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DOCUMENTS Initial Application Date: 45"--.56 Application# l SCO4 IS] 3 COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION CU# Central Permitting 108 E.Front Street,Lillington,NC 27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.hamett.org/permits **A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION** LANDOWNER: -� CAs)at2 �t;6ryaj Mailing Address: 3(4Ly 144,417 301 S City: t"JL h/1 State:/IC. Zip:1833YContact No: Email: `! 661`! (,d Cow (tot APPLICANT*: IPU��,t.! I �� Mailing Address: City: Pptin/1 State:Zip: 3( Contact No: gib-n.9-'1??Email: itivichoI bpi iti�,y6' *Please fill out applicant information if different than landowner evnb AL-&it'A,I.cowl CONTACT NAME APPLYING IN OFFICE: - i*'1f'UliA) I y �' I Phone# ch 6 -z.s Pi-y73`7 PROPERTY LOCATION:Subdivision: Lot#: Lot Size *SW)C.* State Road W/ -,11 State Road Name: 0. 36 ) Map Book&Page:35-OZ/ 0157 Parcel:Q !9/ 4 6( (4.22 PIN: 1SD1-1 -81- 0ID71.06 Zoning.�Slood Zone: X. Watershed: Deed Book&Page /157 Power Company*: *New structures with Progress Energy as service provider need to supply premise number from Progress Energy. PROPOSED USE: D SFD:(Size x Monolithic )#Bedrooms: #Baths:_Basement(w/wo bath):_Garage:_Deck:_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_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: W Addition/Accessory/Other:(SizeI an)Use: U4 S cYL�'1. .�� Closets in addition?(_)yes (_)no Water Supply: County Existing WellN ew 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 (_)no Structures(existing or proposed):Single family dwellings: ` R{,..A" Manufactured Homes: Other(specify): \ A 1 e a{4 • 141 no - Required Residential Property Line Setbacks: Comments: : A ••-•, • , P'UP.4* Front Minimum S Actual 9 S -rno,,,I Lt X4 • ift. 16 X ZD Rear p" - • Closest Side J( `0C- Sidestreet/corner lot Nearest Building - on same lot Residential Land Use Application Page 1 of 2 0 3/1 1 APPLICATION CONTINUES ON BACK SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 4'a 5 POUiir it''oti . D!t' 30/ 50&& 7'64Abod y•5- /27 deho€rje ovl If permits are granted I agree to conform to all ordinan .-s an• la•s• e State of North Carolina regulating such work and the specifications of plans submitted. I hereby state that foregoing statements are accu • f `t• best of my knowledge. Permit subject to revocation if false information is provided. 4ii5-3D-/7 Signature it 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 03/11 NOT FOR LEGAL USE G) V) < rn • NI I f 1.4 0 v s. • .9 vo c. ille s',.., '''''',...,...k. 1 I 1111 --,...Nor N r R 3 oIn a .1- , C a co Z A n ,111 if CD ik < 2 `If © CD 33 I- -, w i S °m P k T a - o a G1 MD N U tI oitib �. /^, o I *ss t po su o ad a • a U1 ji CI CD ip • / 4e#,.. D7 CD 1111W • • I o „�,.., -,,,, 0 5. 7 F, c !/S..2 N °lit s n s. N r o - L4 & i + r+ n + 0 r Appraisal Card http://cama.harnett.org/AppraisalCard.aspx?Parcel=021504 0043 HARNETT COUNTY CAMA WEBVIEWER 5/30/2017 3:57:07 PM JOHNSON CASPER BRENT JOHNSON CANDACE ALTMAN Return/Appeal Parcel:02-1504-- Notes: -0043 3964 US 301 S DUNN 28334 PLAT: UNIQ ID 1500023087 / 223022 ID NO: AVERASBORO RESC ADVALOREM TAX(100),AVERASBORO SCH ADVALOREM TAX(100),COUNTY WIDE 1504-87-0621.000 ADVALOREM TAX(100),DUNN/AVERASBORO FIRE ADVALOREM TAX(100),SOLID WASTE FEE SOLID CARD NO.i or WASTE(1) 1 Revel Year:2017 Tax Year:2018 8.584ACS A F POPE HWY 301 8.600 AC SRC= Appraised by 14 on 01/01/2017 00200 AVERASBORO RURAL SOUTH LAST ACTION TW-02 CI-FR-EX- AT- CONSTRUCTION DETAIL MARKET VALUE 20170508 Foundation-3 DEPRECIATION CORRELATION OF VALUE ER' BASE IStandaro 0.3700 Continuous Footing 5.00 USE MOD(Area !QUAL] RATE I RCN EYB I AYB Sub Floor System-4 50 01 2,159 121 81.07 177229 1980 1967CREDENCE TO MARKET P pod %GOOD 163.0 DEPR.BUILDING VALUE-CARD 111,650 9 Exterior Walls-21 00 DEPR.OB/XF VALUE-CARD 2,000 TYPE:RURAL HOME SITE SINGLE FAMILY RESIDENTIAL MARKET LAND VALUE-CARD 39,910 Face Brick 35.00 SME: 1-1.0 Story TOTAL MARKET VALUE-CARD 153560 , Roofing Structure-03 TOTAL APPRAISED VALUE-CARD Gable 8.00 153,560 Roofing Cover-03 TOTAL APPRAISED VALUE-PARCEL 153,560 Asphalt or Composition 3.00 TOTAL PRESENT USE VALUE-PARCEL 0 Shingle TOTAL VALUE DEFERRED-PARCEL 0 Interior Wall Construction-5 TOTAL TAXABLE VALUE-PARCEL 153`60 Drywall/Sheetrodc 20.00 PRIOR Interior Floor Cover-14 BUILDING VALUE 99,100 OBXF Carpet 6.00 LAND VALUE 2,000 Heating Fuel-04 LAND VALUE 42,690 Electric 1.00 PRESENT USE VALUE 0 Heating Type-04 DEFERRED VALUE 0 Forced Hot Air(FHA-Ducted 4.00 TOTAL VALUE 143,790 Air Conditioning Type-03 PERMIT Central 4.00 CODE I DATE I NOTE I NUMBER I AMOUNT Bedrooms/Bathrooms/Half- ROUT:WTRSHD: Bathrooms SALES DATA 200 12.000 OFF. _ Bedrooms RECORD DATE DEED INDICATE SALES BAS-3 FUS-0 LL-0 BOOK PAGE MOYR TYPE Q/W/I PRICE _ Bathrooms r 03502 0157 5 2017 WD Q I 142000 BAS-2 FUS-O LL-0 00492 0170 2 1967 WD D V 0 Half-Bathroons HEATED AREA 1,867 BAS-OFUS-0LL-0 +- 12--+ NOTES Office 1 F S P I 2024 SAS-OFUS-OLL-0 0 0 0 TOTAL POINT VALUE 1107.000 + 2 9 +- 1 2--+ 3 0 +-1 0-+ BUILDING ADJUSTMENTS I B A S IFST I Quality ` 4 (Above Average 1.1000 I 7 7 Market I 3 Factor 3 1.0500 I +- 1 1-+- 1 0-+ Size Size Size 0.9800 I IFGR I TOTAL ADJUSTMENT FACTOR 1.130 I I I TOTAL QUALITY INDEX 121 3 1 I 1 2 2 I 2 4 I I I I I I I +-9-+ 26 + I +- - - -25 +STP4 +- - -21- - --+ SUBAREA UNIT ORIG% ANN DEP % OB/XF DEPR, TYPE GS AREA % RPL CS CODEDESCRIPTIONCOUNTLTHWTHUNITS PRICE COND BLDG#AYB EYB RATE OVR COND VALUE MS 1,867 100151358.01 STORAGE 0 0 1 2,000.00 100 19751975 55 100 2000 FGR 504 040 1637E/TOTAL OB/XF VALUE FSP 120 040 3891 2,000 FST 70 050 2837 STP 36 020 567 FIREPLACE 3-1 Story 2,200 Single SUBAREA 2,597 177,229 TOTALS BUILDING DIMENSIONS BAS=W42FSP=N10E1251oW 12$W29S31E25N2E9STP=S4 W9N4E9$E26N22E11FGR=E10524W21N24E11$FST=N7E1057W 10$N7$. LAND INFORMATION HIGHEST OTHER ADJUSTMENTS TOTAL AND BEST USE LOCAL FRON DEPTH LND COND AND NOTES ROADLAND UNIT LAND UNT TOTAL ADJUSTED LAND OVERRIDE LAND USE CODE ZONING TAGE DEPTH/SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE VALUE NOTES HOME PAVD 5010 RA-30 0 0 1.0000 0 1.0000 20,000.00 1.00 AC 1.000 20,000.00 200001 0 TOPO ROLLING FRST I PV 6111 RA-30 0 0 1.0000 0 1.0000 5,000.00( 3.58 AC 1.000, 5,000.00 17900 0 WASTE LAND 9600 RA-30 0 0 1.0000 0 1.0000 500.00 4.02 AC 1.000 500.00 2010 0 TOTAL MARKET LAND DATA TOTAL PRESENT USE DATA 8.600 39,910 1ofl 5/30/17,3:57 PM NAME: )4l01 0 i 114d4411 APPIICATIUN#: *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 SHALL 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) 910-893-7.525 option 1 CONFIRMATION# Environmental Health New Septic SvstemCode 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 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 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 given at end of recording for proof of request. • Use Click2Gov or IVR to verify results. Once 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 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(s): can be ranked in order of preference,must choose one. {_} Accepted {_} Innovative 1_} 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? {_}YES {1 NO Do you plan to have an jq,gation system now or in the future? {_}YES {!1 NO Does or will the building contain any drains?Please explain. {4ES (_)NO Are there any existing wells,springs, waterlines or Wastewater Systems on this property? {_}YES {yf NO Is any wastewater going to be generated on the site other than domestic sewage? {_}YES {101 0 Is the site subject to approval by any other Public Agency? {_}YES { ✓rNO Are there any Easements or Right of Ways on this property'? {_}YES { IZN-0 Does the site contain any existing water,cable,phone or underground electric lines? 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 Necessary Inspections To Determine Compliance With Applicable Laws And Rules. I Understand That I Am So ' - 'espon•y F r T. "'roper Identification And Labeling Of All Property Lines And Corners And Making The Site Accessible 1 ' at A Com, 'S'' F .ation Can Be Performed. 0 PROPERTYO t OR OWNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE�_� 10/10 09/09/11 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 harnett org/permits by whomever performing work Must be owner or licensed contractor Address company Application for Residential Building and Trades Permit name&phone must match nM --�—I - % Owner s Name (_ p 4 U t;kvDate 530-17 Site Address 3/61-1 ry 3o1 ( toljkl Phone Directions to job site from Lillington /1 -)pike yZI S e'cAti 1,e-r4-0ii 301.5 -hw A,A Food Lai hofitht.ttme e . d'o X a g /e p045/ erect/ab:de) hc,— ph ,tfj/. bersxc fiord Subdivision Lot Description of Proposed Work e—ep.14.6d e,t #of Bedrooms Heated SF Unheated SF Finished Bonus Room') Crawl Space Slab General Contractor Information �vitn,>�_ AAA/I 7 rti I j"X-eve. 61)0-e-3?-cfz37 Building Contractdr s Company Name Telephone /15/q h/i'o ce eae Va,ih h/C' 2733V .rid .,/".es//Ie'm 4,1_,ams 4,I*Cook Address -Etail Address License # �7 // lec rical Contractor Information Description of Work' , ed° _disc T Service Size v?60 Amps T-Pole _Yes i o /Clo, rs f/P °� 919— 9oa- 49S Electrical Contractors Company Name Telephone o?77 t3 ensew 14-Pudee Beieveli Address Email Address Oasis& R905?(— License# Mechanical/HVAC Contractor Information Description of Work ah pub kt4 -Reit51.i 9/ayzV Mechanical Co actor s Company Name Telephone e2 C Address Email Address License# //Plumbing Contractor Information Description of Work 'glcylb 1i j7.Ie /4 3.4 #Baths cR ►n!e 51 VA,le9/9'- Vee Plumbing Contractor s Company Name Telephone 3619 'p/Afw//c i L'�u i y4i/ ,ce Address ( Email Address Q19a 9 0/145.5 License# Insulation Contractor Information �1 ,ire€ io4 s Wail r4- Insulation Contractor s 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 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 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 F - -6 .on ,s • 2 ars permit re-issue fee is$150 00 After 2 years re-issue fee is as per current fee -chedule // Signature of Ow • •• tractor/Officer(s)of Corporation Date 5730/r2 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 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 Ket)/1-.) " �� Company or Name ✓1 1&11 '1 d€ l3C_ Sign w/Title �sl�i q Date 5-,3d--17