DOCUMENTS FOR REGISTRATION
Kimberly S. Hargrove
REGISTER OF DEEDS
Harnett Count NC
2014 JUL 16 04:05: 34 PM
BK:3230 PG:490-408
FEE: 26.0s0
EXCIS TAX:22s00124.00
HARNETT COUNTY TAX ID# INSTRUMMMAATT1tWILLISOS447
(13"x!' tqVi
111 111111111
2014009447
This Deed Prepared by Reginald B. Kelly,Attorney at Law,P.O.Box 1118,Lillington,NC 27546
PID#130621 0008
REVENUE STAMPS: $124.00
STATE OF NORTH CAROLINA WARRANTY
COUNTY OF HARNETT DEED
This WARRANTY DEED is made the 25th day of June, 2014, by and between Joan
M. Jackson and spouse, Larry B. Jackson of PO Box 305, Bunnlevel, NC 28323 (hereinafter
referred to in the neuter singular as "the Grantor") and The Triumph Capital Group, LLC of
PO Box 208, Lillington, NC 27546 (hereinafter referred to in the neuter singular as "the
Grantee");
WITNESSETH:
THAT said Grantor, for valuable consideration, receipt of which is hereby
acknowledged, has given, granted, bargained, sold and conveyed, and by these presents does
hereby give, grant, bargain, sell and convey unto said Grantee, its heirs, successors,
administrators and assigns, all of that certain piece, parcel or tract of land situate, lying and
being in Upper Little River Township of said County and State, and more particularly
described as follows:
Beginning at an existing iron stake in the centerline of NCSR#1314 (Raven
Rock Road), said existing iron stake being the southeastern corner of Jerry& Sylvia
Cummings tract as deeded in Book 552,Page 39,Harnett County Registry and running
thence as Jerry& Sylvia Cummings line North 67 degrees 43 minutes 27 seconds West
200.80 feet to an existing iron rod at the southwestern corner of Jerry& Sylvia
Cummings tract as shown in deed Book 756,Page 959, Harnett County Registry and
running thence as Jerry& Sylvia Cummings line North 21 degrees 11 minutes 9
seconds East 160.29 feet to an existing iron stake,also being the southeastern corner of
Jerry& Sylvia Cummings tract as shown in deed Book 756, Page 959,Harnett County
Registry, said corner also being located in the line of the Jerri&James Pope tract as
deeded in Book 2188, Page 129 and Plat Book 2006, Page 57, Harnett County Registry;
thence running with the line of Jerri& James Pope tract South 73 degrees 2 minutes 58
seconds East 165.18 feet to an existing iron rod located in the northern edge the right of
way of NCSR 1314 (Raven Rock Road),thence South 73 degrees 5 minutes 45 seconds
East 30.23 feet to a PK Nail in the centerline of NCSR 1314(Raven Rock Road);
running thence with the centerline of NCSR 1413 (Raven Rock Road) South 19 degrees
17 minutes 58 seconds West 178.66 feet to the point and place of beginning, and
containing 0.77 acres more or less.
See the map attached for further reference to legal description.
**The property herein described is ( )or is not()the primary residence of the Grantor
(NCGS 105-317.2)
TO HAVE AND TO HOLD the above-described lands and premises, together with all
appurtenances thereunto belonging, or in anywise appertaining, unto the Grantee, its heirs,
successors, administrators and assigns forever, but subject always, however ,to the limitations
set out above.
AND the said Grantor covenants to and with said Grantee, its heirs, successors,
administrators and assigns that it is lawfully seized in fee simple of said lands and premises,
and has full right and power to convey the same to the Grantee in fee simple (but subject,
however, to the limitations set out above) and that said lands and premises are free from any
and all encumbrances, except as set forth above, and that it will, and its heirs, successors,
administrators and assigns shall forever warrant and defend the title to the same lands and
premises, together with the appurtenances thereunto appertaining, unto the Grantee, its heirs,
successors, administrators and assigns against the lawful claims of all persons whomsoever.
IN WITNESS WHEREOF, the Grantor has hereunto set its hand and seal and does
adopt the printed word "SEAL" beside its name as its lawful seal.
GRANTOR
(SEAL)
an M. Jackson
(SEAL)
La� ckso�
****************************************
STATE OF Nc.
COUNTY OF_ l{cv.,,.,.#
I, a Notary Public of the County and State aforesaid, certify that Joan M. Jackson and
spouse, Larry B. Jackson personally appeared before me this day and acknowledged the due
execution of the foregoinguiaggiment.
Witness my h opevec�i�Jyseal, this t,day of (t,j,1 , 2014.
(S )• h�,4 e �ti Iyl /r11/6,rwb
My Co �I+ iogx Not Public
ii, /ARNe
ANetimitt000
1 _
` I WNW CER151Y THAT THIS V*IS CORRECT AND THAT ,,`,,,III,,,,,."0 CAROL ANY MBE ENCROACHMENTS AK SHOW HEREON.
. i p -a-14
{ LTA OA1 =
>rLC DOS NAP 1S NOT A COMM SURVEY MD HAS NOT L-3729
5071 REMEW5 SY A LOCAL t1OMCINLIDIT AODECY FOR D L
cd/uANCE 1/1H ANY AINIJCA&L LNIO OE ELOPMENT '* 0.4
RO>ILATNriL S5i NAP II ONLY SITENOEO FOR 1HE a��� y �:
PARSES ND PURPOSED SHOMH.1155 MAP M NOT FOR 41 EL 1F'
SEAL
RECgIDATION.NO 117LE REPORT PROYDED. ,'�',,,I,I,,1 I,,,J�
VICINITY MAP This map is not a certified survey and has
not been reviewed by a local government agency for
compliance with any applicable land development
regulations.
1
1 JERRY & STLVIA CUMMINGS I
I 08 758. PG 959 o
EIR EIS
a (r BELOW) N 2111'9' E 160.29' (FLUSH)
n
S
1LR
42 a 4
0.77 AC. m
W AREA BY COORDS.
.ERRI is JAMES POPE
002188, PG 129
PEI 2006, PG 57
Co.
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OR
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z
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tit
in en( LINE) PK
- N 243.6•E _ NAE
S S 1917.58' W 178.66' PK NAIL 233.38'
RAVEN ROCK RD
------EVIL _----_
1•cow AfAI
RA00 srma GRAPHIC SCALE
� " 20 0 40 80
1�IN1 NO 1 INCH - 40 FEET
ril P"OA No, ECLS 14-059 A� FLT, JOAN JACKSON
ZINC RAVEN ROCK 1289 RAVEN ROCK ROAD E C L S
n LOAOM'"LES LILLINGTON,NC
riSu.norimO TNI Kw.Cow.
YAM 1� - �. 777 FIL1M CUIV[
In NI HARNETT CO.,N.C. �NO1u.NC 97E01
`I. DATE PIN 0621-33-5976 DEED BOOK 2268 PAGE 755
•10.897.92117 sa' a a r
7-8-14 stL a.re7saav rwx
09109111 Application#
Harnett County Central P erm�tt Permitting e 1 5- "2i9
Pi 37? ,
Each section below to be filled out PO Box 85 LIllington NC 27548
910 893 7525 Fax 910 893 2793 www hamett org/permits
by whomever performing work
Must be owner or licensed
contractor Address company Application for Residential Budding and Trades Permit
name&phone must match
Owners Name ifl 4l1 W C-4 -ruTRaC [ 4 Date
Site Address 12 S2.9 &Ill EN Roc Phone 9/e)-32Z-24La
Directions to job site from Lillington
Subdivision Lot
Description of Proposed Work #of Bedrooms -3
Heated SF /9 7 t Unheated SF D Finished Bonus Room/ Crawl Space ✓ Slab
General Contractor Information!
Building Contractors Company Name Telephone
Address Email Address
29‘
License#
Electrical Contractor Information,
Description of Work /e w r z Service Size Mc) Amps T-Pole ±Yes No
kitOrr LM-2FN 6 &eria&77 IC 9/c) -5P3- VO6
Electrical Contractors Company Name Telephone
2037 -4 /2TD6E ter. F4yE77u.t(E .v
Address 2 F30 ci Email Address
qo
License#
Mechanical/HVAC Contractor Information
Description of Work
CVs7v771 Nf T v6 9/9- —3 07?
Mechanical Contractors Company Name Telephone
/00 I D64,1 IAA Da . _. .w nc) 4/c 24--y3,
Address Email Address
License#
Plumbing Contractor Information
Description of Work /4• PC On?,3 #Baths 3
Pd-Tre/ck 14),14f4/r= 6coPtnitA) vMB -riG 9/9-397- 5-777
Plumbing Contractor s Company Name Telephone
/4113 Ott) azk'WOkiil reef G /1ER Are
Address �'732cy Email Address
x7-737
License#
Insuiatfog Contractor Information,
_71 So 0174 6 iZe/ir 7r k'5 Qc4° Wet — 77'- 4-(13 S.--
Insulation Contractors Company Name&Address "ye Telephone
*NOTE General Contractor must fill out and sign the second page of this application
I hereby certrfy that I have the authority to make necessary application that the application is correct
and that-the construction will conform to the regulations in the Building Electrical Plumbing and
Mechanical codes and the Harnett County Zoning Ordinance I state the information on the above
contractors is correct as known to me and that by signing below I have obtained all subcontractors
permission to obtain these permits and if my changes occur including listed contractors site plan
number of bedrooms build ng and trade plans Environmental Health permit changes or proposed use
changes I certify it is my responsibility to notify the Harnett County Central Permitting Department of
any and all changes
EXP'- D PE- r S-6 Months to 2 years permit re-issue fee is$1 0 00 After 2 years re-issue fee
is . r . I r:nt f- -,;f hedule
Signature of Owner/Contractor/Officer(s)of Corporation Date
Affidavit for Worker's Compensation NC G S 87-14
The undersigned applicant being the
General Contractor Owner Officer/Agent of the Contractor or Owner
Do hereby confirm under penalties of perjury that the perso n(s) firm(s) or corporation(s) performing the work
set forth in the permit
Has three (3) or mo-e employees and has obtained workers compensation insurance to cover them
Has one(1)or more subcontractors(s)and has obtained workers compensation insurance to cover
them
Has one (1) or more subcontractors(s)who has their own policy of workers compensation insurance
covering themselves
Has no more than two(2)employees and no subcontractors
While working on the project for which this permit is sought it is understood that the Central Permitting
Department issuing the permit may require certificates of coverage of workers compensation insurance prior
to issuance of the permit and at any time during the permitted work from any person firm or corporation
carrying out the work
Company or Na 1
Sign w/Title Date ( ( 0-7 iDDI L
�
'� Date 11 - 1 - / 14
Plan Box # 1 - r l Job Name I fig, .kph C 01 in I‘f_94
C)-12).Ap
App # 3 1 Valuation Z 9 G I R Heated SQ Feet 4 4/6
Garage
Inspections for SFD/SFA
Crawl Slab Mono Basement___
Footing Footing Plum Under Slab Footing
Foundation Foundation Ele. Under Slab Foundation
Address Address Address Waterproofing
Open Floor Slab Mono Slab Plum Under slab
Rough In Rough In Rough In Address
Insulation Insulation Insulation Slab
Final Final Final Open Floor
Rough In
Insulation
Final
Foundation Survey Envir. Health Other
Additions/ Other
Footing
e3L-C)) .
Foundation
Slab CS)&i:14
Mono
Open Floor
Rough In
Insulation
Final