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2016-00000350_EHS 1 o�NT�' p09jo COUNTY OF RANDOLPH •-`` -:' Health Department ° 'l " 204 E Academy St -Asheboro NC 27203 1779„t APPLICATION FOR SUBSURFACE WASTEWATER DISPOSAL PERMIT If the information in the application for an Improvements Permit is falsified, changed or the site is altered, then the Improvements Permit and Authorization to Construct shall become INVALID. The permit is valid for either 60 months or without expiration depending upon the documentation submitted. (Complete site plan=60 months; Complete plat=without expiration.) Applicant: GUNN,SHANNON Date: 2/25/2016 Address: 2300 NC HWY 705 Application #: 2016-00000350 City, ST ZIP: SEAGROVE, NC 27341 Parcel number: 7668158920 Owner: MICHAEL PAUL FEELEY Contact: GUNN,SHANNON Address: 1924 VINE ST Contact phone: 336 963-0307 City, ST ZIP: HOLLY SPRINGS, NC 27540 LOCATION INFORMATION: Location: , Subdivision name: NANCE PLACE Lot number: 14 FACILITY INFORMATION: Proposed use: SINGLE FAMILY RESIDENCE If other, specify: Number of bedrooms: 3 Basement: NO Basement fixtures: NO Number of people/employees: 3 Number of shifts: 0 Number of seats: 0 Number of toilets/urinals: 2 Number of showers/tubs: 2 Water supply: NEW WELL Site contains wetlands: NO Existing wells present: NO Existing easements present: NO Domestic wastewater only: YES Proposed design flow: 360 Comments: - Total application fee: $200.00 AUTHORIZATION TO PROCEED: I 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 site accessible so that a complete site evaluation can be performed. '\...-(1 ° og a6.--/(o Signature of property owner/legal representative* Date *You must provide documentation to support claim as owner's legal representative. - LOCAL TELEPHONE NUMBER - Asheboro: (336) 318-6262 -Greensboro/Liberty: (336) 218-4262 -Archdale/Trinity: (336) 819-3262 http://www.co.randolph.nc.us APPLICATION FOR SUBSURFACE WASTEWATER DISPOSAL PERMIT Page 1 of 1 --- 02o/ - 3-6-6 is okii. `R TO PURCHASE AND CONTRACT-VACANT LOT/LAND [Consult"Guidelines"(form 12G)for guidance in completing this faun) NOTE: This contract is intended for unimproved real property that Buyer will purchase only for personal use and does not have ;immediate plans to subdivide. It should not be used to sell property that is being subdivided unless the property has been platted, properly approved and recorded with the register of deeds as of the date of the contract.If Seller is Buyers builder and the sale involves the construction of a new single family dwelling prior to closing,use the standard Offer to Purchase and Contract—New Construction (Form 800-T) or,if the construction is completed, use the Offer to Purchase and Contract (Form 2-T) with the New Construction Addendum(Form 2A3-T). For valuable consideration,the receipt and legal sufficiency of which are hereby acknowledged,Buyer offers to purchase and Seller upon -' acceptance agrees to sell and convey the Property on the terms and conditions of this Offer To Purchase and Contract and any addendum or modification made in accordance with its terms(together the"Contract"). I. TERMS AND DEFINITIONS:The terms listed below shall have the respective meaning given them as set forth adjacent to each tern. (a) "Seller": Micheal Paul: Feeley, Carolann F. Feeley - (b) 'Buyer":Shannon Gunn (c) "Property":The Property shall include all that real estate described below together with all appurtenances thereto including the improvements located thereon. NOTE: If the Property will include a manufactured (mobile) home(s), Buyer and Seller should consider including the Manufactured (Mobile)Home provision in the Additional Provisions Addendum(Standard Form 2A11-T) with this offer. Street Address:Staleys Farm Rd City: Asheboro Zip: 27205 County:Randolph North Carolina p (NOTE:Governmental authority over taxes,zoning,school districts,utilities and mail delivery may differ from address shown.) Legal Description:(Complete ALL applicable) Plat Reference:Lot/Unit 14 ,Block/Section ,Subdivision/Condominium Nance Place . _ ,as shown on Plat Book/Slide 98 at Page(s) . 3 The PIN/PID or other identification number of the Property is: 7668158920 Other description: p Some or all of the Property may be described in Deed Book 1964 at Page 1918 r (d) "Purchase Price": $ 21,000.00 paid in.U.S.Dollars upon the following terms: $ - BY DUE DILIGENCE FEE made payable and delivered to Seller by the Pffective Date. !' $ 500.00 BY INITIAL EARNEST MONEY DEPOSIT made payable and delivered to Escrow Agent named in Paragraph 1(f)by 0 cash El personal check❑ official bank check 0 wire transfer,EITHER Q with this offer OR ❑ within five(5)days of the Effective Date of this Contract. g $ BY.(ADDHIONAL) EARNEST MONEY DEPOSIT made payable and delivered to [ Escrow Agent named in Paragraph 1(f)by cash or immediately available funds;such,as official bank check or wire transfer no later than. ,TIME BEING OF THE ESSENCE with regard to said date. 4 $ BY ASSUMPTION of the unpaid principal balance and all obligations of Seller on the E existing loan(s)secured by a deed of trust on the Property in accordance with the attached Loan Assumption Addendum(Standard Form 2A6 T). $ BY SELLER FINANCING in accordance with the attached Seller Financing Addendum (Standard Form 2A5-T). N $ 20,500.00 BALANCE of the Purchase Price in cash at Settlement(some or all of which•may be paid k with the proceeds of a new loan). This form.jointly approved by: Page 1 of 11 . STANDARD FORM 12-T t it North Carolina Bar Association Revised 7/2015 e9 North Carolina Association ofREALTORS® Inc. A muuxo1swc l REALTOR 0:pO87b1171ry ©7/2015 ;0.� �� Buyer initials Seller initials f�' r` Re/max Central Aealty,231 South Fayetteville St Asheboro,NC 27203 ne:336302.0187 Fad 336.626.0127 Shannon Gum I John Gatlin • Produced with zipFarm®hy zipLogix 16070 Fifteen Mile Road,Fraser,Michigan 48026 wvm2l0Logix.cortb a • a iATi'5/T17VLl; Or DAY: Unless otherwise provided, for u days,including Saturdays,Sundays, and holidays, whether federal, state,local of religious term. " t unt of"days shall be non the day days' shall .F day following the day upon which c For the purposes afbe performed or made.Any-reference to a date or tine of day shall refer to the date and/or ' any act or notice as provided in this n a: tune of day in 1 _ ASSOCIATIQN OF RF,gf TORS®, C O • N AS TO THE LEGAL AND THE NORTH CAROLINA BAR ASSOCIATION VALIDITY OR ADEQUACY OF ANY.PROVISION OF THIS FORM IN CTTON.IF YOU D0 NOT UNDERSTAND THIS FORM OR OU SHOULD CONSULT A NORTH CARO THAT�'DOES NOT PROVIDE FOR YOUR L1NA REAL ESTATE ATTORNEY BEFORE YOU SIGN IT, come a binding contract on the Effective Date.Unless specifically other payment provided for herein shall.not prevent tins offer from becoming a binding provided otherwise,Buyer's failure to timely deliver i 'give Seller certain rights to terminate the contract as described herein or as otherwise LL g contract,provided that any permitted by Iaw. j • _41.ar .19 2016 • Date: ad/. . . 41-, • on. Gunn Sell er. / � .. Micheal P/_u1 Peale, Date: b'2/c1-1/ /0 • Seller. � �� Cy,Bnyer: Ca, � a F Feeley . iL Entity Seller: • (Name of C/Corporation/Pa ership/Tr /etc.) 1! . (Name of LLC/Corporation/Partnershi p/Trust/etc.) By: • Name: Name: ' Title: ., Title Date: Date: • . [THIS SPACE 1N'TENTIONALLy LEFT BLANK] Page 9of11 STANDARD FORM 12_T ,s Revised 7/2015 E' Produced with*Forme byzlpLods 18070 Fifteen We Road,F s Fraser,Mkh f 7/2015. IBan48026 wWw ixcam Shannon Gunn i1�-