DOCUMENTS Initial Application Dale: Sia(-0) I r7 Application# I '1 SQ2 `k /T`•I c
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
1��,TCCentntr`al✓P�errmitting1-yt-,'��I1008 E. tont Street,Lillinglon, C 27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.harneti.arglpermits
"A RECORDEDSOR/EYIAA , ECOR D DEED(OR OFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
‘341E,4 Wynn Construction, Inc. 2550 Capitol Dr.Ste 105
Mailing Address:
City: Creedmoor Stale:NC Zip:27522 Contact No: 919 603-7965 Email: edward@wynnconstruct.com
APPLICANT*:Edward Averett Mailing Address:2550 Capitol Dr. Ste 105
City: Creedmoor State:NC Zip:27522 Contact No: 919 603-7965 Email: edward@wynncons(ruct.com
'Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE:J. Edward Averett Phone#919 603-7965
Avery Pond Lot#: 7 -Lot Size: O
PROPERTY LOCATION Subdivision: 11 {� Z /
State Road# p3�� _State Road Name:
_ '' ue _ Poll d Lr• Map Book&Page: 20/Ll aof
Parcel: �y 0 O t0.53 0029, - y(f PIN: 0(05-43 636 - z/03000
Zoning: 11 30 Flood Zone: r� Duke Energy
X WatershedA � Deed Book B Page: � I7� Power Company:
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
40 420 ys tar✓ ✓ Slab n1
lif SFD:(Size x )#Bedrooms. #Baths:Z' Basement/^ryn bath): Garage: ✓ Beek: Crawl Bpace: Slab: Slab
(Is the bonus room finished?(✓)yes -, no w/a closet?( 1 yes ( )no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms_#Baths_Basement(wlwo 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:
U 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: I 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 U no
Does the property cont asements whether underground or overhead( )yes ( )no
Structures(existing o propose ' ngle family dwellings: \ Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual_
V&
Rear
25 ZNb y
10 Ii y Closest Side
Sidestreegcorner lot 20
Nearest Building
on same lot
Residential Land Use Application Page 1 of 2 03111
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: From HCCP right onto 210 Hwy. 3 miles, Left on 401 Hwy.for 15 miles
Left on Chalyheate Rd.for 1/8 mile,Avery Pond on the left
If permits are granted I agree • onfor to. ordinanc-. -rid laws of the St e orth Carolina regulating such work and the specifications of plans submitted.
I hereby state that forego) i tome. !accurate • orre to the be knowledge. Permit subiect tor§cation If false information is provided.
rldor - , � te
• tura of Owner o wner'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
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NAME: •vy/N Iiiifn&7os/,Zrfc - 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 1N 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)
910-393-7525 option l CONFIRMATION#
Environmental Health New Septic System Code 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.
• AU 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 he ranked in order of preference,must choose one.
{_} Accepted {_} Innovative (JConvendmral ( ) 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 VINO Do you plan to have ani�t r system now or in the future?
{ }YES (_}N Does or will the building contain any drains?Please explain.
( )YES ( )N Are there any existing wells,springs,waterlines or Wastewater Systems on this property?
(—}YES ( Is any wastewater going to be generated on the site other than domestic sewage?
{ }YES {i/NO NNO 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 {�O 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 Underst h I m Solely Resp Bible For The Pr tiheation And Labeling Of All Properly Lines And Corners And Making
The a asst So at A Co etc S. valuati rarmed. S I /n
RTY OR OW S LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE`
10/10
naaataaa•
CcwwapaldA/llues
AGREEMENTFOR PURCHASE AND SALE OF REAL PROPERTY
1t �
nenuon,North Carolina Association
of REALTORS'
TSS AGREEMENT,including any and all addenda anacbed lwieta("Agreement"),is by and between
ROM Conatructien, Ino
.(n) NA ("Buyer"),and
(individual or State of formation end type of entity)
Little Cream, LLC
a(u) - ltn ("Seller").
(Individual or State of formation and type of entity)
FOR AND IN CONSIDERATION OP THE MUTUAL PROMISES SET POEM HEREIN AND OTHER GOOD AND VALUABLE
CONSIDERATION, WE RECTUM' AND SIIPPICIE•NCY OP WHICH ARE IFd1BB'Y ACKNOWLEDGED, THE PARTIES
HERETO AGREE AS POLLOWS:
Section L Terme and Defultioae:The retina Betel below shall have dm impactive rearming givnu them as oat forth adjacent to ouch
tem.
(a) "Pmn$riv"((Addman)Plane 1, Ann Pond
Lot I - 35, 67, 60, 60 end 70
Plat Reference:Lot(n) AA ,Block or Section Phase 1 ,as ebowu on Plat Book or Slide
2016 et Page(e) 141-142 , Harnett County,omitting of 354/- mane.
If Ebb box is checked, "Property" ,boll mean that propony described on Exhibit A attached hereto and incorporated
herewith by inference,
(Por Information purposes:(i)the tax parcel number of the Pmpexty is: 0653-36-6553
and,(R)soma or all of the Property,couoiatlug of aptnExlmomly 35 acne,is deaeribed in Deed Book
3320 ,Page No. 900 - Harnett County)
together with all bu ldingo and Improvernente thereon and all fixtures end oppurteuoncee thereto and nit pemonni property, if any,
itemized on DehthltA.
$ 81,170,000.00 (b) "Pardon Nee"nbnll mem the munof Ono Million, One Hundred Seventy
Thauennd �__._.Dollen.
payabl on thefollowing tome:
g Aa (i) "Env at Moats"shall mann _ Dullruu
or terve as follows: RA
Upon Dia Agreement becoming n meted in accordance with Section 14,the RarnnE Money shall be
promptly deposited in esmnw with . RIt _ (name of
pemonlentity with whomdoom /led),to be applied ea part payment of the Mahan Prim of the Property at
Closing,or disbursed no agreed upon under the proviuona of Section 10 herein.
Page 1 of S
77Ja 5otsaJuinay approved byy: STANDAADFORM 500.7
NorthCaralloaBar AnodWon Revl d 7t2013
North C.ardloa�'Ax�a,�eoda0on of REALTORS®r ` 07/5015
BuyerTilale Jaa1O _ Seller Initial, J
lena<ssmcpaanWne,mu.,em;:r, C2rsn mm�aaaum rt maaa4Ie Anvft;
Unk flAnd,rmarrommay4ILc s mem en<enes OUth v..aeNipn<aa2 r-- -
THE NORTH CAROLINA ASSOCIATION OF REALTORSab INC.AND THE NORTH CAROLINA BAR ASSOCIATION MAKE
NO REPRESENTATION AS TO THE LEGAL VALIDITY OR ADEQUACY OF ANY PROVISION OF THIS FORM IN ANY
SPECIFIC TRANSACTION. IF YOU DO NOT UNDERSTAND THIS FORM OR FEEL THAT FT DOES NOT PROVIDE MR
YOUR LEGAL NEEDS,YOU SHOULD CONSULT A NORTH CAROLINA REAL ESTATE ATTORNEY BEFORE YOU SIGN
IT.
BUYER: SELLERI
Individual IndWool
awe: tw,t,t1; ,
Ditto:
Enatoesu Entity DosInew Entity
eon Construction, Xnb
Nam of Entity) —r
onto ?Entity)
—ra
r
Nam:
Tido:
Dote: Ice- 57- 1.42_ Data: 6/27/7
The andareigned hereby acknowledges receipt of the Earnest Monty eet forth Weds and agrees to hi:think'Earnest Money b
oorrarlanot with Ike tame Tweet
(Narrm:n'ITclit'a)
Page of 8
STANDARD FORM SlabT
Regaled 74013
C 7/2015
Prottoul Wei zipironra by 21pLctlx 113070 Phan MUD ROW,Frame,UIcI,I0tii owe .flart.8811.oah Avery Pond
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on'. 0511712017
Entry#'. 954192 Inigally filed by wynnhomes
Designated Lien Agent I Project Property !Print & Post
'InvestorsTale Insurance Company seempond rvb3' is ooluLW2 Es �
317 every Pond de I
-11
OnlInr .Iceae _ 1u y me,NC 27526
Address19 W.Parma at /Raleigh NC Emmett County !� -
27631 Cent!actors:
nem'SIM 690 Tea !please post this notice on the tub Sae
jec,517Agg5121 Properly Type Suppliers IS L nntmetor.
Scan ths image withyour smart phots to
view this thing.You can then Me a Notice
1-2 Fen*Dwelling to I Agent for Nis protect
I Owner Information
wynnhomcs
2550 capitol dr.
cretalmooy NC 27522
United States
Email.nancy®trymlmnes.core
Phone:9195281347
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'Ceclrnithl Support Hotline:(538)690.)384
Harnett County Central Permitting /7930 Y/7 /Q
Each section below to be Oiled out PO Box 65 Lillmgton NC 27546
8105937525 Fax 9j08932793 www hernett org/permits
by whomever performing work
Must be owner or licensed
contractor Address company Application for Residential Building and Trades Permit
name 8 phone must match ''-- `` �t J
Owners Name Wt1na/��Cs4.STrj,�-.};anJ ''ttNC. Date
Site Address 3N'7 !TUe,r./y TOA/4 Dr Phone 9/9403-79L,�
Directions to lob site from LlUngtan` Mot NedPr�r;gk/�to Z-IolhJq 3a'ICs Leff aN 90//idyl
4or ISMit \ ke/-4koN C1\ahybe34e. K-d for YRM:le , hoer, Por.rdnAl /eg,
Subdivision % er/ &4S 1 Lot a y ?-
Description of Proposed Work Neu) L./nr oastruelcoy✓ - Sit #of Bedrooms b
Heated SF 2027 Unheated SFFinished Bonus Rcom9 N Crawl Space ✓ Slab
eneral Contractor Information
U)q \ elk 44rU.et;erl ntO, 919 603 . 7y6 c
Butlding Contractors Company Nalne Telephone
24-Sola N401 f. Ste /03 Crea/..Ordt 2322 PL(rc9rleti 44ho,.es.Caat
Address Email Address /
/AZ's
License#
Elect cel Co ltrac olisfsamAkom
Description of Work Neuf Comp/nit i0n1 Service Size 4200 Amps T-Pole _Yes_No
Q.. A. Tac csonl r/ea4hr t 9/9' 730- /Zs/
Electrical Contractors Company Name Telephone p
92-U [akigkA. 1verlsed, NQ'- 275-Dti
Address Email Address
2/ 1 y I
License#
echanicalAC Contractor Information
Description of Work 41e& Cl VA15 meet
(Iert:4Zei . KFea-f antd. A- 9/0 8S8-ODoO
Mechanical Contractors Company Name Telephone
7?l5aasetLeke�/. 440- -24L/1/C x8357
Address Email Address
/I(CZ002/2 /13 bassi
License#
b n Coit cto o Information
Description of Work I ea, 4,4-1 #Baths .2. .-
Tra7�Ars ' lYaraIin9 9/95-sO. 033
Plumbing Contractors Company Narita Telephone
3/(0o-A- Oharkd. elaybg Nt Z73-27
Address Email Address
zz/sz
License#
Insulation Contractor Information pp
TfaM ,.754/27-5oi W9t0/0/-09/ l
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 signing below I have obtained all subcontractors
permission to obtain these permits and if gay 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 FM-6 Mon s to 2 years permi e-issue fee is $150 00 After 2 yearssrre-issue fee
is asp Curren a hedule !
ig lure of Owner/Contractor/Officer(s)nee/ of Corporation Date ' /
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
General Contractor Owner f 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
/ as 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
Hs one (1)or more subcontractors(s)who has their own policy of workers compensation insurance
covering themselves
Has no more than two(2)em ployees and no subcontractors
While working on the project for which this permit rs 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 Nam r RIAs lis/S>`rEaii tad/ C'
Sign Willie / / _ /U / ; r— Date /7
DO NOT REMOVE!
Details: Appointment of Lien Agent Flied on: 0611,12017
Fntry#'. 654192 Initially filed by wynnhomes
Dee Innate(' LI en Agent '. I Project Property 1 i Print & Post
Investors rl Insurrnce Company r pond solativiston W/012 4 0
31]every p
vryV AA.
1151155 5525'I 137 ,NCPS?6 <
macro.19A throat 5i anie507/Raleigh NC ostriett Co tly I ar di2130I '
ICm,nactors:
Phone AAA SO 13114 Please post this notice on the lob Site
Pu:211789 5221 Property Type Suppliers nail 6nbeene aelms.
ll ypwnflicn mn 19 ISaari thision magewihyourmoan phone to
view this Nina Ycando file Notice
1-2 Family Dwellingi
tolen Agent for his pje
Owner Information
ioninithootes
2550 capitol dr.
creeihnoor. NC 27522
United Stales
Road B nancy@ annhomescorn I
Phone 919528-1147
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