DOCUMENTS Initial Application Date: 10/20/2015 'S � �S�
Application# 1 ,
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
/� Central Perttting 108 E. Front Street,Lillington, NC 27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.harnett.org/permits
v RECD D S V Y AP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN HEN SUBMITTING A LAND USE APPLICATION"
&r:Lic.R4omfort Homes, Inc. P 0 Box 369
Mailing Address:
Cit Y: Clayton NC 27528 919 553 3242 comfrthomes @aol.com
State: Zip: Contact No: Email:
APPLICANT*:Comfort Homes, Inc. Mailing Address: P 0 Box 369
Cit : Clayton NC 27528 919 553 3242 comfrthomes @aol.com
Y State: Zip: Contact No: Email:
*Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE:Julian Stewart Phone#919 422 1481
PROPERTY LOCATION: Subdivision: Wyndham Place 10 .586
Lot#: Lot Size:
'
State Road#1448 State Road Name: Rawls Church Rd Map Book&PageaCklo /k�1r!!1�1I
1 `!
Parcel: 040664 0038 41 PIN: 0664-98-7632.000
RA
Zoning: -30 Flood Zone: X Watershed: IV Deed Book&Page: Power Company*: Duke Progress Energy
*New structures with Progress Energy as service provider need to supply 72900670 from Progress Energy.
9 9Y P pp y premise number
PROPOSED USE:
' ' Monolithic
cif SFD:(Size x )#Bedrooms:3 #Baths:?Basement(w/wo bath):_Garage: ✓ Deck: I Crawl Space: ✓ Slab:_Slab:_
(Is the bonus room finished?(_)yes (✓)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 TTM/(Size x )#Bedrooms: Garage: site built?
g ( )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?(___)(�y (_)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) 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 (✓)no
Does the property contain any easements whether underground or overhead(✓)yes (_J no
Structures(existing or proposed):Single family dwellings: proposed Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual 40'
Rear 25' 67'
Closest Side 10' 12'
Sidestreet/corner lot n/a
Nearest Building n/a
on same lot
Residential Land Use Application Page 1 of 2 03/11
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 401 N, right on Rawls Church Rd, left on Atkins road, subdivision on left
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 thdNa ents are a rate d correct to the best of my knowledge. Permit subject to revocation if false information is provided.
c>. . 10/20/15
Signature of Owner 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 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**
Residential Land Use Application Page 2 of 2 03/1 I
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NAME: �l��` fl�c ' ' ''C."\Q"-- • 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 IS ALTERED,THEN THE IMPROVEMENT
PERMIT OR AUTHORIZATION TO CONSTRUCT SHALI.BECOME INVALID. The permit is valid for either 60 months or without expiration
depending upon documentation submitted. (Complete site plan=60 months;Complete plat=without expiration)
910-893-7525 option 1 CONFIRMATION#
` , 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 approiimately 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 qiven at end of recorcinq for proof of request.
• Use Click2Gov or IVR to verify results. On:e approved, proceed to Central Permitting for permits.
Environmental Health Existing 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 lid 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 reauest.
• Use Click2Gov or IVR to hear results. Once approved, proceed to Central Permitting for remaining permits.
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 { Y) Conventional {_} Any
{_) 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"yes",applicant MUST ATTACH SUPPORTING DOCUMENTATION:
{_)YES (_) NO Does the site contain any Jurisdictional Wetlands? V-�\.--clp`... n
(_)YES {.) NO Do you plan to have an irrigatjon system now or in the future?
{_)YES (X} NO Does or will the building contain any drains?Please explain.
(_)YES NO NO Are there any existing wells.snings. 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 NO Does the site contain any existing water,cable,phone or underground electric lines?'"00.-1/43`. 0.`''
If yes please call No Cuts at 800-632-4949 to locate the lines. This is a free service.
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 Nec!ssary 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 A cessible So' 'at A Complete Site E value: Can t e Perfir '-
PROPERTY OWNERS OR OWNERS T• REPRE' _ ►■ ATIVE SIGNATURE(REQUIRED) DATE
10/10
October 20, 2015
Comfort Homes, Inc. has an option to purchase Lots 10, 11, 12, and 13 in Wyndham Place
Subdivision, recorded in Map Book 2006, Page 1094, Harnett County Register of Deeds.
— - ?/1 I '.-
Ll / (Seal)
I, Patricia F. Waite, do hereby certify that Julian R. Stewart, President of Comfort Homes, Inc.,
personally appeared before me this day and acknowledged the due execution of the foregoing
instrument.
Witness my hand and Notarial Seal, this 20th day of October 2015.
� .
C (Notar) Public) �.*``►GIA F� I,,,,
My commission expires 4/2/17. �Q./ TA�cj 9/m'
,,,,,,.1/6-;�oN CO�N�`,��
09/09/11
Application#
Harnett County Central Permitting
Each section below to be kited out 910 893 7526 PO Box 8 Lilting o v NC 27548
Muwhomever
t enowner for used work
harnett«6rPeRnrts
contractor Address company
--_ _. _n io R e a 1 n
Pe name&phone must match
Owners Name— . ■ .■,` �-
Site Address�7+ •k.:%4. Date 1\7....S.:15.
— •�J
�A•• 4 ` a `• ,-.. Phone Ces.. 'S- 1/4\,a►
Directions to job site from Ldhngton . 1
Subdivision . %. ',• ‘\ ob
Descnpbon of Pro (�,� \ ' ` �
Propos • ork��15 ryC �.A��A `l�
Heated SF ,I #of Bedrooms 3
1 Unheated SF ..Finished Bonus Roomy
Si‘....,
al►neral.Contractor Informaron Crawl Space :..Slab
1
Building antractor s Company Name �C __ �,. ass
Telephone
A
LN _ems 4. 10 .. Ad1s• .
•ddress Qy� Cn� Qo�, Q`1t\c,
\` I` Email Address
License# `�
•
Electrical ontractor Information
Descnption of Work Ro e.
P usl���t 7`r:�.a Service Size ZOVAmps T-Pole Yes No
c ;c._ 9l -t)S-45"7 7
Electrical Contractor s Company Name Telephone
7pS 7t045/445 Vii &e aiel•el. Se/...� /1(C
Address Email Address
22 RS
License#
Meehan Ical/HVAC Contractor Information
Description of Work Rogy 4 4',i 1t-r,,'„.cpc�`--�e."Ae,. I/e,�:<' i.�
ig—3-?9-6d 84(
Mec anlcal Contractors Company Name Telephone
3 3,Siap4_1a54, L .... C-2:,-....d�-,1/L- 275-? ?
Address Email Address
/86 q cf
License #
a Plumbing Contractor Information
Description of Work Rot fki.\ •t jr-1`0%.044./5 #Baths
A*tbit-}�lu.*4d:.5 7j? 734t - /3 ??
Plumbing Contractors Company Name Telephone
7SS &X Mid., ed. C )4r V: .2?S2o
Address Email Address
2
e=..6.23
License#
_ Insulation Contractor Information T th4•4t-i-i,rdjta 'art "SiI Ot iP e—G-a,), 9/l, b /l" 07
1?Insulation Contractors Company Name &Adbfress Telephone
'NOTE General Contractor mutt 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 stoning below I have obtained all subcontractors
permission to obtain these permits and if;i_y changes occur including listed contractors site plan
number of bedrooms building and trade plan; 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 yeas permit re-issue fee is $150 00 After 2 years re-issue fee
is as per current fee schedule
Signature of Owner/Contracto Officers 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 pdrjtiry`{fiat the person(s)rfirm(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)zind has obtained workers compensation insurance to cover
them
XHas 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 cert ficates 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 Name
Sign w/17 tle \ \Q ( Date v
Appointment of Lien Agent: Details- LiensNC Lien Service https://apps.liensnc.com/scr/appointment/details.html?entryNumber=...
DO NOT REMOVE!
Details: Appointment of Lien Agent
Entry #: 368970 Filed on: 10/20/2015
Initially filed by: ComfortHomes
Designated Lien Agent Project Property Print & Post
WFG National Title Insurance Company Wyndham Place lot 10 ❑ �+,' ❑
62 GRAHAMRIDGE LANE '
Online:wwwliensnc.comcmup FUQUAY-VARINA,NC 27526
Address:19 W.Hargett SL,Suite 507/Raleigh,NC Harnett County ❑ ,,F.# a
27601
Phone:888-690-7384
Contractors:
Please post this notice on the Job Site.
Fax:913-489-5231 Property Type
Suppliers and Subcontractors:
Email:support(u?fiensnc-comm.li,.upp„rti,lienrno o,ml
Scan this image with your smart phone to
view this filing.You can then file a Notice
1-2 Family Dwelling to Lien Agent for this project.
Owner Information
Comfort Homes,Inc.
P 0 Box 369
Clayton, NC 27528
United States
Email:comfrthomes@aol.com
Phone:919-553-3242
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Technical Support Hotline:(888)690-7384
I of 1 10/20/2015 9:40 AM