LAND USE R Initial Application Date: II- 1 (40-L5 [r
Application# �'! —SOO Z 4'(4 3(0
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 7 108 E.Front Street,Lillington,NC 27546 Phone:(910)893-7525 Fax:(910)893-2793 www.harnett.org/permits
LANDOWNER: i�4. Mailing Address: 346 I {..Qq.∎O N 1�0O
City: Ro P.t $A 1\s State:`1�C ZipaT 46Contact#Q10-•1414-+�."14'J . Email: e Y Ib1MLs4Smaj.Q,Qw,...
APPLICANT*:V114v pb•1114120%,. 1&p yW,� Mailing Address: 14I1I0 RAYl1'3 ,'5')St,l' qt, �5
City: .C.TTP ty to- State: - Zip:B% II Contact# 91D`t01'Ssos Email:'/; ,(1%ir
*Please fill out plicant information if different than landowner J (I
CONTACT NAME APPLYING IN OFFICE: LL�t� Phone# ,/
PROPERTY LOCATION:Subdivision: MA-4 IStk `lck-e-s+ Lot#: 12 Lot Size: •�l(oq -L°
State Road# State Road Name: n [�1-� c7 Map Book&Page: .1610/ 19
Parcel: IDplo d 5(1 rI `: O�j t 0 1 l PIN: `1 5 L 1– t t —-31 ( 1 . OO 6 /►
Zoning`�►� Food Zone: X. Watershed:_ Deed Book&Page: 63739/ 6 71 I Power Company*: O/14( (
*New structures with Progress Energy as service provider need to supply premise number `– from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
Ne al Lt.) ±4 ��m� — �- ort'a 11' — L.t.si >"+o
5 4-oc k INAav4s4} Dw\ - L -131 ue - Lcsf a-•... r t -
PROPOSED USE:
1 1 2S .25 Deck:❑ SFD:(Size 9LD x�� )#Bedrooms. #Baths:_Basement(w/wo bath): Garage Deck: Crawl Space: Slab:_Slab: /1�r
(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
O 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: X County Existing Well New Well(#of dwellings using well )*MUST have operable water before final
Sewage Supply: X 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 A)no
Structures(existing or proposed):Single family dwellings: . Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum As Actual 40
Rear 2.5 99,2
Closest Side )ti 3 3
Sidestreet/corner lot
Nearest Building
on same lot
If permits are granted I agree to c form t all o . •s�•s and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
�,
I hereby state that foregoing st ents e • ancLporrect to the best of my knowledge. Permit subject to revocation if false information is provided.
ignature of Owner or Owner's Agent D to
**This application expires 6 months from the Initial date If permits have not been issued**
A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION
I
1 I FUND SETBACKS THIS SURVEY IS OF AN EXISTING PARCEL OR
PO=PORCH OF LAND AND DOES NOT CREATE A
///,/ P=PATIO FRONT 35� NEW STREET OR CHANGE AN EXISTING STREET.
o Sw=SIDEWALK SIDE 25'
DW=CONC DRIVEWAY REAR 10'
ED=LLECTRIC BOX SIDE STREET 20'
STOCK MARKET DR ScO=CLEANOUT
Z / A SHAWN T. RUMBERGER, PLS L-4909 DATE
L.
LD TP=TELEPHONE PEDESTAL
M X HEIGHT 35;
w wM=WATER METER IMPERVIOUS AREA THIS MAP IS ONLY INTENDED FOR THE PARTIES
FIFTY CALIBER DR Ac=AIR CONDITIONING UNIT HOUSE 1,829 SQ.FT. AND PURPOSES SHOWN. THIS MAP IS NOT FOR
BOC=BACK OF CURB
EOP=EDGE OF PAVEMENT DRIVE 699 SQ.FT. RECORDATION. NO TITLE REPORT PROVIDED.
STRIKE EAGLE DR WALK 72 SQ.FT.
o IRON PIPE FOUND
ti IRON PIPE SET 0 NAIL SET TOTAL 2,600 SQ.FT.
VICINITY MAP (NTS)
SITE PL AA/fN!! �A PO OV Al_ 64) /
f\IC,'fCC 1
zl 4, Ls .04__
o Admu s ra'Jr or
il
1 1931
I I ,_.
I I
S 89°31'33" E -- 186.25'
I CO
z 7 o
r o N
Ii o D Cil C ∎---•
-<
rn
Cil
43.0' I 92 P -I
I - 44.00' ! U1
CJi 0 rn O
_ Iii I3 20,000 S.F.
c — s.ao' 0.46 AC. m D
co
r- I I 2. q $
z
to 0 40.0' 41.00' 99.2' _ —
.O I i00 1 °o Z
-I
U1 I Cn
:U U1 I j W 0
rn I 4; 0
`-
m
S 89°8'43" W 186.26'
I I
X /
91 )
GRAPHIC SCALE I
40 0 20 1 I
I
P R E L I M I N A R Y
1 inch = 40 ft. P LOT PLAN
C pRoJEcr: FOR
GRH 15-009 GARY ROBINSON HOMES - E C L 5
DRAWN BY: APS BLUE CHIP COURT � ` G L O B A L ig; LOT 92 MARKET PLACE SUBDIVISION U.S. VETERAN-O WNED
1 '`�0 BARBECUE TWP., HERNETT CO., NC za7 FIBN DRIVE
ATE: P.B. 2014, PG. 199 ANODE R,NC 27501
11-5-15 910.0 97.3367 ecuolwc.co., Y1 0.6°7.333V Irwxl
Harnett County Central Permitting 14—$& 341k 1G
Each section below to be filled out PO Box 65 Ldlington NC 27546
910 893 7525 Fax 910 893 2793 www harnett org/permits
by whomever performing work
Must be owner or licensed
contractor Address company Application.for Residential Btu ldina and Trades Permit
name&phone must match
Owners Name • c4...e_¢,,, 11
^I-015.,y4 Q �•�V V Date `U l IS
Site Address Z°d $1Lk_g aki.40 Phone 910-'K 1- SsQ5
Directions to job site from Lillington C70 KJ J --q 0 k D `� R, A
41).V. ` c.\- o"hA)o •
■. •
Subdivision M 0.r d ?leue,tG Lot 9 P
Description of Proposed Work 5,4 4,4 ,4 #of Bedrooms Y
Heated SF 19114, Unheated SF 4 at4 Finished Bonus Room? Crawl Space Slab x Mon o
General Contractor Information
Gar 6%n-aerrt o w, eS I U!.. 910 ,- 1 X1'1 ..9,'5(e t,
Building Contractors Company Nellie Telephone
L// '-/0 Ri ens,e 3t"-, u IIS 11(11.41.c,\n,',rrsar% oines b6.4,00.,.
Address Email Address
ipas
License #
glectricel Contractor IrJformatlon
Description of Work N«14) (10eviokkl wc.tA aw. Service Size .od Amps T-Pole i _Yes No
Tau�ord Elec r',�, 9/0-- `NISI- 09c1
Electrlaal Contractor s Company Name Telephone
949 PAn 1)r, i 1\4142 'Nokks, �,43 (4, 4.1+ua.0
Address Email Address
It 169 -1--
License#
Mechanical/HVAC Contractor information
Description of Work 5 ', n 3 (Q, VA im ly IJ R w r a t
Q1. '� '►� * , ��. , f �•= ti `u - cito - `bSet -4(000
Mechanical Contractors Comp- y Name Telephone
12)0x I b'1 I , No ks a w .6y r VIOmQSQ• Ce-n,
Address Email Alidr6rss
H50,1 9,0011_
License#
Elumbmg gatim cy lifof .gtiol
Description of Work #Baths 4-
i e.11 14ctAr.g. Ply+•n0b',n 6)10-'171- 99 Si
Plumbing Contractors Comp�ny Name Telephone
P 0%14, u Soy% A50"a, uftvo• n Que 4.504 os.toi k',nato le,a Pte¢ r 't2',
Address Email Addres
'zy got p -i
License#
Insulation Contr`aaor Information
G- Ada Ar—La LJ'rl! Y1 0 ' ; ,t� - 1 45'cie. ------ 9/0- 4-0/-i S
Insulatio Contractors Company Name : Address 115 Telephone
ti/^e 01 jra )10e215ii
*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 pv sigma below I have obtained all subcontractors
permission to obtain these permits and if a_y changes occur including listed contractors site plan
number of bedrooms building and trade plans Environmental Health permit changes or proposed use
changes I ce 'y it is my response• ty t• notify the Harnett County Central Permitting Department of
any and all c/nges
EXPIRED • - -MIT F S -6 on o 2 years permit re-issue fee is$150 00 After 2 years re-issue fee
is as per .rrent fee ched
Signature o Owner/Contractor/Officer(s)of Corporation Date
M 111 IS
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
a� 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
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 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 Name V
v��s� /1isGGC
Sign w/Title � j PrvS`�,_,,.;�� Date If I f t j5
-I
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 11/06/2015
Entry #: 377734 Initially filed by: po39quinn
Designated Lien Agent Project Property
Print & Post
Premier Land Title Insurance Company Lot 92 Market Place
38 Blue Chip Court ❑crl v ❑
Online:www,liensnc.com „ Bunnlevel,NC 27505 ?•.-3
Harnett County
Address:19 W.Hargett St.,Suite 507/Raleigh, •••,�•� 1.
NC'27601 ❑ `T;13 •Phone:888-690-7384 Property Type Contractors:
Fax:913-489-5231 Please post this notice on the Job Site.
Email:gunoort(&liensnc.com... 1-2 Family Dwelling Suppliers and Subcontractors:
Scan this image with your smart phone to
view this filing.You can then file a Notice
Owner Information Date of First Furnishing wLien Agent for this project.
Trace Homes,Inc. 11/25/2015
3857 Legion Road
Hope Mills, NC 28348
United States
Email:patsy.grhomes(czgmail.com
Phone:910-987-1789
View Comments(0)
Technical Support Hotline:(888)690-7384