: Slab: 
TOTAL HTD SQ FT______GARAGE SQ FT______ (Is the bonus room finished? ( ) yes ( ) no w/ a closet? ( ) yes ( ) no (if yes add in with # bedrooms)
Modular: (Size x ) # Bedrooms # Baths Basement (w/wo bath) Garage: Site Built Deck: On Frame Off Frame 
TOTAL HTD SQ FT___________________ (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. BedroomsPer Unit: TOTAL HTD SQ FT______________
Home Occupation: # Rooms: Use: Hours of Operation:#Employees:
Addition/Accessory/Other: (Size x ) Use: Closets in addition? ( ) yes ( ) noTOTAL HTD SQ FT_____________ GARAGE_________________
Water Supply: County Existing Well New Well (# of dwellings using well ) *Musthave operable water before final(Need to Complete New Well Application at the same time as New Tank) 
Sewage Supply: New Septic Tank ____ Expansion ____ Relocation Existing Septic Tank County Sewer 
(Complete Environmental Health Checklist on other side of application if Septic) 
Does owner of this tract of land, own land that contains a manufactured home within five hundred feet (500’) of tract listed above? ( ) yes ( ) noDoes the property contain any easements whether underground oroverhead ( ) yes ( ) noStructures (existing or proposed): Single family dwellings: Manufactured Homes: Other (specify): 
If permits are granted I agree to conform to all ordinances andlaws 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. 
Signature of Owner or Owner’s AgentDate***It is the owner/applicants responsibility to provide the county with any applicable information about the subject property, including but not limited 
NVR INC DBA RYAN HOMESRALEIGHNC276075734 TRINITY ROAD, SUITE 200919-987-1930msweitze@nvrinc.comMEREDITH SWEITZER5734 TRINITY ROAD, SUITE 200RALEIGHNC27607919-987-1930msweitze@nvrinc.comRA-30N/AWS-IV30'20'10'20'14042.510/20/20156 BELLA VITA WAY 0652-92-1863.0003635 : 0823 28190339710/20/20
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** 


APPLICATION CONTINUES ON BACK 




**This application 
expires 6 months from the initial date if permits have not been issued** 

*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 expirationdepending upon 
documentation submitted. (Complete site plan =60 months;Complete plat = without expiration) 


� 
Environmental Health New Septic System 
 
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 youclean out the undergrowthto 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. 
� 
Environmental Health Existing Tank Inspections 
 
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 place. (Unless inspection is for a septic tank in a mobile home park)
DO NOT LEAVE LIDS OFF OF SEPTIC TANK
“MORE INFORMATION MAY BE REQUIRED TO COMPLETE ANY INSPECTION” 


SEPTIC 

 If applying for authorization to construct please indicate desired system type(s): can be ranked in order of preference, must choose one. 
{__} Accepted {__} Innovative 
{__} Conventional 
{__} Any 
{__} Alternative {__} Other 
_________________________________ 

The applicant shall notify the local health department upon submittal of this applicationif any of the following apply 
to the property in 
question. If the answeris “yes”, applicant MUST ATTACH SUPPORTING DOCUMENTATION: 

{__}YES {__} NO 
Does 
the 
site contain any Jurisdictional Wetlands? 
{__}YES {__} NO 
Do you plan to have an irrigation system now or in the future? 
{__}YES {__} NO Does 
or will the building contain any drains? Please explain.____________________________________ 
{___}YES {___} 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 800-632-4949 to 
locate the lines. This is a free service. 

I Have ReadThis Application And Certify That The Information ProvidedHerein IsTrue,Complete AndCorrect. AuthorizedCounty And State 


Officials Are Granted Right Of Entry ToConduct Necessary Inspections To DetermineCompliance 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 Site 
Accessible So That A Complete Site Evaluation Can Be Performed.