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DOCUMENTS Initial Application Dale: \D I ILO ' I n Application I 1 SOLI-4 I Is Cu# COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION Central Permitting 108 E.Front Street,❑llington,NC 27546 Phone:(910)893-7525 ext2 Fax:(910)893-2793 www.harnett.org/permits "A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION" LANDOWNER:Wynn Construction, Inc. Mailing Address:2550 Capitol Dr.Ste 105 City: Creedmoor Stale:NC Zip:27522 Contact No: 919 603-7965 Email: edward@wynnconstruct.com APPLICANT':Edward Averelt Mailing Address:2550 Capitol Dr. Ste 105 city: Creedmoor Slate:NC Zip:27522 Contact No: 919603-7965 Email: edward@wynnconstruct.com 'Please fill out applicant information if different than landowner CONTACT NAME APPLYING IN OFFICE:J. Edward Averelt Phone#91 9 603-7965 (( PROPERTY LOCATION.Subdivision: Avery Pond Lot#:_in 2 Lot Size_ { 9 Stale Road/I 70 State Road Name:_ lyyc)_` __ Podgy- Dr. Map Book&Page:7,-0/Ll 10/ ParceC OSOk'c3 002? 57 (PIN: O(o53- 34, /Zo? D00 Zoning: 2130 Flood Zone: ` Watershed:/ " • Deed Book&Page:SS lb, 0-1 Power Company`: Duke Energy *New structures with Progress Energy as service provider need to supply premise number from Progress Energy. PROPOSED USE: SED:(SIzoa_S)#Bedrooms:#Balhs.2.3 aasemenir^ )vo bath):_Garage: Y Beek:_ Nc:le Crawl Space. Slab: Slat Y (Is the bonus room finished?(.21 yes _,no w/a closer?( 1 yes ( )no(if yes add In with#bedrooms) ❑ Mod:(Size_x_)#Bedrooms_#Baths_Basement(w/wo bath)_Garage:_Site Built Deck: On Frame Off Fame_ (Is the second floor finished?( )yes (_,_)no Any other site built additions?( )yes ( ) no ❑ Manufactured Home:_SW_DW_TW(Size it )#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 beforefinal Sewage Supply: if 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 prop sed' Ingle family dwellings: \ Manufactured Homes: Other(specify): Required Residential Property Line Setbacks Comments: Front Minimum 35 Actual SO.?.. Rear 25 91/.7 y Closest Side 10 Sldestiest/corner 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 right onto 210 Hwy. 3 miles, Lefton 401 Hwy.for 15 miles Left on Chalybeate Rd.for 118 mile,Avery Pond on the left If permits are granted I agree onfor to - ordinan nd laws of the St a odh Carolina regulating such work and the specifications of plans submitted. I hereby state that forego) s erne.d alaccurale- • erre to the be knowledge. Permit subiect to v cation If false Information is provided. - A%/ - A tura of Owner ner's Agent Date mit 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 dale If permits have not been Issued" Residential Land Use Application Page 2 of 2 03/11 / § il / E SITE PLAN APPROVAL k . ■ s e USE w = . OMS - — P" ° � ' || } • : c ,- 1.-Q---1112/0_-_ ® , t ---- Zorn Nt•• ¥ . � , § • : I- & | § ( | 92 ` _ i 5 k: g I_Via; i., ! lsk - Id \ § � ' li § 2d | ) 1 V . (a ! . ; | ) ■ E ` . ■ r | § . | § a kiz | 11111„ lik | , 1 | § ` § | e ------- k , ©a.o/. »+ # t 1111 I »@ ---______,--- pfli ) ft ONO 3310/1313/114.1110N NAME: /}1 /ldrie7itWWf it - APPLICATION tI: *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 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. 0 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) • 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 (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 {E} NO Does the site contain any Jurisdictional Wetlands?/ {_}YES {i) NO Do you plan to have an lineation system now or in the future? { }YES {4 Does or will the building contain any drains?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? (_)YES {41--NO Is the site subject to approval by any other Public Agency? {_)YES {/} NO Are there any Easements or Right of Ways on this property? {OYES (A/° 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 Rend 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-1 IE I m Solely Resp sible For The P• • Mention And Labeling Of All Property Lines And Corners And Malting The a ss' So at A Co ate ' valuati •armed. • e - R Y ERS OR OW S LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) h l- g 10/10 DO NOT REMOVE! Details: Appointment of Lien Agent Entry#: 654360 Filed on: 05(17/2017 Initially filed by: wynnhomes Desig noted Lien Agent Project Property !!Print & Post i imcSIOES TA<Insurance CompanYaversp tlsubdivision lm rvPI? 0 469 ovecy pond dr. nI' gfI'om IlfgyY sienna,NC71526 19 W.Xoe RueiµNe haul ell C 01101Y li 27601 Contractors: Inmv:HI-690-73P Please post his nolle on the lob Site Fes 9°429-5111-5111 Property Type epailowpanSippy eSubcontractors: rmpe n ., a,,...., Sean A image with your h viewone.to this fling You an then le n Notice 1-2 Family Dwelling can Agent for this 1 '.Owner information 2550 capitol Jr. nrene:moeamonq NC 27522 United States n Emni. nncy®t-nuhon¢s mm !Phonee:019-525-1347 View Commons(0) To hnicat Support Hotilnet(gsa)6Ya13g4 u,.,u.., I . rr Harnett County Central Permitting /7soo 91 to,y PO Box 65 Lillington NC 27548 Each section below to be Idled out 910 893 7526 Fax 910 893 2793 www hernett orglpermtts by whomever performing work QTf /!7 Must be owner or licensed �/ contractor Address company Application for Residential Building and Trades Permit name&phone must match 11''.. /l 4;17 Owners Name W aalit eal S ride-, Date (P 1 7 Site Address 1/4, rha G/ac/7 odd Or Phone W9603-M5— Directions to lob site from LillingtonPIA" Nett r:g hI.t o tit°l ult♦ 3Aet le' Leff aid 'y0//fail for Icnvtt� Lak- ou Ghallibea+e. R.d for YR .te , AOeri Po.rdn,L /et^•f. Subdivision Autry Pail �r Lot v7 Description of Proposed Work Neld COOS fru&7od -' 5,0 #of Bedrooms 3 Jt3 Healed SF Unheated SF 220 Finished Bonus Room9 Crawl Space te's Slab General Contractor Information (A)t�nn J 14- d r .bg rue. 9/9 b03 . 7966- Builth g Contractors Company Name Telephone ZSro ea N4°' 1f. S/e /os erealderde 27522 edrohr`e4/yn4hor,s-•Casa Address Email Address / 6a9SL1/62,3-- License icense# Elegqt(ical Contractor Information Description of Work idea COasfru 4100 Service Size ;OO Amps T-Pole _Yes_No Q. (\. 5ae 4oa Clealr:L 9/9' 73o- /Zs/ Electrical Contractors Company Name Telephone 92 to i 2aetgk d. Be *1t,Ne 275-oy Address Email Address try yy License # AechanicalIFiVAC Contractor Information Description of Work 4/eW COALS frac 02t✓ (ter+:0zed- Neat a.ntd A:r 9/o 858-&2o0 Mechanical Contractors Company Name Telephone 7973aasetlpketd. jgsberindye.NC n$3S7 Address Email Address ft20o2/2 113 elasist License # .r/- bin Co act r Information Description of Work J (Olt rDr✓ #Baths .2 73 -c— 's ! 9/9.sc0- +'13 /Qg Contractor �pany �A9 3 Plumbing Contractors Company Narhe Telephone 3/(00- 4 On(arPd. (/ayhw Ne- Z7c2-7 Address Email Address 2.2-15-2.- License # Insulation Contractor Information ��� ��1_0999 TfaM ..TS4/af oe/ 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 stoning below I have obtained all subcontractors permission to obtain these permits and if agy 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 a ES -6 Mon s to 2 years permit a-issue fee is $150 00 After2 years re-issue fee is asp Currenrime hedule /71, 7 ig ture o Owner/Contractor/Officer(s)of Corporation Date Affidavit for Worker's Compensation NC GS 87-14 The undersigned applicant being the General Contractor _Owner /7—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 n [ _ Company or Nam;/�_/"nn 60467<rEdi On�/yJ.1RlC Sign w/Title �, /L/� L L M6 Date DO NOT REMOVE! Details: Appointment of Lien Agent Filed on, 05/17/2017 Entry IP 654360 Initially pled by'.wynnhomos l oeaignated Lien Agont 11 Project Property 'Print& Post Titlet o r 2 F l ld Inn lot 0171d r I "llJ , . I r m r yentas,NC 7516 Addnsha9W. unmmv NV Willeil aunty 1 O. i I Cuntra eters. I hunt Bea.evo UPI Plume post this nn;anmelobsLe. fro nit-Pysz 'Property Type Fupudno and flmUn rn du 1 Ens innrml o LL' Seen tans mmge with your SlIkla phone V Lhie filing You can then file a Noun. 14 Family Dwelling I to Lien Agent for this project. Owner Information ,wyntbritEr. I 2550 capuol dr. ereedmoar NC 2)522 United sates 1 Email neneYad rynnhomecrom Pbonc:9l9-511134] Viwlnmtrent (0) Technical Support thanes(EPP)E921113