DOCUMENTS Initial Application Date: 5 id LP/I•1 Application# in 7.-05 I L_
cu#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
1'�Cent/raalll Permittingmi .100.8{E..�Fronntt St eet,Lillington,� N 27546 Phone'(910)893-7525 ext:2 Fax:(910)893-2793 www.harnetLorg/permits
"N RECORbED /t�An1'HECOR ED DEEM OFFER TOO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
1rNtr•Wynn Construction, Inc. 2550 Capitol Dr. Ste 105
LA w rvtrc' Mailing Address:
City: Creedmoor State:NC Zip:27522 Contact No 918 603-7965 Email: edward@wynnconstrucLcom
APPLICANT':Edward AverettMailing Address:2550 Capitol Dr. Ste 105
City Creedmoor State NC Zip:27522 Contact No: 919 603-7965 Email: edward@wynnconstruct.com
'Please fill out applicant information it different than landowner
CONTACT NAME APPLYING IN OFFICE:J. Edward Averett Phone#919 603-7965196/
PROPERTY LOCATIOSubdivision: Avery Pond
N '-7
Lot#: / 'Lot,'%G Size:^' ' S a
State Road# State Road Name:_ e POA{ 1..)r Map Book&Page: �- 20/Parcel: p OSD10S3 ao2? ysff� 'PIN'. 0(053- .3b 6620 OO
Zoning: QA30 Flood Zone: XC Watershed:A• ( teed Book 8 Page: C-%-%7TP Power Company*: Duke Energy
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
I, A^ / ii UV / / Monncad.
0 SFD:(Size fW x WO)#Bedrooms: #Baths:2' Basemen(' w bath):_Garage: ✓ Beet Crawl Space:/Slab: Slab
Qs the bonus room finished?(#Z-yes , no w/a closet?U yes ( )no(if yes add in with#bedrooms)
O Mod:(Size x )tt 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 )8 Bedrooms: Garage: (site built?_)Deck: (site built?_)
❑ Duplex:(Size x )No.Buildings: No,Bedrooms Per Unit:
❑ Home Occupation:#Rooms: Use: Hours of Operation: #Employees:
O 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 (_)no
Does the property contain any easements whether underground or overhead(U yes ( )no
Structures(existing o roposed).Single family dwellings: ' Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
p6 '
Front Minimum 35 Actual_. /-
Rear 25 IV"
10 22.77
Closest Side
Sidestreellcorner 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 Chalybeate Rd.for 1/8 mile,Avery Pond on the left
If permits are granted I agree enter to ordinanc nd laws of the SI a odh Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoi s terve a accurate erre to the be knowledge. Permit surbiecl to r cation If false information is provided.
lure of Owner wner's Agent Date
"9t 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
t
INang NEimFaEE OM NAD u
t
E
g
T
v
AVERY POND
ORI VE so
0 <� p„KtbioNN11.3PD"E1 7, RAW
RR C a tI0.0• 1.4,i).
a'ZS'h .\
1 gI.
9 i v
19so
e $ 8 8 n
3 =
9 O -I
O
_12. 1
iri DisrRirr1Sli"F PLANK A��PPFii)V
A:
a,
Sir
G _y_l
lJ
-;E
% *BEDROOMS
2 .9%s -,rte aC
iji
6 P amr
$ $a ih
s {. i!0ii
g8
_ a8$
a
ni
1 Ix
NAME:19A4 o,14,47;' -ole ni&r - APPLICATION H:
*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 BECAME 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 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.
• 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 he ranked in order of preference,must choose one.
f I Accepted { } Innovative 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:
( }YFS /NO Does the site contain any Jurisdictional Wetlands?
{ }YES VI,/NO Do you plan to have an judgstion syslem now or in the futm'e?
(DYES {// rvSJ Does or will the building contain any drains?Please explain. _
( }YES (_jj NJ) Are there any existing wells,springs,waterlines or Wastewater Systems on this property?
{ }YES {/1//NO Is any wastewater going to be generated on the site other than domestic sewage?
{ }YES {'131O Is the site subject to approval by any other Public Agency?
{ }YES {/}NO Are there any Easements or Might of Ways on this property?
{_)YES {jO 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 llnderst. i Ir I sm Solely Resp. sible For The P'. - [Mention And Labeling Of All Property Lines And Corners And Making
The • ass • So ' at A ateS' .vnlueti, e ' 'armed. //•7
//is ,vii /
I , ARTY •'t ERS OR OW E'S LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE,
10/10
C i.mmerelilAlll.Rc.
AGREEMENT FOR PURCHASE AND SALE OP REAL PROPERTY
II MOOR North Carolina Association
of REALTORS&
This AGREEMENT,including any and all addenda attached haste("Agreement"),it.by mid between
Wynn Construction, Ina ,
a(n) NA CBuyer"),mod
(WBviduel or State offormminn cad typo of entity)
Little Ca,00, LLC _ ,
a(n) _ 1111 ("Sonar).
(individual or Sale of formstion and type of entity)
FOR AND IN CONSIDRRAIION OP THE MUTUAL PROMISES SET PORTE HEREIN AND OMR GOOD AND VALUABLE
CONSIDERATION, THE RECBBrf AND SUFFICIENCY OP WHICH ARE HEREBY ACKNOWLEDGED, THE PARTIES
mutant'AGREE AS FOLLOWS:
Section 1.Terme sad Demtidonu:The tams listed below shml levo the respective meaning given them as set form atjnouu to each
tenu.
(n) "Finatriv"((Address)Phalle 1, Avery Pond
Lot 1 - 35, 67, 60, 69 and 70 _.
PlatRe(erence:Lat(e) RA ,Block or Section rhes* 1 ,ON shown on Plat Book or Slick
2016 etPage(e) 1411442, _ aarn.tt County,eonai,Bng of 3St/- acne.
U If thio box is checked, "Property" almll mean that pmpedy described on EuhIbfl A attached hetero and incotporsted
herewith by Inference,
(For information purposes:(1)the tax parcel number of the Property is: 0653-36-6553 _;
end,(I)some or all of the Property,cousimlag of approximately 35 scree,is described in Deed Book
3326 ,Page No. 990 , Cornett County,)
together with ail buiblwgn and Improvements thereon end all future and appurtenances thereto and all personal property, if any,
itemised on Ethlhlt A.
$ 01,170,000.00 (b) "Bonham Price"nholl mean the mon of Ono Million, One Eundrod Barents
Mourns] —. —_.__..Donate,
pod a*die folloag krme:
$ _ la (I) "EarmstMonev"shallmnon _ Dollars
or terve eafollowi: RA
Upon this Agreement becoming n contract in accordance with Section I9,the Purnell Money shall he
promptly deposited in mans with , RA _ _(name of
person/entity wlm whom deposited),to ho applied as pan payment of the Pmchmm Price of the Property or
Mains,or&Mused au weed upon under the provhdona of Section 10 herein,
Page I of B
Tbk form JttiIy approved 67�: STANDARD FORM 560UT
North C.ralkaBar MaodWon Revksd 712013
,.y. illNorth Carolina of REALTORS®,I i 07/1015
Buyer While -30(o Seller Initials "/
MontanIllias13,4oymc.a ::
nn.n.WI mr,'warn mm nut twow, bisaix iton nwu au xwr"'ru,, IW*e amm > ss♦ Aim Mar
THE NORTH CAROLINA ASSOCNTTON OP REALTORS®,INC.AND THE NORTH CAROLINA BAR ASSOCIATION MAI@
NO REPRESENTATION AS TO THE LEGAL,VALIDITY OR ADEQUACY OF ANY PROVISION OP THIS FORM IN ANY
SPECIFIC TRANSACTION, It YOU DO NOT UNDERSTAND THIS FORM OR PEEL THAT IT DOES NOT PROVIDE POR
YOUR LEGAL NEEDS,YOU SHOULD CONSULT A NORTH CAROLINA REAL ESTATE ATTORNEY BEFORE YOU SIGN
IT.
BUM; SELLER!
Individual Individual
_ -- Date: ._
Ondmee Katy Dueled®Entity
Ceeattectinn Illg F¢L 1e C Talo t_ SLC ___....._ ..
—— Neem of Battey)
-- mu: of k!utity)
Nunio:
Title __. . .- .__.. file 64/74
_..._ //- --_. —_—
Data __. - --
Title- ---- - -- ---- ---- --
___ ___ _________ _ ________ __Date _7
The undersigned hereby admowlesldn receipt of the Earned Money set forth herein end epees to hold add Earn®Monty In
mordants with the tome beret
Nam::ntIra i)
Dam:w3. —__._.._—_____.___. By: e1P„ _
Page S of S
STANDARD FORM 51102T
Revised 7/2013
0 712015
pmdmed wim*Fon')hy aplopix ieoyu seam lee Rol,Frani,Mhhlou,41026 maguiduntil Aver/Pond
Harnett County Central Permitting /T 2)0Y/ Y72--
C --
Each section below to be filled outPO Box 65 lillington NC 27546
by whomever performing work 916 893 7526 Fax 0.10o 99783 www hernett erg/permits
Must be owner or licensed RP Y
contractor Address company Application for Residential Building and Trades Permit
name 8 phone must match //�i /
Owners Name a Q0 '(ratl;en1 I rt4C, Date b—/7-7
Site Address //r flyer? nNc Dr. Phone %/9603-Ms--
Directions to lob site from Lillinglon Fro.. Nett r; I d o z-io Nti 3M1 le. Lef f ON 90//fey/
for Igm; ', Le-{koru G,alybealrt Qd For YRA:le , Auer, Poadn,, left.
Subdivision Aver/ lad0l �iLot V I _
Description of Proposed Work Aka) epos fru/C1o0/ — 510 #of Bedrooms 4
Heated SF/885 Unheated SF 70 3 Finished Bonus Room2 Crawl Space ` Slab
General Contractor Information
(.1.)4 INA Ltic.-1raCt:eA rite. 9/9 /003 796 S
BuildiAg Contractors Company Nalne Telephone
2S3-0 (1a N-61 P-. Ste 4-C&ealesrQ 27x22 Pderd aewip I/mnes.est
Address Email Address /
License #
Elet cal Co ltrac or In orma
Description of Work Nei) CDNS/ri&C Baa/ Service Size ,ZOO Amps T-Pole _Yes_No
Q. H. Saz c s C/et h- t 9/9' 730- /Z s/
Electrical Contractors Company Name Telephone
92-6► Pec.: k d. 13uuokt,Ne- 27,SD'1
Address Email Address
2II y9
License#
/Mechanical) VAC Contractor Information
Description of Work /veal Co.1Strae •CA/
(I art:tali- kat &Nit A,r 9/D es's-&o o
Mechanical Contractors Company Name Telephone
7?lbasetAokat/. Iifetia3tdptt 28367
Address Email Address
/i/CZoo2/2 /13 ass/
License#
i n bin Contracto o ation
Description of Workeats r rc,✓ #Baths .2 3
1rdtrs ' 9%4,n�9 9/9,rco- V133
Plumbing Contractors Company Na a Telephone
311eo-4 O,rar2d. elarliw Alt 27.5-2.1Address / Email Address
Z2-/S2,
License#
-y-� Insulation Contractor Information
7;174 m ..Z?SQ/at,oi ct/? !0(0/-0999
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 tuy 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 FEESyyyyyy -6 Mon s to 2 years permit e-issue fee is$150 00 After 2 yearss]re-issue fee
is as p curre ���hedule [
Sig lure o Owner/Contractor/Officer(s)of Corporation Date el
c Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
General Contractor Owner 4,---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
r tHas 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
17 Has one(1)or more subcontractors(s)who has they 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 /� 1
Company or Nam' RIM £11,& 4rhtL7r' ,11.--44C- . // Q
Sign wrritle , / / > /died, eoza. c i' Date e 'V 7
POST AT JOB SITE - DO NOT REMOVE
LIEN AGENT INFORMATION
EFFECTIVE APRIL 1, 2013
In accordance with North Carolina General Assembly Session Law 2012-158, Inspection
Departments are not allowed to issue any permit where the project cost is $30,000 or more
unless the application is for improvements to an existing dwelling that the applicant uses as a
residence OR the property owner has designated a lien agent and provided the inspection
department with the required information:
NOTICE TO THE LIEN AGENTNTA
Lien Claimant's Name: 2 t itsTirs rile A.
Lien Claimants Mailing Address: // IV. Harr P' JTf JCC 6b7
///�'pppa�e;/(97�//`se 2-?G_bey/•
rn
Lien Claimant's Physical Address: // W. ✓/- JiricJV
ryn /&Cryo s y.Z� do/
Lien Claimant's Telephone#: _ D8g- 470- 73
Lien Claimant's Fax#: _Ilei ;-' D ? 1/45-2-3/
/1n
Lien Claimant's E-Mail Address: 3yppOr7 @/I eASAIC_.V"M
r
Description of the p operty (include address, lot#, and parcel identification number)
V/5- eery /-2 ii 1 Vali/
Contractor Name: 01 tat eaLT itOPCf
Contractor Address: eap; Id a
eteed koerf 27522.Alt- z7c2
Contractor Telephone# 7/? Seg-/39?
Successor Lien Agent Information: In the event that the lien agent revokes its consent to serve
as lien agent or is removed by the owner, or otherwise becomes unable or unwilling to serve
before the completion of all improvements to the real property, the owner shall within 3 business
days of the notice or such event do the following: (1) Designate a successor lien agent and
provide written notice of designation to the successor lien agent; (2) Provide the contact
information for the successor Hen agent to the inspection department that issued any required
building permit and: (3) Display the contact information for the successor lien agent on the
building permit or attachment thereto posted
posted on the improved property.
Date. ((� /2/
Signed: - (/D