DOCUMENTS Initial Application Date: Lop V/I / a r Y. Application#
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street.Lillington,NC 27546 Phone.(910)893-7525 ext:2 Fax:(910)893-2793 www.harneb.orylpermits
RECORDED SURVEY
MAP,RECORDED DEED ION OFFER TO PURCHASE)8 SITE PLAN ARE REQUIRED` WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER: h/11 �LLf'1 3A ailing Address. [>?C ,] 13)o r _r•
City: �/
l e-r State/"�-Zip DVS)) Contact No: Email:
APPLICnnI S IuI4?,Too(il Carr irMailing Address: POAek ;135
City: E✓ State:7/t. Zip: -27i-0)Contact No. 9/9-5?ti-YJSV Email: 1%/A tn1nrh{vtmi<I/Z�iK.leo on
Please fill applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE: Phone# /� /�
PROPERTY LOCATION:Subdivision': �^ Lot#'.ail Lot Size: I 'x+S/9c
State Road# 414 State Road Name: a• aR - rm •Book Paged"Ito /
Parcel: by U SS 15)07.- 45�/Y PIN._COSS - 131r& -57/0 • COL
Zoning1LIO Flood Zone: X Watershed: A-AF"1 Deed Book 8 Pa9e�l4 /I 4414 Power Company:
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
Yr Manalidrk
SFD:(Size�x�' )#Betlrooms:3 #Baths Basement(wlwo bath): Garage'. Deck'. 'Crawl Space:✓Slab'. Slab'.
Is the bonus room finished?( )yes (A/no w/a closet?( )yes ( )no(if yes add in with#bedrooms)
❑ Mod.(Size x )if Bedrooms #Baths Basement(w/wo bath) Garage:_Site Built Deck._ On Frame_OH Frame_
Is the second Boor 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:_
❑ Addition/Accessory/Other:(Size x )Use: Closets in addition?(_)yes (_)no
Water Supply: V County Existing Well New Well(#of dwellings using well )'Must have operable water before final
Sewage Supply: L.---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(5001 of tract listed above?( )yes ( )no
Does the property contain any easements whether underground or overhead(_)yes (_)no
Structures(existingpropose 'Single family dwellings: ` Manufactured
Homes:
� Other(specify):
Required Residential Property Line Setbacks: Comments:Cr
Front Minimum Actual ''�yl1
Rear a� fir ^`
Closest Side
SidestreeVcomer lot
Nearest Building
on same lot
Residential Land Use Application Page t of 2 03/11
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 401 4c- Pi Ast.akr. suv _
1
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If permits are granted I agree to conform to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing s tements are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
, SiMgnatitr6 of er or Owner's Agent 6-X-/7
Date
•
"'It Is the owner/applicants responsibilgy to provide the county with any applicable information about the subject property,iriclddhiB but not limited
to:boundary information;house location,underground or overhead easements,etc.The county or its employees are not resptnsible for any
Indorrect or Missing information that is contained within these'applicatlons.t
**This application expires 6 months from the initial date if permits have not been issued"
•
Residential Land Use Application Page 2 of 2 03111
f , l FGENn SFTRAFEL THIS SURVEY IS OF AN EXISTING PARCEL OR
AC-AR CONDITONING UNIT FRONT 35' PARCELS OF LAND AND DOES NOT CREATE A
�9 BOC-BACK OF CURB SIDE 10' NEW SWEET OR CHANGE AN EXISTING SWEET.
SITE• 4 Q DW-CONC DRNEWAY REAR 25'
EB-ELECTRIC BOX
1r S EOP-EDGE OF PAVEMENT
P-PAHO SHAWN T. RUMBERGER, PLS L-4909 DATE
PO-PORCH ILMPFRNOU5 AREA.
SCO-CLEANOUT HOUSE 2,518 SO.Fi PAIS MAP IS ONLY INTENDED FOR THE PARPES
SW-SIDEWALX
SR 144] Tp-TELEPHONE PEDESTAL DRIVE 0]5 SO FT. AND PURPOSES SHOWN. THIS MAP IS NOT FOR
WALK 393 SOFT. RECORDATON. NO TILE REPORT PROVIDED.
ER METER COVERED 187 SO.PT.
o IRON
Q IRON PIPE FOUND PORCH
Q IRON PIPE SEI BqPMr�
I o NAIL SET TOTAL 8,4} SO.Fi. AF 1,
VICINITY MAP (NTS) °
N/F
ALEXANDER WILLIAMS
(NTS) e Au — —14PIN 0655.32-3511
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GRAPHIC SCALE PINEY GROVE RAWLS RD
6D30 SR 1414 - 60' PUBLIC R/W LINE TABLE
PRELIMINARYLINE
w[
LI s :RmE 1w
1 inch = 60 ft. PLOT PLAN .1 f
PROJECT: FOR
m 17-001 PINEY GROVE RAMS JORDAN JOHN MOSES 8e ECL S
DRAWN an OLAI JORDAN BECKY C wl
2'z. ;(.G L 0 B A L
✓ SCALE: 1"=60L 251 PINEY GROVE RAWLS RD
Art 19 N McawLEV ST
� IRA78 HECTOR'S CREEK TWP., HARNETT CO., NC SI D.eszaasi iaSSLDSC sec1.
06-25-17 P.B. 6M2016, PG. 310 910.597.2320 CFAXI CC*C-4175
NAME: S bl,4.111.Pin To Adel ' i' - —'S 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 IN THIS APPLICATION IS FALSIFIED,CHANGED.OR THE SITE IS ALTERED,THEN THE IMPROVEMENT
PERMIT OR AUTHORIZATION TO CONSTRUCT SHALT.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)
3 910-893-7525 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 (it
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 8 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(sn can be ranked in order of preference,must choose one.
{ } Accepted I—I Innovative I Conventional (_I Any
{ 1 Alternative I_I 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 1.4/NO Does the site contain any Jurisdictional Wetlands?
L)YES I I Do you plan to have an irrigationaystem now or in the future?
1—}YES I— NO Does or will the building contain any drains?Please explain.
I IYES I vf NO Are there any existing wells,springs, waterlines or Wastewater Systems on this property?
I—I YES I ANO Is any wastewater going to be generated on the site other than domestic sewage?
1IYES ht-'1-NO Is the site subject to approval by any other Public Agency?
1=1 YES !O Are there any Easements or Right of Ways on this property?
II YES LerNO 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 Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site Accessible hat A ' mplEvaluation Can Be Performed.
/fir 9.4
4 -J-d/-7
PROPERTY S OR OW LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE
10/10
r^ Date L.PI�.�.0 I /
Plan Box p F 1 Job Name �e»./-4-htrr-
App# k‘n.O o Valuation IC 7C3-14 SQ Feet IL 4 I
Garage 531
Z. I7Z
Inspections for SFD/SFA
Crawl ,! Slab_ Mono_ Basement_
Footing Footing Plum Under Slab Footing
Foundation Foundation Ele. Under Slab Foundation
Address Address Address Waterproofing
Open Floor Slab Mono Slab Plum Under slab
Rough In Rough In Rough In Address
Insulation Insulation Insulation Slab
Final Final Final Open Floor
Rough In
Insulation
Final
Foundation Survey_ Envir. Health./ Other
Additions/Other
Footing
Foundation_
Slab_
Mono_
Open Floor_
Rough In
Insulation_
Final
09109/11 Application'g
Harnett County Central Permitting ) nso`�n ' P-70 r
PO Box 65 411mgton NC 27546
Each section below to be filled our 910 893 7525 Fax 910 893 2793 www hamee ors/permits
by whomever performing work
Must be owner or licensed
contractor Address company Application for Residential Building and Trades Penna
name 8 phone must match /pl
Owners Name in{In Deary 3err✓S/1 Date
Site Address Phone
Directions to job site from Lillington
Subdivision Lot
Description of Proposed Work #of Bedrooms
Heated SF Unheated SF Finished Bonus Room/ Crawl Space _Slab
General Contractor Information
Spr )].4F✓/1 700 )IoM LC ILL SAY/I- /i
Building Contractors Company Name Telephone
99/ ogles nm �b.,.r/ fgm Hrv�rr 416
Address Email Address
/A 270
License#
Electrical Contractor Information
Description of Work Service Size Jin Amps T-Pole 1.--1-les_No
,c 4)0 e4iC4cerr 9)9- 44 - 7— '3-S1/-
Electrical
s1Electrical Contractors Company Name Telephone
/9/(3' AJC ol/O Arts>y ,t)/ /
Address Email Address
/30 -�
License#
mechanical/HVAC Contractor Information
Description of Work
(Oen
(� � l ON/c✓` 14-f< Fa 174— 9)9—c-ro-77//
Mechanical Contractor s Company Name Telephone
S -O J2< 7O rl,ocl clayIn AJ<
Address Email Address
29101 1
License#
plumbina Contractor Information
Description of Work #Baths g.,
Oputle aAim h65 I / L /7-S)y-72aC
Plumbing Contractors Compig1S0 Name Telephone
6 "y Q y, d Rd Qr'NI /t rn J ,vC "--
Address Email Address
.2/6 y9
License#
Insulation Contractor Information
ice, r:6' tlo -3()y fl5'-
Insulation Cont actor 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 stanlna below I have obtained all subcontractors
permission to obtain these Permits and if any 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 FEES-6 Months to 2 years permit re-issue fee is$150 00 After 2 years re-issue fee
is as per currenschedule
Signat3re of Owner/Contractor/Officer(s)of Corporation Date
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
I/ 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
covenng 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 pnor
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 Name -ctigern out!' I1cwrPS LLC
Sign w/ iUe Gni. - .I ' Date 7-/9-/7
DO NOT REMOVEI
Details: Appointment of Lien Agent Filed on: 06f26/20t7
Entry I: 676759 Initially flied by:
south.rnteuchhemollc
Doi eeeted Lion Agent Project Property
Print & Post
known The Isolaoe Company Id 2A
Piety Grove Rawls rd Q.. U
wae:.ww.Yi.or®....,._......... FN Vote .1 NC27526 6'7�;,<
*straw 19 W H. In 9c.6Ss 5071 Ammo,
NC 27401 'm•'Zd°
Phnom 119(90a99,4 Property Type Contractors:
Fw:917.a89S7.1l Phare post this mks w the lob Sia
/all:_—ze_—..__.._ .—_, 1.2 Pooh'Ow piling Sappers ad Sobaaltsnas:
Soo 6e iniga with y ox nett phoneto
view nog.You ant dm We*Notice
Owner Information
to Gm AROlt for ms 980.15144
suntan Touch Hama LLC
PO Em 2135
Angier,NC 27501
Milted Mates
Emit wu&aontclhonlalk(a neil.com
Photo;919-524.3354
Kew Com:W.(0)
TcbnktIBepp*Y Romeo(888)690.7384
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Bldg Insp scheduled before 2pm available next business day.
Application Number 17-50041708 Date 7/14/17
Property Address 94672 *UNASSIGNED
PARCEL NUMBER 08-0655- - -0030- -45-
Application type description CP NEW RESIDENTIAL (SFD)
Subdivision Name VANNA ROBINSON ESTATE
Property Zoning RES/AGRI DIST - RA-40
Owner Contractor
JORDAN JOHN M & BECKY C SOUTHERN TOUCH HOMES, LLC
203 BLAIR DRIVE PO BOX 2135
ANGIER NC 27501 ANGIER, NC 27501
ANGIER NC 27501
(919) 639-4672
Applicant
SOUTHERN TOUCH HOMES
PO BOX 2435
ANGIER NC 27501
(919) 524-3354
--- Structure Information 000 000 65 . 7X48 . 7 3BDR 2BA CRAWL W/GARAGE & DECK
Flood Zone FLOOD ZONE X
Other struct info # BEDROOMS 3000000 . 00
PROPOSED USE SFD
SEPTIC - EXISTING? NEW TANK
WATER SUPPLY COUNTY
Permit BLDG,MECH, ELEC, PLB, INSU PERMIT
Additional desc .
Phone Access Code 1197813
Issue Date . . 7/14/17 Valuation . . . . 0
Expiration Date . 7/14/18
Special Notes and Comments
T/S: 06/26/2017 11 : 15 AM JBROCK ----
401 TO PINEY GROVE RAWLS RD
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
PERMIT INCLUDES BLDG, ELEC, MECH, PLUMB
INSULATION AND LAND USE.
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Work must conform and comply with the
STATE BUILDING CODE and all other State
and local laws, ordinances & regulations
HARNETT COUNTY CENTRAL PERMITTING
P.O . BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Bldg Insp scheduled before 2pm available next business day.
Page 2
Application Number 17-50041708 Date 7/14/17
Property Address 94672 *UNASSIGNED
PARCEL NUMBER 08-0655- - -0030- -45-
Application description . . CP NEW RESIDENTIAL (SFD)
Subdivision Name VANNA ROBINSON ESTATE
Property Zoning RES/AGRI DIST - RA-40
Permit BLDG,MECH, ELEC, PLB, INSU PERMIT
Additional desc .
Phone Access Code 1197813
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
10-30 814 A814 ADDRESS CONFIRMATION /
10 101 B101 R*BLDG FOOTING / TEMP SVC POLE / /
20 103 B103 R*BLDG FOUND & TEMP SVC POLE / /
30-999 105 B105 R*OPEN FLOOR / /
40-50 129 I129 R*INSULATION INSPECTION / /
40-60 425 R425 FOUR TRADE ROUGH IN / /
40-60 125 R125 ONE TRADE ROUGH IN / /
40-60 325 R325 THREE TRADE ROUGH IN / /
40-60 225 R225 TWO TRADE ROUGH IN / /
50-60 429 R429 FOUR TRADE FINAL _/_/
50-60 131 R131 ONE TRADE FINAL / /
50-60 329 R329 THREE TRADE FINAL /
50-60 229 R229 TWO TRADE FINAL /
50-60 209 E209 R*ELEC TEMP POWER CERT / /
999 H824 ENVIR. OPERATIONS PERMIT / /