DOCUMENTS Initial Application Date: WI Al I 1 1 Application# I `iceIVTI / e!.-
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.harnett.org/permits
**ARECORDED SURVEY MAP,yRECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
(Slat S �� JJ C�.1� r1.6�'Mailing Address: �9�� l,le ef c LL10CJbe A ce) Tie vCJ .
city:CCul(C (d((C��Uit st/ate:AX- Zip: afl jb3 Contact No: ?IO tt;-WW&q EmaiNLYSM)Ent Lir'CV)hho(Y' .Ca°
2PLICANP:_cif. ss'- .flailing Address:
City: State: Zip: Contact No: Email:
'Please fill out applicant information if different than landowner
y.� /�/y
CONTACT NAME APPLYING IN OFFICE:/6 ! I e X1 1' )"V Hcvi ( kith),
C/' 1 'f6>-c(1 IV'^� Q
PROPERTY LOCATION:Subdivision: 2-/R r4ah8A (ex77)cfoci /�o4` ith), Lot#: (' )W Lot Size: 1�{V�JWA a-S
State Road`�#�/��-/It) State
�Road Name: l I^ �p� / //'� �/']/Map ook&Page:a 3a1 /'f
Parcel: (Y2lOr3�G5I1 k Oasa k-n PIN:4�T-15 40 OQW /� ,,/
Zoning: -7O(Z Flood Zone: n Watershed:0411 Deed Book&Page: )p Power Company": l 1 ef'/1,'t /6(//f
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE: /� L
�.r� I_, r A ��i / �t ?8I/U Monolittr
l3 SFD:(Size ixlhlR)#Bedrooms:4 #Baths, `'�asement(w/wo bath):NC Garage: Y Deck:FU Crawl Space:_Slab:_Slab:
(Is the bonus room finished?( )yes ( 1 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 ( )no
O Manufactured Home:_SW_OW_TW(Size x )#Bedrooms:_Garage: (site built?_)Deck: (site built?_)
❑ Duplex:(Size x )No. Buildings: No.Bedrooms Per Unit:
U 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 beforefinal
Sewage Supply: 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 hundred feet(5008 of tract listed above?( )yes k/no
1 Does the properly contain any easements whether underground or overhead( )yes ( )no
Structures(existing Ingle family dwellings: ✓ Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual
3`i
Rear r)S I a5.I /
)2
Closest Side 5llI JO '+J. /
Sidestreet/corner lot tl�
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:
c Zic 1ocrifrT// ff/. /l? (Cf/t Pa jL/K (1 c,.n
Doe/17r(fs M• 7i!/ 1 /6// /oc/(c7 r,n 0/76//i///c
Cc f tfc( 'SlI I enh,, <fPey
71.2(n ,if on al/17 /0// / f on InLt .ifei . Cees cf/u-Sild ,
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 ements are accurate and rrect to the best of my knowledge. Permit subject to revocation if false information is provided.
Signature of Owner o ner's AgentDr ate '
"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
OFFER TO PURCHASE AND CONTRACT-VACANT LOT/LAND
For valuable consideration,the receipt and legal aumoiaoy of which aro hereby nekuowledged,Buyer offers to purchase nasi Seller
upon nccaptancc otos to Boll and convoy the Property on the terms and conditions of this Offer To Purchase and Contract mid any
addendum or modlfeallon made In accordance with Its Terms(together the"Contract").
I. 'TI1lMS AND DRPINITIONS:The terns listed ej, shall have to respective meaning given Mem as set hili adjacent to each
lean. (_LG
(n)"Seller"': PP Develynnw t Q on l.,
(b)"Bnyor : .. al, - ,
TWO/
, .
(o)")' apody":'Tse Propertyshall include all that real estate doscrhbed palmy together with nil oppnrenmaa thereto Inehtding the
Improvements lasted thereon. .
Street Address:
Cisy: Cameron
County: Jlmncll ,North Carelim
(NOTE:Governmental authority over taws,zoning,school districts,utilities mid moll delivery may difhr from address shown,)
Legal Description:(Complete FILL oppiteablo)
Plat Rolarouieo:Lots) Athols located lnPmt213 ofManors at Unbutton Plamtiorand Lot 254 In Vlllaaenl Lo,dnaloiPlaatattou
Plat Book/Page: 2013A06-307 mid Plat Book 3161756
(d)"Purelnao Price":
$ 1.696500.00 paid BtU.S.Dollars upon the following terms:
$ Na BY DUB DILAORNCB PUB made payable to Seller
S BY INITIAL EARNEST MONEY DEPOSIT made j Dyable to Escrow Agent name)
In Paragraph 1(0 with Inds offer by Li cash b3 personal cheek O official bank chock
❑other:
S 13Y(ADDITIONAL)BARNEST MONEY DBPOSlTnade payable to Escrow Agent
named In In Paragraph 1(0 by cash or Immediately available Mods such as official bank
. cheek or wird transfer to be delivered to Escnw Agent no Inter than
7HIWE
BEING OP 2'IHRRS,9ENCE MD regard to sold dale.
S DY ASSUMPTION oflire unpaid principal bniareomut all obllgnlionsafattleron the
existing lonu(a)secured by n dad of trust an the Properly In accoinanco with the
attached Loan Assumption Addendum Mondani Perm 2A641).
$ BY SBLI.BR FINANCING In accordance with the attached Seller Financing
• Addendum(Slmrdenl Penn 2A5-T).
S 1.696500.00 DALANCftoflho Purchase Price In ash M Settlement(some or all ofwhlcb any be
paid with the proceeds of n new lean
Should Buyer fail to deilveroit er the Due Diligence Fee or any Initial tinniest Money Deposit by the Uffeclivo Dote,or should any
cheek orethc•hash paid by Buyer be dishonored,for any rason,by the Insllhdion Opoh which the payment is drawn,Buyer shall
have olio(I)balking day Mor written notice to deliver good Muds to the payee.In nim ovant Buyer does not timely deliver good
Muds,Sella shall Imve the right to terminale Ills Contract upon written notice to Buyer.
(o)"[tamest Money Deposit":The Initial Boniest Money Deposit,the Additional tamest Money Deposit and any other const
monies laid In connection withlhis transaction,hereinafter collectively inbred to as"Boreal Money DeposlN,shall be deposited
and tiold In esenry by Meow Agent until Closing,at which Dine i1 will be credited to Buyer,or until this CoOroot is otherwise
Icminnled.hi the ovoid:(I)this offer Is not accepted;or(1)n condition of any mulling cannot Is not satisfied,Bron the Earned
Money Deposit shall be refunded to Boyer.In the oval(thread'colds Contract by Seller,the famed Money Deposit shall be
refluided to Buyer upon ihiye'srequest,but such rehire shell not affect may other remedies available to Buyer for melt broach.In
the event ofbIro�acl,ofilds Centred by Buyer,the Barnes;Money Deposit atoll be pMd to Boiler upon Selle's request es liquidated
Buyer lolllnls-T"� Seller bridals r1
------111 err Page I of II
Assoololon Female,la D Revised 7/1007,TION 'this slcadsrd Neu baa qaaoroadfohity by:Wont,Camhhm
Maid by ApmnniuWlb we NC Unr Anemia]Ion North Menne DarMce.WIa—NCRarrelnl No.12
Noah Cbrolinn Ameclada n n f lteniters8,bre.—mwimd rami I Zr
drones mid ns Sollor's sola mast oxohalvo remedy for such breach,but without limiting Seller's sig0u ander Paragraphs 2(o)and
2(d)fordnm5ngc to the Properly or Seller's righl to lath the Duo Diligence Pee.ll Is acknowledged by the parties that payment of
lite Rnmost Money Deposit to Roller in Ilse event ern branch of this Contract by IBsyer Is componsateyand not punitive,such mnounl
being a reasonable olhnmlon oflho acetal loss that Seller would Incur Os n result ofslIelt bleach.llselmymenl of the Earnest Money
Deposit to Seller shall not constitute n penalty or forfeiture bill actual compensation hi Sollees anticipated loss,both parties
acknowledging the difficulty dolonnining Seller's actual denmges hr such breach.If legal procsedings ran brought by Buyer or
Seiler against the other to recover the Eantol Motley Deposit,the prevailing party hi the proceedingslinll be entitled to recover(tont
thenomproveiling party ronsonable attorney hes and court costs foe tuned In connection with Ihe proceeding.
(Q"Eserew Agent"(hosed Immo): WA
(NOTE:In he event ofa dispute between Roller nod Buyer over the disposition of the Eames;Money Deposit held in escrow,n
licensed real estatebroker("Broker,b required by slate law(mod Escrow Agent,Knot a Broker,hereby agrees)to retain the Boniest
Money Deposit In the Escrow Agent's Mut or escrow account mull Escrow Agent has obtained a written ialonse noes the miles
consenting to Itsdisposition or until disbursement is ordered by a cowl ofconpotontJurlsdkllon.Alternatively,Ira Broker is holding
the Damen Money Deposit,the Broker may deposit the disputed monies whit the Appropriate cloak of court In accoelnnco with the
provisions of N.C.O.S.§93k1 2.)
THE PARTIES AGREE THAT A IWAL BSTATB BROKERAGE PJRM ACTING AS ESCROW AGENT MAY PLACIi THE
EARNEST MONEY DEPOSIT IN AN IN'1•BIUIST BEARING TRUST ACCOUNT AND THAI'ANY INTEREST EARNED
THEREON SHALL BE DISBURSED TO THE ESCROW AGENT MONTHLY IN CONSIDERATION OF THE 6XPBNSI3S
INCURRED EY MAINTAINING SUCH ACCOUNT AND RECORDS ASSOCIATED TI IIRUWITH.
(g)"Bffecllvo Bate":The(Into than(I)the Inst one of Buyer mid Seller has algae)or Initialed this°Miror the fnal counteroffer,If
my,mid(2)such signing or InhlalingIs connnunlented to(hominy malting the offer or counteroffer,as Iho case may bo.
(h) "Dao Dlllgesee"; Buyer's oppodanity during the Dile Diligence Period to Investigate Rio Property nod the huasecllon
contemplated by'Ms Contract,Ino udtngbut net necessarily Ihulled to dienmtlos described In Pnregmph2below,to decide whether
Brier,In Buyo"s solodlsoretlon,will proceed with ortennhato Ilse Imnsncdon.
(p"Due Diligence Fee":A negotiated amount,irony,paid by Buyer to Seller wino this Connect for Buyer's tight to conduct Duo -
Diligence during Ike Duro Diligence Period.It shall he he propody of Seller upon the Bffbcilve Date and shall be a credit to Buyer
at Closing.Tito Dm Diligence Poo shall be no.t f uudablo except In the event ofa outdone'breath of ils Contract by Seller,or If
this Contract Is lonnbetcd nndorParagrnllt 6(i)o•Pnrograph 9,or as otherwise provided Inany addetdum hereto. Bayer and Seller
each expressly waive any right that They any have to deny Iho right to consul Dna Dlllgonco Or to assert any defense as to the
enforceability of Ihis Contract based on the ebsonce or alleged lnsnffeio ey of Boy Due Diligence Pee,It being Ibo Intent of the
proles to create n legallybinding coniine for the purchase mrd sale ofthe Property nlhhuiangard to Iho existence or amount ofnny
Due Diligence Pee.
(J)"Due Diligence Period":The period beginning on the Effective Dale and extending Trough 5:00 p.m.Iwo weeks after the
Jif'oeilvo Dale of this Conine TIMII 0P THE1ESSRNC7l with ingnnl losald dao.
(k)"Settlement":The proper execution and delivery to 11wsollienent agent of nil documents necessary to complete the OinancIlon
conte upinled by this Comms,Inohidhig the deed,selllonsan statement,demi of tram and other loan or conveyance documents,and
Ihueseltlolnnt agent's receipt of all Rinds necessary to complete such transaction.
(I)"Settlement Delo"! The parties agree that Settlement will Inko place un (IS dove from the Effective Date of Ibis Catboat
(Ile"Settlement DUO),unless otherwise agreed hn,ilku3,at a limo and place designated by Buyer.
(in)"Closing":The legal process which results hi the transfer of tido to the Properly Eau Seller to Buyer.Closing includes the
Ibilowing slops:(I)the Settlement(defined above);(2)Ileo completion ofn satisfactory Olio update to the Properly following the
Sellennmt;(3)the settlement agent's receipt oranlhorization to disburse nil necessary Mods;mod pp roc011111 lou hi Iho appropriate
count'meshy of Om slangs)and deed(s)oflnnl,Ifm%y,which shall lake place ae soon ns reasonably possible for the settlement
agent after Settlement.Upon web recordation oflhc dced(s)and dcod(s)ofirnst,rally,Closing shall be deemed completed anti the
Buyer Initials Li, _ Seller Inllinls _
Page 2 of I I
Aneehilon Point No.IOa tracked 9/2007,1/1011 7111,/W/WW1 Dat Inn Leto gWrovcdJabntYby:Nmlh 041.11"
prions by ASrcaani Wlli l,eNC Tu,Mseclauimr ft/trine/441n nm Assoeltlon—NO Eal'erai No.12
Noun Cmollnn Assededon OIRMnong,Inc—Slmrdard Point Ill'
proceeds ofsalo shall bo disbursed by the settlement ager In accordance with the setllounetit atatonient and Ilio provisions of Chapter
45A of the North Cmplina Oaneml Statutes,lithe title endow shonki reveal unexpected limns,enonnsbmnces or other title dofeels,
or Inho solllentenl agent Is not nnlha1zed to disbnno all Itoccssmy Nerds,(hon Ileo Closing shall be suspended and the SoittoinonI
deemed delayed muter Primarily!' 10(Donny in Sotllemoni/Closhlg).
00"Spednl Assessnonls":A charge against the Property by a governmental authority In addition to nil vnlorenl Iaxos or by nn
owners'association In addition to any regular ossossnre t(duos),either of which may be n Ile,,against the Property.A Special
Assossnont may be eithor proposed orconflnned.
"Proposed Special Assesmnnnf:A Special Assessment Nal Is under formal consideration but lvldch lin not been approved prim'
to Refitment.
"Confrlllel Speelni Assessment":A Special Assessment dial has been approved Mar to Seliomonl whether or not It Is fully
payable al limo ofSnll lanont.
2. BUYER'S DUB DILICENCB PROCUSS:
(a)Loon:During IhaDse Diligence Poriod,Buyer,nt Bayer's expense,shall be mauled to pestle for and approval of
the Loan Welty.
(NOTE:Buyer Is advised to consult with Buyer's lender ptlor to signing Ibis offer to assure that the Due Diligence Ported allows
sufficient lime for the appmisal to ha completed and for Buyer's lender to provide Buyer sufficient Information to decide whether to
proceed with or terminate Ilio li nsnUlon.)
(b)Properly Investigation:During Me Di wD)llgoncePeriod,Buyer or Buyer'sngunis or repmsanlalives,at Bryor'sexpense,shall
be entitled to conduct all desired tests,surveys,Oppralsale,htvostlgntlons,exnulhsllers and Inspections oldie Properly as Buyer
dooms emendate,Winding bel NOT limited to Ibo(*flowing:
(I)Soil,Ulltliles And But9rOHInataI:RI/pods to determine whether he soil Is suitable for 13nyar'e intended use and whollia
there is any environmental conlandnnllmy,law,rale orMA111011euhat may prohibit,rennet or limit Beer's Intended use
(II)Soptle/Sowor System:Any applicable Investigation®to determine:(I)one conditional an existing sewage system,(2)the
oosts and expense to Install a sewage system approved by an oxisting kaprovomant Permit,(3)the availability and expanse to
connect to a public or community sower syslons,enNor 01).whether an Improvement Permit or wrillel ovninmlml may bo
obtained Ron the County Health Department fora nultnblo ground absorption maga system.
((ID Water:Any applicnbto invesiigallon(s)to dellonnino:(I)the condition of an existing private drinking water well,(2)the
costs and expensos to Install a pdvale drinking water wotl approved byan existing Constalaion Penult,(3)Ibeavailability,costs
and oxpslses to connect to a public or community water system,or It aha'al Ovate well,matter('I) whether a Conslnielion
Penult maybe obtained gam the County Health Deparhnout for a privnlo drinking water twill.
(Iv)Rorlav of Documents:Review of Iho Malawian ofRoshricliva Covenants,Bylaws,Anlolos of Ineospomtlost Rules and
Regulations,mid othergovomhng documents of mW applicable owners'association amforsubdivision.litho Propriy Is subject
to regulation by an owners'nsso4latiot,it Is teconmmo,idoil that Bnyor rovlew Ilio condoled Owners'Association DIsolomre
And Addendum(Standard Form 2A 124)provided by Bolter dot to signing this offer.
(v)Apprnisnls:An appraisal of Ilse Properly,
(vi)Survey:A survey Co determine whalhor Ihoro are any maroachmpnts on the Property gem atUaceg propanles(fmaos,
N9mways,etc.),cnoronchnsenls Rant the Plopertyonto mtinconl propenes,road orally moments amanita t roProPerb',lack
of tenni access to a public right•of--wy,or Indogallo or erroneous legal doscrlpliea In previous deeds to the Property.
(191)Zoning mid Cgvammenial Rognlallon:bwesllgailon ofeumoni or proposed zoning orother govnrnasitd regulation that
may effect Buyer's Iolanda% use of the Property, mljaoeni land uses, pintail or proposed road eoiWrneIimn, and school
attendance zones,
(vIIU Ploed award: Invwllgntlon of palmitin'flood hazards on the Piously, and/or any requbenenl to Pendine flood
insimice in order to obtain the Loan.
(o)Buyer's Obligation to RamisDnnmgo:Royer shall,at Bnya's expense,promptly repair any damage to(Ito Proporly mulling
from any activities of Bgycr mid Buyer's agentp nod contraolas,but Daye shall not be responsible for any damage armlet by
accepted maniocs applicable to any N.C.licensed professional perfuming reasonable oppmhnls,lolls,surveys,oxnmhmllons mid
Inspections oflhe Properly.This monk obligation shall survives ny termination oflhls Central.
Buyer Inlllnis idL Soder initials _ }
Page3 of I I
Arswlallon PaniiNo.12Oitcrhed duce,10 11 'fin midard Nunbas nen approvedJoGdrb7:With Cordo
I'Mlel by ASawnal trim arc We lnrMabmn Wald Ceewa Bar Aualedon-NC lint Pam Na 12
NonbcSuolinn Association ofltenm,re,Inc-Simdea Tann 12T
•
•
(d)Indemnity:B1yor1vl11 Indemnify mid hold Seller hnnndoss tont all loss,damage,almastills or costs,which shall nriso out of
arycontmel,agreement,or hUmy to superset'or property as a result of any nellvhles of Buyer mid Buyer's agents and combustors
relating to the Properly except for any loss,Mnlago,claim,snit or cost mbiog out ofpro-oxislhtg conditions of No Properlyand/or
out of Seller'smogligonco orwIllNl acts or omissions.Tlds halomnityshall survive lids Conran and mry lorminallen hereof
(o)Buyer's Bight to Tonnlnnto Buyer shall have the right to temilimic hits Conlmcl for nay reason or no mason,by dallverfng to
Seller writhes notice of Iona inllon (iho 'Ten nhnnllon Notice")during the Duo Diligence Period (or any agreed-upon wrlgon
extension oflhe Duo Diligence Period),NAM BRING OP THE ESSENCE Unmoor IlntelyloScots the'Ibnnhaliat Notice,this
Contract shall be lonolnalorl and the Hamesl Money Deposit shall bo refunded to Buyer.
(WARNING:If Buyer is not satisfied will the midis or progress of Buyer's Due Dlllgenco,Buyer should terminate this Contract,
prior to Iho arphullw:grlhe This Dfl/gano Period,unless Buyer can obtain n nwhlen oxtonslal B»nn Seller.SELLER IS NOT
OBUOATBDTO GRANT AN EXTENSION.Buyer's Mum to delivers'tormhintionNotice to Seller prior to hie expiration ditto
Duo Diligence Period shall constitute n walvor by Buyer of any right to lorudnnle this Contract based on any mailer rotating to
Buyer's Duo Diligence.
(NOTE: Pollowing the Duo Diligwec Period,Buyer may mill exercise a right la Iomthele this Contract for any other reason
peonilled undo.the hens of lids Contract orNodh Carolina Inw3
(0 CLOSING SHALL CONSTITUTE ACCEPTANCE OF TIIE PROPERTY IN ITS THEN EXISTING CONDITION
UNLESS PROVISION IS OTIIBRWfll MADE IN WRITING.
3, BUYER REPRESENTATIONS:
(a)Imran:Buyer O does❑docs mol have to obinlu a new loan is order Co purchase Iho Properly,If Boyar Is obtaining n naso loan,
Buyer Intends to obtain a loon as follows:❑Conventional O 011lon loan pl a❑Med hale❑Adjustable Rule
In the pdnolpal amort of for lean of yenr(s),al no Initial 10100e11 talo not to exceed 94 par
annum Elm'Loan").
(NOTE:If Buyer raprosams that Boyer does not have to obtain a new loon In of Iorto pnrohnso the Properly,Seller Is advised,prior
tosigninglids otbg to obtain documentation tom Bnyor n'111011 dentatalmlostltnl Buyer viIl be able to close on IIID l'ropody without
Me necessity necessity of obtaining a new loan.)
(b)Other Properly:Mow U does❑does not have to sell or lease outer real plopetty in onkr to qualify for a new loran or to
complete purchase.(NOTE:If Btlyor does have to soli,Buyer and Seller should co:Ishtar Melulhin a Contingent Sole Addendum
(glmndnrd Pont'24221)with Ibis ours•.)
(o) Porfornance of Buyer's Phnuehd Obligations: To the hese of Buyer's knowledge, Moro am no other dr mntstances or
conditions oxisling as ofBledale of Minaret would prohibit Bayer from performing Unyor's financial obligations In acconlaee
with this Conlrecl,except ns may hespeolfeally sot forth heroin.
A. BUYER OBLIGATIONS:
(a)Owners'Assocletiot Pees/Charges:Buyer shall lay any ices rcgniredfoiconfndngaccount payment Information on owners'
association clues or assessments sir payment or monition and any chnrgo made by Iho owners'essoclation In connection with tho
disposition of the Property to Buyer,Including any transfer ant/or doonnolit fee Imposed by the owner'nssooinliol.Buyer shall
not be responsible Ibr fees Incurred by Seller in completing Ile Owners'Association Disclosing and Addendum(.Standm'Form
2AI24).
(b)Responsibility for Proposed Special Assossmads:Buyershnll take Iitie subject to all Proposed Special Assessments disclosed
by Solite In Paaglaph S(b),Irony.
(o)ResponslbIlhy for Celt*Costs:hlnyershall In rospmudble Droll coals With 1011100110 any loan obinuud by Buyer,appalnd,
title search,Mlle Iusnlnnee,110001011M OKI deed mid for pnopnmllon nod recording of all inslmmona required to secure tie tinlanco of
the Puelase Prie unpaid at Sallome t.
Buyer Initials W'• , Seller Initials
Paged of 11
A0oel00o0 00011110.120 laded 711007,10011 'Hilt standard fe%nlm;been nppewd!Only by:Nath Caallun
Ihinted by APeaunlaai lhoNC DoAsfadnllon Nam CamlenllnrAsmelallon-NC Ba Form Na 12
Nath Cynthia Arsalmlon of halibut,lac.-xnuidnrd Pae1121•
5. SELLER REPRB$INLATIONS:
(n)Ownership:Seller roprosonls that Seller:
10 has owned the Properly for at least ono year.
❑has owned Iho Property for less then one year.
❑does not yet own the Properly.
(b)Assessmoeds:To the best of Sellas knowledge More are no Proposed Special Assessments except as follows(lased"Nolle"or
the ldoiNfenlion of such nssossmonls,gaily): None .
goiter vomits that (here are no Confirmed Special Assessments except as follows (instal"Nee"or the Identification of such
assessments,tinny): None .
(a)Owners'Assoelnllon(s)and Dao:To best of Solla°s knowledge,ownorship oldie Property O subjects Cl dao not sailed
Buyer to regulation by ono arinoro owners'nssoolatlan(s)and governing documents,which Impose vndous mandatory covenants,
conditions and restrictions upon the Properly and Buyer's enjoyment Ilminof,mending bin not limited to obligations to Imy regular
assessiiwilts (does) and Special Assessments. if!hero Is an owners' nssoclali0lh (hen an Owners' Association Plsclomro anti
Addendum(Stanched Ponn 2Al2-T)shnll be complaint by Seller,at Seller's expense,nod nowt be nlleloled as nn addendum to this
Contact.
(d)Sewage System Parent(0 Applicable,CI Not Applicable)Seller walnuts that the sewage system described In the
improvement Ponta attached hereto has bean installed,which svnimnly survives Closing,but makes no Anther representation es to
Ike system.
(o)Private PrhiNng Water Well Peretti(U Appllenblo U Not Applicable) sefiorsmnals Ihnn n private drinking wale avell
has been Installed,svhioh waimnly survive,Closing,but makes'to Author roprocnlmlon as to the well.(((hell Installed aferJuly
I,2008,attach Improvomonl Pcnnit hereto.)
6, SRLLI3R OBLIGATIONS:
(a)Evldonee of'1'ltlo Seller was to use bol ends to deliver ho Buyer as soon ns reasonably possible Mier the BAecliva Dae,
copies of all title Information hi possession of or available to Seller,Including but not limited 10:11110 bienrnsimpollutes,nmontoy's
opinions on title,survoya,covenants,deeds,notes mut deeds Moist Mud easomo0's rolmIng to IIIaProporty.Seder authorizes Way
attorney presently orprovlmwly representing Salter to raloso mid disclose any idle Insurance policy hi such atemoy's file to Buyer
mid beth Buyers andgollers agents and attornots;mid(2)NuPropedY's dile insurcror Its aging to release and disoloso all materials
in rho Properly's 011e Insurer's(or lltlo tonnes am it's)file to Boyar mid both Bnycrs end Seller's agents and attorneys.
(b)Access to Properly:Seller shall pinvlde reasonable access to Ileo Property(Inohuting svorkeg,existing uS1111es)through No
moiler of Closing or possosslon by Buyer.To the extant nppliontlo,Seller shall also be rationalblo forlinroly clearing dint portion
of Iho)'tepety required by the County to porform tests,Inspections mitVor ovnlnalions to<tetannhl the sultebillty oftheProperty
for a sewage system anchor private drinking Water well.
(o)Renown of Sellor's Properly:Sailor droll remove,by the dale possession Is mode available to Buyer,nil poisonal property
which Is not n pail oflho purchase and all garbage and debris from the Propody.
(d)Affidavit and Indemnification Agreonent:Seller shall Amish at Settlement an affidavit and hldoinniicnllmi wowed hi
Iona sedentary to Buyer and amines title Inanity, If any,gxealed by Bettor mut any person or entity who has perfmmod or
Blabbed tabor,services,nmlerlais or rental equipment as desodbed InN.C.O.S.§AAA-*to(improperly within 120 days priorto Ito
dale 0150100menl verifying stmt Mali anti poison Docility has been paid a gill mitt smaeing to hidonudly Buyer,Buyer's iendcl¢)
mut Bayer's title limiter against nil loss from any cause or clam arising(herommm.
(o)Pnymau nut Snfslhotlon pf Lions:An deeds otmnk liens and other charges against the Pioperty,not assumed by Buyer,must
be paid and seislicd by goiter prior to or at So ienio l Such dial ennolello may be promptly obtained following Closing.Boller
Bind terrain obligatedo
to°Melo any such annolllntions following Closing.
Buyer Ingalls ``lFl _Sollor initials
J ' Page 5 of II
Awoelellml Von Ne.12 w Sorbed 711007,112011 11thsiR lord fatelau bon Nlpm¢dlohdb•by:NOM Carellee
Pdnlell by Agrcerenl reel lite NC ger Association Noah Caroltno f..Ano rat 1,—NC ger Perm No.12
Nmlh enrollee Association of llenllors10.limo.—Steward Pea lir
(0 Tale,Lognl Access:Seller shell execute end deliver a GENERAL WARRANTY DEED far the Property at Settlement unless
otherwise slated heroin,which/hall convey fee simple marketable nod Insurable IIIc,Bto of all encumbrances except:ad velment
Ines or the muscat year(pinmled through the dale of Settlement;utility oasolrtents and liiwiolalel reslrlCllve covenants That do not
materially erred the value orate Pre reify;and such other o cunrbmuccs as may be assumed or specifically approved by Brayer In
writing.The Namely smut have legal access to a public right otwoy.
(NOTE: If any sale of the Properly may boa"short sale,'consideration should be given to attaching a Short Salo Addendum
(Standard Vona 2M 4-T)as on eddonlunl to this Contract),
(g)Deed,Excise Tuxes:Seilersholl pay for proparelon of deed and all other documents account)'to perform Seller's obligations
under Ills Contract,nod for stale and county excise axes required by tow.'rho deed is to he mode to: fns directed by Bnvob
(h)Agreement to Pey Buyer Expenses:Seller shall pay m Settlement$ N/A toward any of Buyer's expanses associated
with the'imitateof the Property less any poilien disapproved by anyone lender.
(NOTE:Examples otBuyer's expenses assaolaled with the purchase oldie Properly Include,but simnel limited to,discount points,
loan origlnallmr hes,appmisnl Res,attorney's fees,Inspection foes,and"pwpolds'(taxes,Insurance,owners'association does,
ale.)).
(t Payment of Confirmed Special Assessments:Solley shall pay all Confirmed Special Assessments,if any,provided that the
amount thereof ems be reasonably delen incl or estimated.
Q)Lnle Listing Penalties:All properly Inx leo listing penalties,tray,shall be paid by Saler.
(k)Owners'Association Disclosure mid Addendum(Standard Porn 2Al2-r):If applicable,Seller shell provide the completed
Owners'Association Disclosure mid Addendum(Standard Porto 2Al2-T)to Buyer on or before the Effective Delo.
(I)Seller's Failure to Comply or Breach:)(Seller fills to materially comply with any ofsollar's obligations under this Pongmph
6 or Sole'maternally breuohos this Conlin',mrd Buyer elects In tornrinalo This Contract as'insult ofsuch(allure or Monet,(hen
the Ennrost Money Deposit addle DuoDlllgeico Peeshnll be regulon to Dyer sad generation toimbnrao loBlryor the reasonable
costs aohaliy locum!byBuye'In commotion with Buyer's Due Diligence without&footing any other remedies.
7. PRORATIONS AND ADJUSTMENTS:Unless otherwise provided,the following Items shall be prorated through the date of
Settlement and oilkeradjusted between the pale or paid at Selllourent: I
(a)Tuxes on Real Prnporly:Ad valorem taxes on nmi property shell be prorated on n onleula'year basis;
(b)Reeds:Rents,Irony,for Ike Properly;
(o)Dues:Owners'nsseninlion mauler assessments(dues)mid other like charges.
8. CONDITION OP PROPERTY AT CLOSING:The Properly must be In snbslnnllally the sale or better condition at Closing as
an Iho date or this offer,masomRle wear and tear excepted.
9 RISK OF LOSS:The risk of loss or damage by Bre or other casualty prier to Closing shall he upon Seller.If the lnprovoments on
the Properly aro destroyed or molorinlly damaged prior to Closing,Buyer may terminate this Contract by written notice delivered to
Shclorer Seller's aged and the gamest Money Deposit mud any Duo Diligence Fee shall be rebuttal to Buyer.in the event Boyar does
NOT clod to Ieminalu this Caramel,Buyer shall be entitled to receive,In addition to the Properly,any of Seller's Insurance proceeds
payable on account oldie damage or doslnlelon applicable to the Properly being purchased.Seller Is advised not to cancel oxlxlbig
Insurance on the Propertyuntil ager confirmln record lia ii of the heel.
10. DELAY IN SETTLEMEN17CLOSING: Absent agreement to the oniony le this Contract or any subsequent modification
thereto,if a patty Is unable to complete Settlement by the Selilenront Date but Intends to complete the Imnsaction and Is acting In good
ollli arid with reasonable diligence to proceed to Settlement("Doloying Pant),and it the oilier fray Is ready,willing nod able Io
complete Settlement on Ne Settlement Dale eiNor.Delaymg party")than the Delaying Patty shall give as pouch notice as possible to
the NonDolayingParlyamt soltlemog agenl and shall hoe$itled to a delay In Satltement,If the panles BB to complete Settlement alit
Closing within Tenneco (14)days or the Settlement Dale,or to BrNhcr wend the Settlement Date by written agreement,Ilion the
Buyer Initials Seller lnlllals):
Page 6 of I I
Anoelaion Form No.120 Revhcd 7/1007,I/)ell 'Thi,aanlere roan lmr hien wavarxdJehirh•by:Norah Corollas
I'dalsd by Agreement with the NC Ba Assorlollon Nottha ellroenrAsssoelalion-NC fin Female.12
Nadi,Online Aaeelnton otRenhloro%Inv.-Smada l Vann 121'
Delnyllg PRI &IialI be In breach nild Ilio 14 nil Iaylug Pony may Iondnnlc Ihis Conlmol 1.011 210111 bo(minted to enforce any remedies
Refillable to such party tinder lids Conlmcl for Me breach.
I I. POSSESSION:Unless otherwise provided herein,possession shall be delivered at Closing.No alterations,excnvallae,tree or
vegolnllon removal or other such activities maybe done borate possession Is delivered.
12. OTHER PROVISIONS AND CONDITIONS:CHECK AL1.STANDARD ADDENDA THAT MAY RE A PART OP THIS
CONTRACT, IP ANY, AND A'TT'ACH HERETO.ITEMIZE ALL OTHER ADDENDA TO THIS CONTRACT, IP ANY, AND
ATTACH 11UIt111'O. (NOTE: UNDER NORTH CAROLINA LAW, REAL ESTATE BROKERS ARE NOT PERMITTED TO
DRAFT CONDI'T'IONS Olt CONTINGENCIES TO THIS CON'T'RACT'.)
CI Addilloan'Provisions Addendum(Penn 2A 11-17 ❑Lon Assumption Addondnnl(Pone 246-T)
❑Back-Up Contract Addendum(Vona 2A VT) CI Owners'Association Disclosure And Addendum(Porn12A 121)
0 Contingent Selo AddenNon(Form 2A2-T) LI Seller Pinnnoing Addendum(Polo 2A5-T)
LT Short Sale Addendum(Porn 2A IA-T)
❑OTHER• Sae Exhibit A and 13 nlaohad hereto for additional Inns oflhls Conlmcl.
I I. ASSIGNMENTS:This Connect may not be assigned without the written consent of nil ladies estop!In connection with n lox-
deferred exchange,bol if assigned byngraenieu,thou Ibis Contract shall be binding en lie assignee nod assIgnee's holmand successors.
1 d, TAX-DEFERRED EXCHANGE;fn the event Buyer of Seller desires to ollbct n Ins-dottwed exchange in connection will'duo
conveyance of Ma Property,Buyer mud Sollor agree lo coopomlo In°Ebeling such exchange;provided,however,That the exchanging
party shell be responsible for ell additional costs associated with such exchange,and provided RIdhue,that n non•oxclaugingpnrlyahnll
not assume any additional nobility with Inspect to such,Inx•defwed eobnngo.Hopwood Sohlorshall execute such additional documents,
haluding asslglnlolll adds Contract In commotion therewith,al no cost to the nomexolingig patty,as shall be required to give effect
to this provision.
15. PARTIES: 11111 Contract shall be binding upon and shall Inure to the benefit of Buyer and Sailer and hair respeellvo heli,
successors mud assigns.As used herein,wools In the singular Include Lha plural anti the masculine include the fe nhdno and neuter
genders,as appropriate.
1 e. SURVIVAL:ltmty provision herein conlnliied width by Its mann and effect Is required to be observed,kept or performed after
dip Closing,II shall survive the Closing and remain blinding upon nod for Ma benefit of the parties hereto until Rdly observed,kept or
marooned,
17. ENTIRE ACREEMRNT:This Contract contains the anlhoegnnomont&111e parties and Ihioro UW no repnesentalioa,Inducements
or other provisions other than Mose expressed heroin.All nougat,nddlllons or deletions hereto must be In writing and stoned by all
pnrtles.Nothing winked heroin shall niter any agreement balwcon a IU AIXOlto or brokorand Sailer or Enyor as conlnied In any
listing nitration!,buyer agency egroeraem,ora any other agency agreement between them.
18. NOTICE:Any notice,or cenmmnlcallun to be given to a party heroin may be given to the party or to such party's agent.Any
wrlltannotice or commdnicntlon In commotion with the tronsnctlon conampialedd by this Contract may he given l0 n party dr a party's
agent by sending or transmitting II to any mailing address,e-mail address or rax number set(Nit lin Tho"Halloo Infos allot"soot ion
below.Seller and Boyer num that the"Notice lnformallan"and"Escrow Achmowledgme t"sections below shah not caslluulo n
nalodnl pan of this Contract,and dint the addition ormodhlleelon any information bomb shall not consihalo a injection otnn offer
or the creation of a comderoffe.
19. EXECUTION:This Connect tiny besignel In niulliploorighols or countervails,all of which together tonging*one and(Mune
Instrument,and Tho pndies Maul ns their seals the word"SEAL"beside Moirslghmlees below.
20. COMPUTATION OF DAYS:Union olhewise provided,for purposes of ills Conlon,the tone"days"than"mean cansecngvo
calendar din,including Salurdnys,Sundays,sodholidays,whether reckon,stale,local or teligIous.Par the purpose of m1001011ng
Boyar gdlinlsS t _ Seller lnitlnls
Page of 12
AeocMleu lie No.13 U Refined V2007,111011 TeesIe dad term Ins been nlIirovedJolnlly hr Na,Il,Carolina
Pantedby Ayceneiwnb lheNC lin,Al«Indan NaphCnrollun Bar Assoclellon—NC liar lbnNo.12
NoabemolM AueelellonofMMMcus, no.—8000110110000 IzT
days,Iiia comdof"dnya"shall Login on Lila clay followingihe day upon which noy net or mince as provided In this Contract was required
la be purloined or mode.
TIIE NORTH CAROLINA ASSOCIATION OP REALTORS°,INC.AND THE NORTH CAROLINA DAR ASSOCIATION MAKD
NO REPRESENTATION AS TO TIM LUOAI. VALIDITY OR ADEQUACY OP ANY PROVISION OP THIS PORN! IN ANY
SPECIFIC TRANSACTION.IF YOU DO NOT UNDERSTAND THIS FORM OR PEEL THAT IT DOES NOT PROVIDE POR
YOUR LOCAL NEEDS,YOU SHOULD CONSULT'A NORTH CAROLINA REAL ESTATE ATTORNEY DUI'ORR YOU SION
Tills offer shall become binding cannot on IIIc Effeolivo Dino,
OUYEIt: SELLER'
I Pr ,De4el .vM4 r
H&H Co sl'ncl oofPPflJyy 11hlor111q LLC SosNl WtvJau'lilJ=L6 T
Print Nmno: C KrtV ` � Print Nona: rJY4L A1 AU'tll '
TSIo: S. V• '1. TTON: v 1A1` -
Dnle: �p./� Dalai J ISd�'�
•
Unyor Ldlinis% " Boller Inillnla �1�t— __
111ff/ Pap 8 of 12
MscolMlon l'omeNo.110 Rocked moo?.111011 1Lls auidud Aar lisbeen o11PrevedJolmly by:Noali Cannan
MhMd by A&ennenl with Re NCIIa AsiocIalon Na111011011111llnrMicslnllon—NC PS(Ioin'No.12
Nodh CTrIInnissocintlen ofltenllen9,Ino.—Flnndord Pani 12T
•
_r NOTICE INFORMA'T'ION
(NOTE: INSERT TDB ADDRESS AND/OR ELECTRONIC DELIVERY ADDRESS IIACH PARTY AND AOIINT APPROVES
FOR THE RECEIPT OP ANY NOTICE CONTEMPLATED EY THIS CONTRACT.INSBIIT"N/A"FOR ANY WHICH ARE NOT
APPROVED.)
BUYER NOTICE ADDRESS: SELLER NOTICE ADDRESS:
Mailing Addross: II&li Nomas.N o Kowv Avant Mailing Address:
2919 Breozewnod Ave Salle 400.PavollevIlle.NC 28x04
Dryer Faxl: (9101485.0464 SellerFnxg:
buyer&mall:J(e oAvanlnhglwme..con Seller Email:
SELLING AGENT NOTICE ADDRESS: LISTING AGENT NOTICE ADDRESS:
Plnn Name: Finn Namo:
Aoling as U Buyer's Agent O Seller's(nm)Agonl U Duni Acting as O Seller's Agonl U Dual Agent
Agent Mailing Address:
Melling Address:
Individual Listing Agont•.
Individual Selling Agad: U Aoiing as a DosignntedPunl Agent @hock only irnpplicnbio)
U Acting ns n Dmlguaed Dual Agent @hack only Ir License 0:
applicable) LIsling Agad Phonon: _
l.lcanso Listing Agan FaxE:
Ii: Listing Agan E-
Selli ng Agent Plionek mall:
Selling Agent - ---
Faxil:
Selling Agent E-
mail:
ESCROW ACKNOWLEDGMENT OF INITIAL EARNEST MONEY DEPOSIT
Meow Agent nelojowledges receipt Mite Inillnl Emmert Money Deposit nod norms to hold and disburse diesnnso In actonlnneo
with Ileo loons hereof,
Dale 111011:
By:
(Signnlm3)
(Print mon*
Player initials Gti Sailor lnlllMs
Pagan aril
Msorlellon PortaN°.12O Wised 1)1001,I/1011 'ILInlmelatJ 2mnias been Ntpnve4jololly by:North Cardin
PNtIodb)Awccla nlwImlic NC norAscodmlan Nonhlball0ngnrAnalulon•'NCIInrPon'No.12
Nardi Lbrollno Asmdntton orlbaIIo,ll,lot—SWneord Pont 12T
•
j:XHIUPI'A
A doming Ilml more specifically Idenlllles the Property
_X_Is nllncllcd
is not nllacimd
Bnyor Initials Al) Sailor 101111is .a).. _
1 Pogo 10 of I I
Association From No.12 0 nesdud111007,1/1011 'Nis Mondani loon I m Ion nryimrwllobnh•Iyc Noah Moline
PAM by A¢nenunl dish the NC Elm AssocrGIton Nol@CNolilq Der Auoelalion-NC 11nrPoml No,12
NonhcmollnndsmAmlmlorfealmme,Ino.-41andald roan I2T
VI.(d$ tl yY.wLgiMDINMu I,uWl nIu ,uIIMNNMYJnp
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vla 1 „10 ,‘AN ' '',. ' : le *1\ a
4171 p.m II •-.;;;;0- two . ,.,./. -- ]-
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lAddlllonnl Torahs)
I. Purelinso Price: Buyer shall pay Forty-Three Thousand Five Hundred Dollars(543,500)ibr each l.ol In The Metiers Pad
213,Part 2C and Parl 2O. Buyer agrees to n three percent(394)amnml escalator on the purchase price for this ln'fheManors
Pan 213.
2. Sallleuet Date:Buyer agrees to purchase the fldllal ton(ID)lois within fonyBvo(45)da s ofl11e Ofbelvo Date oflhls
centrad. Those lots will be lots 638,639,340,730,731,753,751,755,756,757 in Manor al Lexington Plantation talus lot
254 in Village at Lexington Plantation which will be the Model Homo for Boyar. Fndhermoro,Buyer noes 10 keep tan(10)
unsold homes built n1 all halos by closing on an additional lot within allay(30)days after the solo of an hwontory house
ponding to a third party. Buyer Anther agrees le purchase a Mininpnn of twenty-four(24)lots ovary twelve 02)months.
3. Buyer's Bights:
n. Boyar shall have the dgld to list,soil and inalhoI their houses in Lexington Plantation.
b. Buyer shall have Seller's permission to construct Inventory homes,and n model hone on lot 254 odor to lire lot
Salllauell Pale mid Seller agrees to Assist Buyer In obtaining,al Buyer expense,building'lentils from the county.
a. Buyer will the sole builder far the Manors al Lexington Plantation Pad 20(311 Lok).
d. Notwilhstandhlganything to the°enmity In Section 12 of the Offarto Porahae,Boyer hereby reserves she 4ghl to
assign this Contin!to another party,whiten'moulting written permission of Seller;however,upon nay such Buyer
assignment,Buyer shall nal be relieved orally nubility muter this OBbrTo Purchase,absent n written release(tom
Belief.
4. Seller's Obligations:
a. Lot coolers stall be slaked and marked intorno th0 Settlement Dale.
b. All lot Improvements,Jnohidhlg water services,sewer services,laved slreets,sIrcel lighting,erosion control,
oleetdeal,telephone,cable,all minium ala landscaping and amenities shall becompleted prior to the Settlement
Data.
o. The plat for The Manors Pad 2O shall be recorded.
y.\ d. Sollorwanmilc that nil streets have bean constructed to NCDOT stnndnnk mud agrees to cause such streets to be
ebmaintained until such lino as Beller applies for mud receives NCDOT accepleme.
e.--8ellorrrwleeMmnIrsh lkotempt-Buyer mrinrylng-NQA.dncsonmtretmsadiels 01111 awl Snlenstthensoisbudlt
MlnlsatMvrttldttl)Bgly
C Iraq prat oft Lot receives any fill material,the same lot shall have been compaeled by mechanical moans and shall
moat or exceed ninety-five poroenr(95%)compaction,cnladnkd by Iho Proctor test.
5. Onye^s Option to Purchase The Moneta at Lexington I'Innlnllon Part 2C(56 Iola)and Pet 21)(30 tots):
a. Seller giants to Buyortha Option to Purchase the 56 lots In Pat 20 and ate 30 els In Pmt 2D. Upon notification
Nom Seller of its intent to develop the smalltime,al@arpet 2C mi/or Part2D,Buyer shell have thirty(30)days to
present to Seller an Offer to Purchase for the Lois to be developed, Tim Offer to Purohaso shall certain the same
(onus and conditions as staled In this Of br to Purchase,
Bayer initials Sailer hdllnls
Page 1 l of II
Aeoalnliai Vonii No.12O ltovlse47/1007,112011 this slind S rem lin,bran op iowdJokiIy by:WWI.Cnrolino
Idinle64y A2naunhdm setiC Un:AlsolOai North['mann Dor Association-NC Um Joint No.12
Noll,Carolina AsewlallonofRobb"Ino.-Srmidad Flinn 321'
Application#
Harnett County Central Permitting
PO Box 65 Lillington,NC 27546
*Each section below to be filled out 910-893-7525 Fax 910-893-2793 www.harnett.orglpermits
by whomever performing work.
Must be owner or licensed
contractor. Address,company Application for Residential Building and Trades Permit
name 8 phone must match
Owner's Name: H&H Constructors of Favettevill(jt LLC. Date:
Site
��,'' ///ff
Address: • r Pl a • 14.0 • Phone. • (p(4
Directions to job site from Lillington: NC Hwy 210 to Spring Lake, Turn Rt. On Overhills turn left to stay on
Overhills. Continue straight onto Nursery. Turn Rt. On 24/87, Turn Rt on Sawyer. Keep Straight.t.l
Subdivision: The Manor (rD Lexington Plantation Lot: IS(P
Description of,,P�rro(Gpyosed Work: New Single Family Dwelling #of Bedrooms:q
Heated SF:pw:WI Unheated SFrThaa Finished Bonus Room? Crawl Space: Slab:
General Contractor Information
H&H Constructors of Fayetteville, LLC, 910-486-4864
Building Contractor's Company Name Telephone
2919 Breezewood Ave. Ste. 400 Fay., NC 28303 Leannahair(o)hhhomes.com
Address Email Address
74158
License#
Electrical Contractor Information
Description of Work Service Size: 200 Amps T-Pole: X Yes_No
JM Pope Electric, Inc. 919-776-5144
Electrical Contractors Company Name Telephone
409 Chatham Street Sanford, NC 27330 electricpope(awindstream.net
Address Email Address
21326
License#
Mechanical/HVAC Contractor Information
Description of Work
Carolina Comfort Air Inc. 919-934-1060
Mechanical Contractor's Company Name Telephone
5212 US Hwy 70 Business, Clayton, NC 27520 carolinacomfortair(owahoo.com
Address Email Address
29077 H-3-I
License#
Plumbing Contractor Information
Description of Work #Baths al e5
Dell Haire Plumbing 910-429-9939
Plumbing Contractor's Company Name Telephone
PO Box 65048,620 Gillespie St. Fay, NC 28306 dellhaireplumbinq(a)hotmail.com
Address Email Address
32886P-1
License#
Insulation Contractor Information
Tricity Insulation, Inc. 418 Person St. Fay., NC 28301 910-486-8855
Insulation Contractor's Company Name&Address Telephone
*NOTE: General Contractor/owner 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 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 current fee schedule.
Signature of Owner/Contracto icer(s)of Corporation Lo'SiIl
Date
Affidavit for Worker's Compensation N.C.G.S. 87-14
The undersigned applicant being the:
X 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:
X 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 worker's 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 Name: H&H Constructors of Fayetteville, LLC. /�nn ^^—1
Sign w/Title: �QQbwGr .�.r /Permitting Coordinator Date:LQ/� r 1 l 11
Appointment of Lien Agent: Details - LiensNC Lien Service Page 1 of I
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 06/28/2017
Entry N: 8]851) Initially filed by: meaganbradehaw
Designated Lien Agent Project Property Print & Post
Puss Ammcen l lite Insurance Company MLP000756 Lot 7%Manor@ Lexington Off-.""-0
Plantation '?k1
OnlinetnyEimmacTutt 209 PITI FIELD RIM m
Address.19W Hargett Si.swp 507/xllagh.NC Cameron,NC 28726 Q-
.-
HamenCounty
Z/nol Contractors:
Phone:0&0-690.9561 Please post this notice on the Job Site
Email: Property yplsutrtgl
ms: Perty Te supplier.and Subcontractors:
:::. Scant is.image vetch your an phone
view tilts m mg You canthen rite n Nona
to Lien Agent for nits project
L2 Family Dwelling
Owner Information
Date of First Furnishing
H&H Con srnnam of Fayetteville,LLC
2919 Oreemwood Avenue Ste 400
Fayenenlle. NC 2%03
I:nited States O5/2l/2019
Email I can tialah@hh homes corn
Phone 0161X6-4H 4
View Cnnt m encs l0)
Technical Support mline::9801 E00-7]S4
https://apps.liensnc.com/scr/appointment/details.html?entryNumber-6785I7&printable= 6/28/2017