DOCUMENTS R Initial Application Date: l b -I LQ "1 14 Application# 14 ' 3 A
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central 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 Af LAND USE APPLICATION"
LANDOWNER: /Y t 1 i0✓1 • 1 e f q // Mailing Address: /6 664-/ Q tri r / �t VQ t do
City: r State: f ( Zip: ( Contact No:9O t/oi.37 .3?-49,9 Email: �!
APPLICANT': j/fay, JQ hef SO 41 LJd, tie/5 Mailing Address: J r2`/ l.- h 5C4t I q// pa.
City: /11/91ei State:/( zip:v/756/ Contact No: //9 907 G79 4 Email:
'Please fill out-Applicant information if different than landowner
/ /
CONTACT NAME APPLYING IN OFFICE: f Igo ,/t1 /1054/0 Phone# /U
/9 V 2 7 02997
PROPERTY LOCATION: Subdivision: Kei 1-4) /fit//' Lot#: 7 y Lot Size: y 6 1
State Road#` 15 i/ Q State) Road NName: ) kLI-6Y 1 1J I i.SM —, q G Map Book&Page? 1151c1 / '
Parcel: 1 F ��5" �! (D) p 01 PIN: 0 5 1 -1 _I -y)07 .voO
Zoninga ._Flood Zone:, A, Watershed: - Deed Book&Page: 3P/i0 I /to Power Company*: .9u Nt e ".'t4 CO2
New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
Monolithic
la.../SFD:(Size fig. x5'1.6)#Bedrooms:_ #Baths: 3 Basement(w/wo bath):_Garage: 17 Deck:_Crawl Space:_Slab: X Slab:_
(Is the bonus room finished?( -'1 yes ( 1/)no w/a closet?(_)yes (_)no(if 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 x )#Bedrooms: 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 Existing Well New Well(#of dwellings using well )*Must have operable water before final
Sewage Supply: New Septic Tank(Complete Checklist) Existing Septic Tank(Complete Checklist) X 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 (L1')no
Does the property contain any easements whether underground or overhead(_)yes (_)no
Structures(existing or proposed):Single family dwellings: nufactured Homes: Other(specify):
J2:1Cg• 1(4 f�//__ � J
Required Residential Property Line Setbacks: Comments: Li C T/' Q. 5/ UL_ pi(An ,
Front Minimum JS Actual LI C (
Rear ,DS c25±
Closest Side 1 A1' 6
Sidestreet/corner lot
Nearest Building
on same lot
Residential Land Use Application Page 1 of 2 03/11
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: y2 i t -d eO l/es]UU C T7'
P e4iISc.1 rl C 5/// 5 I Ai-- 6 r) /f e/1.4 !I//4 PS
(hiss Due / 1- d✓►ci hif- 9V Is a i /chi-
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 statements are rate nd orrect to the best of my knowledge. Permit subject to revocation if false information is provided.
id '75-1
Signature of Ow er or Owner's Agent Date
'**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 countyor 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**
Residential Land Use Application Page 2 of 2 03/11
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09109/11 Application#
Harnett County Central Permitting
PO Box 65 Lillington NC 27546
Each section below to be filled out 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 f��l r,e,n 1111 Q.0 c? I I -Date /0- / 6-y
Site Address 3�'7 Ke /-kh )411k Rd Phone ?/) x.37 3502
Directions to job site from Lillington gig I toward 5 CI "wr hel! ea 1/e3 C
T 1l� e Peci(Q,l Rd S y 54-,0 1314- e Y, K. ILA ki 11k UU
IS}- pa.rI A k-l- I S Fi f S4- doe o f\ le-C.+
Subdivision Ke 14-h P1115 Lot 91/
Description of Proposed Work N-ew l4 i #of Bedrooms
Heated SF Ma Unheated SF Finished Bonus Room') I'5 Crawl Space Slab f
General Contractor Information
kler3 Ir<C q19 �a7 d9 74
Building Contractors Company Name Telephone
sa9I C lA,Se,, kci II Qd (4Q1el (U(
Address `'� Email Address
License#
Electrical Contractor Information
Description of Work e I e Ieci 1 wo r K Service Size ,U4 Amps T-Pole ✓Yes No
1\c r '4 i QC+ricq Sc'tv∎cz 919 LQ39 lig37
Electrical Contractor s Company Name Telephone
731 mo,br- Sc\
Address Email Address
J 6o77U
License#
Mechanical/HVAC Contractor Information
Description of Work i v‘Q a- (qtr
Sk".,9herso ett - vNo a- R - 9'19 3 L 003-:
Mechanical Contractor s Company me Telephone
31-13 1(\ Ot��s1n Or /8(01-I
Address Email Address
_g(o 1
License#
Plumbing Contractor Information
Description of Work Q l u ,,�b..�. #Baths 3
W4- Vs./ P1�nnbtinqq Co. r•C 9/9 (o 39 O19Cl
Plumbing Contractors Compstfy Name Telephone
73S ea i- i,3S 128 v33t e(
Address Email Address
O$
License#
Insulation Contractor Information,
1A1 1,n' lc, io v'■ vie/ ki L— G7 19 Wog- 99ao
Insulation Contractors Company Name&Address Telephone
*NOTE General Contractor must fill out and sign the second page of this application
I hereby certify 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 sinning below I have obtained all subcontractors
permission to obtain these permits and if any changes occur including listed contractors site plan
number of bedrooms building 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
EXPIRED PERMIT FEES 6 Months to 2 years permit re-issue fee is $150 00 After 2 years re-issue fee
is as per current fee schedule
Signature of Owne ontractor/Officer(s)of Corporation Date
Affidavit for Worker's Compensation N C 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 person(s) firm(s)or corporation(s)performing the work
set forth in the permit
Has three(3)or more 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
cdvering 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 f
Company or Name 15 r t4v� SQ 11\V,So,/ ,, lder-) _L i
�
Sign w/Titie ns�y, ��,.: Date J1 — 15 r
Print Page 1 of 2
Subject: FW:LiensNC Notice of Appointment of Lien Agent-Address 387 Keith Hits Rd,Lillington.27546
From: Myron McCall(mmccall@perry-rnccall.corn)
To: bjohnsonbuilders @yahoo.corn;
Date: Thursday.October 23,2014 4:57 AM
FYI,I put 10/24/14 as first date of furnishing.Is that o-k?
Myron E McCall
V.12 President
Corporate Off. TEL 904.292.2645
6262(lnenf.nd Road MOBILE 904-2)2-3802
Crriy-McCall , I12& FAX: 904.292-2643
fY1�51a1(7I(M IN'. -nk.oll.•ry E-MAIL. 1pm.ualla°em-ntiull uqa
0 nook Goon
Ihu menage may rounnr hJnnnd and or pr.gsrw.ary nk>Aa6."end Ls*nbsIfor the
person'Wm lo wife.a..s.m-vrinaih.ndJTmd.Urw by atlunu mirM.Prariblad
From:LiensNC Support imailto:donotreply @lienanc.com]
Seat:Wednesday,October 22,2014 5:52 PM
Subject:LiensNC Notice of Appointment of Lien Agent-Address:387 Keith Hills Rd.,Lillington,27546
A(n)Appointment of Lien Agent was filed on October 22,2014,05:51:50 PM using the North Carolina Online Lien Agent System(LiensNC).Details of this filing
include:
Project Property
McCall Residence,Lot 94,Plat Book 19 pg 48,Deed Book 3246 pg 96.
387 Keith Hills Rd.
Lillington,NC 27546
Harnett County
Entry Number:206324(entry search,view related filings)
Date of Filing:October 22,2014,05:51:50 PM
Lien Agent
Fidelity National Title Company,LLC
• Online:www.11eesnc.com
• Address:19 W.Hargett St.,Suite 507/Raleigh,NC 27601
• Phone:888-690-7384
• Fax:913-489-5231
• Email:suonortiolliensnc com
Owner Information
Myron
10664 Quail Ridge Drive
Ponte Vedra, FL 32081
United States Email:1nmccall@,perrv-mccall.com
Phone:904-237-3802
Design Professions&
Dale or First Furnishing
October 24,2014
Click to view full filing details
https://us-mg5.mail.yahoo.com/neo/launch7.rand=evmmpmvk2d74j 10/27/2014
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Date Ib" I JL/
Plan Box# C. 01 Job NameRrfun )(A(iprl 130.11 at
App # ��7 a Valuation �( Heated
pP 1 ��0 7 SQ Feet I
Garage 5 3 3
2_2?c
Inspections for SFD/SFA•
Crawl Slab Mono Basement
Footing Footing Plum Under Slab Footing
Fou ndation 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
Foundation
Slab
Mono
Open Floor
Rough In
Insulation
•
Final __,__
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call: (910) 893-7525 Fax: (910) 893-2793
Bldg Insp scheduled before 2pm available next business day.
Application Number 14-50032932 Date 10/28/14
Property Address KEITH HILLS RD
PARCEL NUMBER 11-0579- - -0178- -01-
Application type description CP NEW RESIDENTIAL (SFD)
Subdivision Name KEITH HILLS PAGE 2
Property Zoning CONSERVATION DISTRICT
Owner Contractor
MCCALL MYRON BRIAN JOHNSON BUILDERS INC
10664 QUAIL RIDGE DR 635 CHISENHALL RD
PONTE VEDRA FL 32081 ANGIER NC 27501
(904 ) 237-3802 (919) 639-3714
Applicant
BRIAN JOHNSON BUILDERS #94
529 CHISENHALL RD
ANGIER NC 27501
( 919) 427-2976
--- Structure Information 000 000 52X54 . 6 3BDR SLAB W/ GARAGE
Flood Zone FLOOD ZONE X
Other struct info # BEDROOMS 3000000 . 00
PROPOSED USE SFD
SEPTIC - EXISTING? SEWER
WATER SUPPLY COUNTY
Permit BLDG,MECH, ELEC, PLB, INSU PERMIT
Additional desc .
Phone Access Code 1058320
Issue Date . . . 10/28/14 Valuation . . . . 0
Expiration Date . 10/28/15
Special Notes and Comments
T/S : 02/19/2014 10 : 55 AM JBROCK -- --
KEITH HILLS LOT 94 ADDRESS: 387 KEITH
HILLS RD
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
PERMIT INCLUDES BLDG, ELEC,MECH, PLUMB
INSULATION AND LAND USE.
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Work must conform and comply with the
STATE BUILDING CODE and all other State
and local laws, ordinances & regulations
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: ( 910) 893-2793
Bldg Insp scheduled before 2pm available next business day.
Page 2
Application Number 14-50032932 Date 10/28/14
Property Address KEITH HILLS RD
PARCEL NUMBER 11-0579- - -0178- -01-
Application description . . CP NEW RESIDENTIAL (SFD)
Subdivision Name KEITH HILLS PAGE 2
Property Zoning CONSERVATION DISTRICT
Permit BLDG,MECH, ELEC, PLB, INSU PERMIT
Additional desc .
Phone Access Code 1058320
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
10 101 B101 R*BLDG FOOTING / TEMP SVC POLE / /_
20 103 B103 R*BLDG FOUND & TEMP SVC POLE _/ /_
20-30 814 A814 ADDRESS CONFIRMATION _/_/_
30-999 111 B111 R*BLDG SLAB INSP/TEMP SVC POLE / /_
30-999 309 P309 R*PLUMB UNDER SLAB _/_/_
30 104 B104 R*FOUND & SETBACK VERIF SURVEY / /_
40-50 129 I129 R*INSULATION INSPECTION _/_/_
40-60 425 R425 FOUR TRADE ROUGH IN / /_
40-60 125 R125 ONE TRADE ROUGH IN / /_
40-60 325 R325 THREE TRADE ROUGH IN _/_/_
40-60 225 R225 TWO TRADE ROUGH IN _/_/_
50-60 429 R429 FOUR TRADE FINAL _/_/_
50-60 131 R131 ONE TRADE FINAL / /_
50-60 329 R329 THREE TRADE FINAL _/_/_
50-60 229 R229 TWO TRADE FINAL _/_/_