DOCUMENTS Initial Application Date: x"kj C/1r7 Application# .5E t J1f II9C)
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108�E./F1ronntt Sttree�tLill�ingtoon,NC 27546 Phone'. (910)893-7525 ext:2 Fax:(910)893-2793 www.harnett org/permits
13 x'A RECORDED SURVEYMAP,RECORDEDDEED(OR OFFER TORCHASE)A SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION'•
Comfort Homes, Inc. Mailing Address:P O Box 369
City: Clayton State:NC Zip'27528 Contact Na: 919 553 3242 Email: comfrthomes@aol.com
APPLICANT':Comfort Homes, Inc. Mailing Address:P O Box 369
City: Clayton State'.NC Zip:27528 Contact No'. 919 553 3242 Email: comfrthomes@aol.com
'Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE:Julian Stewart Phone#919 422 1481
PROPERTY LOCATION:Subdivision Oxford Woods Lot#:6 Lot Size' .626 acre
State Road#1006 State Road Name: Old Stage Road N Map Book&PageI HDR / Q 14
Parcel. 040692 0017 16 PIN: 0682^-98-564[3.0`00`^t
Zoning:RA-30 Flood Zone: x Watershed'. IV Deed Book&Page'. a�ll�4,y / 35a. Power Company: Duke Progress Energy
'New structures with Progress Energy as service provider need to supply premise number from from Progress Energy.
PROPOSED USE:
Monolithic
SFD:(Size 46 x 49 )#Bedrooms:3 #Baths.2 Basement(w/wo bath): Garage'. ✓ Deck: I Crawl Space: ✓ Slab:_Slab:
(Is the bonus room finished?( )yes (✓)no wl a closet?(i 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 (_J 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_t Use: Closets in addition?(_J 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) 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 (✓ 1 no
Does the property contain any easements whether underground or overhead(I)yes (J no
Structures(existing o •ro•ose• .Single family dwellings'.proposed Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual 70'
Rear 25' 66'
Closest Side 10 11
Sidestreeticorner lot n/a
Nearest Building n/a
on same lot
Residential Land Use Applicator Page l of 2 03111
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: NC 210 N;right on Benson Road; right on Old Stage; subdivision on right
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 egoing stat are a ate and correct to the best of my knowledge. Permit subject to revocation if false information is provitled.
caents Q __--. 3129117
Signature of Owner or Owner's Agent Date
^9t is the ownerlapplicants 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"
Re e nal Land Us,Aor.,ca.ron Paye 2 or'_ a_ II
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NAME: , C
x�" r , 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 APPLIC.AfION IS FALSIFIED.CHANGED,OR THE SITE IS ALTERED.THEN THE INIPROVENIENT
PERMIT OR AUTHORIZATION TO CONSTRUCT SHALL RECONIE INVALID. The permit is valid for either 60 months or without expiration
depending.upon documentation submitted- (Complete site plan is 60 months:Complete plat=without expiration)
910-893-7525 option I CONFIRMATION# _
Environmental Health New Septic SystemCode 800
• All property irons must be made visible. Place "pink properly flags" on each corner iron of lot. All property
lines must be clearly flagged approximately 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 atlfor 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
B00 (after selecting notification permit if multiple permits exist) for Environmental Health inspection. Please note
confirmation number(liven at end of recording for proof of recuest.
• Use Click2Gov or IVR to verify results. Once approved. proceed to Central Permitting for permits.
Environmental Health Existing Tank Inspections Code 803
• Follow above instructions for placing flags and card on property.
• Prepare for inspection by removing soil over outlet end cf 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 borne 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 request.
• 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 fs can be ranked in order of preference.const ehoa se one.
Ll Accepted I—I Innovative Ix{ Conventional I_-,I Any
II Alternative LI Other
The applicant shall notify the local health department upon submittal of thisi application if any of the following apply to the properly in
question. If the answer is"yes', applicant MUST ATTACH SUPPORTING DOCUMENTATION:
IIYES I—I NO Does the site contain any Jurisdictional Wetlands? W\\LCI c,++ (1
I_{YES I .) NO Do you plan to have an jpjga 'o c stem now or in the future?
LI YES { I NO Does or will the building contain any drains?Please explain.
I—IVES IBX1 NO Are there any existing wells.springs-waterlines gr Wastewater Systems on this properly?
(_IYES ( /1Y NO Is any wastewater going to be generated on the site other than domestic sewage?
Lyy AYES & NO Is the site subject to approval by any other Public Agency?
Irl YES (`')� NO Are there any Easements or Right of Ways on this property^
IL YES I }y' NO Does the site contain any existing water,cable.phone or underground electric lines?"'opNy@ SScet aelnS
ee
If yes please call No Cuts at 800-6324919 to locate the lines. This is a free service.
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I Ha%e Read This Application And Certify That The Information Provided Heflin Is True,Complete And Correct. Authorized County Md
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 Properly Lines And Corners And Making
'fht a eSoI at A 'am te Site Lsialuation Can Be Performed. (� (�
di el ' ._ ------------ ----_ - J-aQ•1-)
PROPERTY OWN
;it
OR OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE
10/10
March 29, 2017
Comfort Homes, Inc. has an option to purchase Lots 5, 6, 7, and 40 in Oxford Woods Subdivision,
recorded in Map Book 2008, Pages 214-215, Harnett County Register of Deeds.
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 29th day of March 2017.
Mar (Notary Public)
My commission expires 4/2/17.
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001001/1 Application#
Harnett County Central Permitting
Sem wmpn tibio b be MIM outPO Sox 05 UIbngton NC 21546
by whomever performing work 910 893'/526 Fla 910 sae 210.1 www Mrnett orghpehm6e
Must be s.iw orbowsed
L Irina ' Amina mrnpanr Aoohcatfon for Residential Building end Trades Pend
none 0 phone must maim
Owners NameeeQcc�L�Q\ " • s Date la`l(�
'V
Site Address %r,11/4".�e.1\� Le 16. A! • Phones\q-S59-934�
Directions to pb site from Lilhngton ♦v - a\Cl N C\O��t S. QR\��s. c2, (\'
's\C1 c•Ak-4% Qct
Subdivision V 1..<J<a• �1%.1Cf,`\\ Lot �L
Description of Proposed Work
1 g\-.: t S'S( Cafl% " 1 edrooms J
Heated SF \kd\\ Unheated SF ko Finished Bonus Room' Crawl Space Slab _
Gemini Contractor Information
c;:Nm "1/4\ 1/4"teln. -U1/4-NQ _ 0.\31/4-Ss5-3 �
Building Contractors Companx NaMe Telephone
5 - 3bq � 7 � comic\\cNocae» -(c10-0\
eocr�
Address Email Address
33\Ciy
License#
Electne!l Cgntrsctor Information
Description of Work •�..4. . 'S c Oui Service Sae 1;100 Amps T-Pole _Yes_No
S..svacce\a. _ Ck\L\- (kfts - osg9
Electrical Contractor s Company Name A Telephone
SOS ( S•.-S �tSaN'A% q4
Address e &M y15C- Email Address
aackaS- a-)S1Lin
License#
Mechanical/14VAC Contractor Information
Descnpaon of W orkrA'M \V<.c'(\ \O .ec t<\Sas c,v
- 3a.9-0\0 \„
Mechanics Contractors Company Name Telephone
Address ` \ Email Address
License#
Plumbing Contractor Information
Descnpbon of Works.,. a':tr c S. #Baths
C1/4mbingC\Z?torsCompa _ Q\q �'Y\-\'S2<
Plumbing^Contractors Company me Telephone
` 5 S \`w
Address a7;0Emahl Address
ao%-a
License#
lneulatlgn Contractor Intonation
Insulation Contractor s Company Name&Address V.at , 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 signing below I have obtained all subcontractors
permission to obtain these permits and if, y 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 PERMR FEES-6 Months to 2 years permit re-issue fee is$150 00 After 2 years re-issue fee
is as per current feee+sscchhedule
Signature of Owner/Contrraacto Ofhs)
cer( of Corporation Date aq`\el
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the \/
General Contractor Owner h Officer/Agent of the Contractor or Owner
Do hereby confirm under penalties of perjury{hat 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 work ars 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 nderstood 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 `'li tt�l.���]On�� \ �/�
Sign wflTe t„ -P._, ars \t. Date - ag-1 i
Appointment of Lien Agent: Details- LiensNC Lien Service https://apps.liensnc.com/scr/appointment/delails,html?entryNumber=...
DO NOT REMOVE!
Details: Appointment of Lien Agent Piled on: 03/28/2er17
Entry #: 626916 Initially flied by: ComfortHomes
Designated Lien Agent Project Property Print & Post
WF(i National Title Insurance Company Oxford Woods lot 6 1!il7.:
135 OXFORD WORDS DRIVE 97(91aN
Onl'me.www liemnccom i.p.,...,„,a,,, ANGIER,NC 27501 11'!1
Addreu:19 W Hagen Sr, uite FN()Weigh,NC I lames County
9601
Contractors:
Phone:88889A7187 Please posl this notice on Me lob Site.
Fa..93-489-523l Property Type
Supplies and Subcontractors:
[mail:yp�ma5ine r m..,..et Scall this image with your smart phone to
mew this filing.You can then tile a Notice
1-2 Family Dwelling to Lien Agent for this project
Owner Information
Callan Homes,Inc
P O Box 369
Clayton, NC 27528
United States
Fntail.condnhomcs^naol cont
Phone:9I0-553-3242
View Comments(0)
Technical Support hotline:(888)690-7389
•
I of I 3/28/2017 3:32 PM
�('� 'l I� Date LA Lac) -7
Plan Box# r l , �-i Job Name � j--� Htr YIQ1
App# 4-11 � Valuatioll S-41 CC SQ Feet 1/ l I
Garage ti 1 G
= 209-7
Inspections for FD/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
Foundation_
Slab_
Mono_
Open Floor_
Rough In
Insulation_
Final