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DOCUMENTS Initial Application Date:'0 Application# 1n Say-//411? CU# COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION Central Permitting 408 E.Front Street,Lillington,NC 27546 Phone: (910)893-7525 ext:2 Fax:(910)893-2793 www.harnettorg/permits t- r ' Lt- 4)t cross L.c.c. "A RECORDED SU VE P,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION" r'Wynn Construction, Inc. Mailing Address:2550 Capitol Dr. Ste 105 City: Creedmoor State: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@wynnconstruct.com 'Please fill out applicant information if different than landowner CONTACT NAME APPLYING IN OFFICE: Edward Averett Phone F919 603--7965 p PROPERTY LOCATION' Subdivision: Avery Pond e 1 (� Lot#: t1 S -Lot Size: /6 a State Road# / 2-0 State Road Name: '��ru a �1 lCIAi a �3r. Map Book&Page: 20/6 l Lo/ Parcel: p1OSO633 002? S/ PIN: 06953- ZG S670-000 Zoning: ):/E JO Flood Zone: Watershed: Deed Book 8 Page: / Power Company: Duke Energy 'New structures with Progress Energy as service provider need to supply premise number from Progress Energy. PROPOSED USE: 0 SED:(Size !OV7 x 6)Q)#Bedrooms: #Bathrl Basements Iwo bath):_Garage: ✓ Beak Crawl Space. _Slab: Slab (Is the bonus room finished?(✓Syes _ 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 I )no ❑ Manufactured Home:_SW_DW TW(Sizex )#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: ✓ 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 and,own land that contains a manufactured home within five hundred feet(50D')of tract listed above?(__)yes (_)no Does the property contain any easements whether underground or overhead( )yes ( )no Structures(existing c propose 'Single family dwellings: ( Manufactured Homes: Other(specify): Required Residential Property Line Setbacks: Comments: Front Minimum 35 Actual_�3^�x� Rear 25 l V / / Closest Side 19 jq/ SidestreeUcorner lot 20 Nearest Building on same lot Residential Land Use Application Page 1 of 2 03/11 APPLICATION CONTINUES ON BACK SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: From HCCP fight 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 onfor toordinanc:. .nd laws of the St e firth Carolina regulating such work and the specifications of plans submitted. I hereby slate that foregoi s tame• :/accurate • •rre la the be knowledge. Permit subject to9ation if false information is provided. / • -tura of Owner 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 , . ~— ®------ \ ) j ` AVERY �, a m R 2 ■ w, , , �. k —® �_ .,:a ,1I ; I 11 : &; . . . - ® k k! f [ | / - :0 . ` § MO | § ■= B § $ 92 I § §0 ,. ! [ ) s» | ! |o2 § ! p § k� | ! t ® EL& | � r CO i , ! 0 | / � § ! £ t10 | . in | E SITE PLANAPPROVAL 4;i USE «__-- : k �. }�\ |al ON CM 3010134 tiliON ._ :_ - a i , , ryi 100 At CO. NAME: *if olditeZ ',ate_ - APPLICATION is *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) 910-893-7525 option I 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 Ild back In place. (Unless inspection is for a septic tank in a mobile home park) • 00 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 BOO 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 {�Oonventional ( ) 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 I/NO Does the site contain any Jurisdictional Wetlands? { )YES (4 N0 Do you plan to have anjn,anti n syM n now or in the future? { IVES ( d Does or will the building contain any doing?Please explain. ( )YES { Are there any existing wells,springs, waterlines or Wastewater Systems on this property? ()YES (( , NO Is any wastewater going to be generated on the site other than domestic sewage? L( (_}YES r1NO Is the site subject to approval by any other Public Agency? (_}YES {_4 NO Are there any Easements or Right of Ways on this property? ( }YES (rO 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 five 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 Lows And Rules. I Underst i by I :m Solely Rasp' sible For The to ' tification And Labeling Of All Property Lines And Corners And Making The ,sorssr So ' at A Cote ,valuati„y Ail . ormed. /7 ise- R V •'' ERS OR OW •S LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE 10/ID aeaLTWSW CeR11Rne1RII///��oe AGREEMENT'FOR PURCHASE AND SALE OF REAL PROPERTY it REAuOR1 North Carolina Association of REALTORS* THIS AGREEMENT,including any and all addenda armohed hereto("Agreement"),is by mid between __ _ Minn Cgnettuction, Inc sin) Na ("Buyer"),and (individual or State of lamellae end typo of entity) Little Cron, LLC a(n) _ ire ("Seller"), flndivkbml or State of formation and type of endty) FOR AND IN CONSIDERATION OP THE MUTUAL PROMISEES SET PORTH HEREON AND OTHER GOOD AND VALUABLE CONSIDERATION, THE RECEIPT AND SUFFICIENCY OP WHICH An HEREBY ACKNOWLEDGED, THE EARTHS HERETO AGREE AS FOLLOWS: Section 1,Terme and Defnlflonm The terms listed below shall ham the respective meaning given ahem as net forth adjacent to each team (a) "PEbnsfly t((Adrienne)Phan 1, Ann Fond Lot 1 - 39, 67, 66, 60 and 70 Mut Rafeaence:Lot(o) Ell ,Block or Seatim Phase 1 ,nsshown on Plat Book or Slide 2016 at Page(s) 111-142 , emesis County,coanyogng of 35t/- _ acme, If this box is checked, "Property" Malt mem d nt papery described on ERMM*A attached hello and incorporated herewith by esference, (Par intonation papaw(I)the tax parcel number of the Property ill: 0653-3S-6953 and,(g)Borne or all of the Property,cousiuting of approximately 36 scree,is deseribed in Deed Book 5328 ,Puge No. 900 Dernett County.) together with ell buildings and improvements thereon and all fixtures and uppudenancee thereto end till personal property, if any, itemized on EahfMt A. $ 0.70,000.00 (b) "Pond's= PrIeee"Wall mem Her roma of Ono 11112ion, One Bnndred seventy Thousand Depots, nimble on the following smut 5 Ito (9 "Earns!Money'shall mato _Doll= or terms m follows: Mt Upon thio Agreement becoming a coohact in accordance with Section 19,the Hareem Money nbull be promptly deposited Memory with . NA _ (name of person/entity with whom depm(itd),to be applied as part payment of the Purchase Noe of the Property at Clueing,or disbursed nu agreed upon under the provisions of Section 10 hempn. Page 1 of B TLN form Jolmy9'ppmved by: STANDARD F0RM 5804 North Carolina Bar MBodMton Revised 7/2013 ra North Corona Aaoda&on of REALTORS®, J 07019 11. Buyer Initiate 7'0(p Seller InitialsWym LN nan[MUM niFon.,Mv'etlm=a Novara rl"Nu„rm 4%unmbr4Wa.I M real' ay rd mitt,,Li,ePia an)PO't nrrrr�m THE NORTH CAROLINA ASSOCIATION OP REALTORS®,INC.AND THE NORTH CAROLINA BAR ASSOCIATION MAKS 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 TT DOES NOT PROVIDE MR YOUR LBOAL NEEDS,YOU SHOULD CONSULT A NORTH CAROLINA REAL ESTATE ATDDRNEY BEFORE YOU SIGN IT. DUI/ER: SELLERI Dunstan® Wielded Daus; Darla _ _ _ . Dela: DAte „ . Ontinass Entity Rolm®ITatity _ _ gtosetrnation, Igo 2,11: 3es C aria,_3•Le ow of Entity) . f Entity) _ TTITI Nmuz: Name): Title: fide: Date: The undersigned hereby acknowledges receipt of the Ens Money set forth heredn End agree.to hold said Earnest Money to accordance with the terms bend (lifting of Mon) Mao:gn, Hy: sE Page 1 of El STANDARD FORM!Ma Revised 74013 7/2015 Poeta&ehnljaPonr0 hy alploglx 10010 Minn Mb Runt Fut 141Chlasil 41003 111131M11.0113kall AvcryPorld DO NOT REMOVE! Details: Appointment of Lien Agent Entry U'. 6b2976 Filed Oil 115/15/201] Initially filed by_wynnhomes Designated Lien Agent Project Property Print & Post hivesIon TitIt Insurance Company nverye d subdivision lul oss WAN mon no Draw; 420 pond !�( C. [ - f 9Y Y rumpNC 2]526 3tdre01�.1sw. h Si / igle NC' h C 0Y it. (Lone.AAs-6ni))6J Conlmelori: Please past chis notice on the lob Slit. 99 CH Jet 231 Property Type L sue,LIPygrydlirna¢Lom=_.�_ 9npplloa nn119uhmntr'+dnM: Sean image wnh your soon phone In 1 2 Faintly DrvellloN view Oils Glinf You can then file Nnliee en ten Agent for this protect . Owner Information avnlemon 2550 capitol dr creedmnnr NC 27522 United Slates Lau nanyjwyiirhomeseom Phone 919929-1349 Prey C uuwend tot 1 ethnical sippnli IIoOhOm(888)690 00109/11 Application# D Harnett County Central Permitting /7600 y/�/p 6 PO Box 65 411mgton NC 27546 Each section below to be filled out 910 893 7525 Fax 910 B93 2703 www Barnett org/permits by whomever performing work Must be owner or licensed contractor Address company Application for Residential Buildinn and Trades Permit name&phone must match '• ` /l 1 Owners Name W t.a Cocci-Aid-at SNCL Date o —/7 Site Address 9ZOy,4✓et't� mold ix. Phone 91/76•03-MS— Directions /96J3-79�5 Directions to lob site from Lillington Pmos Net? 1-1k+ 2-10 Saar les Leff oa4 '/e//t51 for 4, Le-{koN C.-halybe14G 1`d For YRes:le , Aocri Rad,5,4 /e(1 Subdivision Avery Podd Lot SS Description of Proposed Work /veu) CONS r/hue-4i' — 5f0 #of Bedrooms V Healed SF 2346 Unheated SF8a 10 Finished Bonus Room'' N Crawl Space _Slab General Contractor Information 6.10A Last t;eri true. 919 /003 - 796 S BuildiAg Contractors Company Wain Telephone 2-ao ('a N4o1 P-. s/e /OSGu,/,evorAt 2322 edwar1R4/ynn/iopies.CM2 Address Email Address / y6Z?S License # �jetioA/ Srervice Sation Description of Work Neu! [IpMf/IrtC .JN Service Size 100 Amps T-Pole _Yes_No Q.- R. 5aelcso a C/ecfr:t 9/?' 73o- /Zs/ Electrical Contractors Company Name Telephone 92-Ie1 Pala;gk A. 130 soa, NY'- 27Sa't Address Email Address 2� L yy License # Juludlechanicali VAC Contractor Information Description of Work /vein Coa/Stracv OA/ est:0:e.A- kat a.Atd. A:r 9/0 8SB-464°o Mechanical Contractors Company Name Telephone 7?ISaasartokePd. Jarba3./7tM- 1$.367 Address Email Address /VCzooz/2 N3 asst License# � ma "Contractor Information Description of Work Gl //Baths -. /I/� S p,A9193—so• 033 3J Plumbing Contractor Company Nene Telephone 3/& o-/4. O,1tarN. elay4.' Alt Z7s2-7 Address Email Address Z/SLLZZ-/5"2--- License icense# Insulation Contractor Information �J p Tfaiu /a 3Q/2f oil/ T/? r0%/-099 / 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 slanina below I have obtained all subcontractors permission to obtain these permits and if AIDC changes occur including listed contractors site plan number of bedrooms building and trade plans Environmental Health permit changes or proposed use changes I certify itis my responsibility to notify the Harnett County Central Permitting Department of any and all changes EXPIRE PERMIT FEESppp�� -6 Mon s to 2 years pems e-issue fee is $150 00 After 2 years re-issue fee is as p currenthedule tura o Owner/Contractor/Officer(s)of Corporation Date Affidavit for Worker's Compensation NC G S 87-14 The undersigned applicant being the General Contractor Owner V.-..-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 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 ''/ // Company or Nam W 0A &A;/�/,r��ed�y�t il(/(/�rlL'(I // /� Sign w/Title U.� d C-aa%4/. eirkr( Date DO NOT REMOVE! Details: Appointment of Lien Agent Filed on: 05/15/2017 Entry a:6621376 Initially moa by. wynnhomes Designated Lien Agent Project Property Print & Post Ti le Insinance Company avers pn nil Lthelivisien lin 055 Q• 4 0 420 pond a 5dr. 0 linlinri mu nn n yawn'sleYny N fLL.,.[ Address:In m NnryouSI,Suns l Adrian.NC A e county 6 1+jy2 + Phone:naecieoN Please poll this nudge DCI Lilo lob Sas i Fur.913.780.5221 Property Type Suppliers and Subeonvntlors: Fend.yy onN Om ma inns — Scan ebvimage im your rm ms a No to VIEW 1110 films doe can then filee allouce 12 Deeply Dwelling to Lion am rogues raleel. Owner Information " nnhunies 2550 repeal ar. naedlSoe NC 22522 Una Sr lin Fined:naaS© 3.p3.12 ¢mm Fiume:9l9 S18J View C demons 10) Technical Suppe I Hotline](MMA)600.72154