DOCUMENTS Initial Application Date:A..LR l Application# 11.50C:9-1 ` O 2 2,
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.harnettorg/permits
"A RECORDED SURVEYVEMAP,yRECORDED DEED(OR OFFER TO PURCHASE)R� &SITE PLAN ARE REQUIRED "
WHEN SUBMITTING A LAND USE APPLICATION
LANDOWNER:HE H U9atytrix*ir j . l t LLO /I/•Mailing Address: d 9� 13'e e z C(L)L{d,,4Oy'. fk y'J
city:r\----/k(Q (ktj U State:A..� Zip:ab 9l'3 Contact No: 9/0'9'cf* fW EmaiitesdinclhairehkkOR1CS.C:YN
APPLICANT': S f AS is ti CDLVk UL Mailing Address',
City: State: Zip: Contact No: Email:
'Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE:1 Lea- Il l r\Cu r • 9i0-v ,-Yf6v
PROPERTY LOCATION:Subdivision: //li 1'IanOA (exi/l51fp1 NQM/6/&' Lot#:9 Lot Size: 1..CreS
State Road#Q�-((� c�)I � State Road Name: I 1 (: ] a Map Book&Page:6)O13
Parcel: //0—\O1 U .051 (, naRa 43 PIN:g 15 - aO -4 7 �j /
Zoning:/U4-ZU(Z Flood Zone: 7k Watershed: N q'Deed Book&Pag ' / Power Company*: l %,9/'? /C�•
'New structures with Progress Energy as service provider need to supply premise num er� from Progress Energy.
PROPOSED USE: /
tr.-SR):
/ USE:,
1 so
��LL ee�� ii Cr OD' Monah�A/
t SFD'.(Size xy ,0#Bedrooms:3_#BathS�?Basement(w o bathe. 0 Garage: Deck:FO—Crawl Space: Slab: Slab:V
(Is the bonus room finished?( )yes no w/a closet?( )yes (fno(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?( lyes ( )no Any other site built additions?( )yes ( )no
❑ Manufactured Home:_SW DW_TW(Size x )if Bedrooms:_Garage: (site built? )Deck: (site built? 1
❑ 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?( 1 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 land,own and that contains a manufactured home within/five hundred feet(500')of tract listed above?( )yes (f/)no
4'Does the property contain any easements whether underground or
overhead(✓1 yes ( 1 no
Structures(existing or proposed):Single family dwellings: L, I Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks:. ( Comments: \^
Front Minimum 3s Actualt
�T�D .
Rear .)C 1 I 1
Closest Side ti to Ira.31
^• �
SldestreeVcorner lot )U f7 1 . I I
Nearest Building
on same lot
Residential Land Use Application Page l of 2 03111
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
N c Zio it)cEye/rd/ Iyr, <7y lak P, 7 /4 r{ o.-,
(Due(l1Ill t ild. lr)rn /e71 /0c/gy o.-, 04zi,A,/(c
di ftic<, S /: f ti' /0A.Ilfreri .
-Iv rn if un ay/17 iUrn ! + on JCt ULyeer , /Cu, Ifrr,-S'U
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.
1 hereby state that foregoing st meets are accurate and car set to the best of my knowledge. Permit subject
Sto1rrevocation if false information is provided.
II
Signature of Owner o ner's Agent "I ate, 1
***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
I, MICHAEL P. GRIFFIN , certify that under my direction and
supervision, this map was drawn from an acrual field survey, that the error Y�
of closure of the survey as calculated by coordinates is 1:10,000+; that the 4
4
area shown hereon was calculated by coordinates. .`d,
Witness may hand and seal this 0A7E day of MONTH 2017 4
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PROPOSED
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4C7ill FS
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TAPLOW TRAIL
50' PUBLIC/UTILITY R/W
RENSCN: LEFT HAND&RECONFIO 6/21/17
Cl R=25.00' L=33.49' N08'37'21"W 31.04'
C2 =225.00' L=37.05' S42'17'14"E 37.00' I SETBACKS
OFFER TO PURCHASE AND CONTRACT-VACANT LOT/LAND
For valuable consideration,the receipt and Segni sufficiency of which are!tetchy acknowledged,Buyer offers to purchase mel Seller
upon acceptance agrees to sell and convoy the Properly on the lams and conditions of this Offer To Purchase and Contract and any
addendum or modification Runde III accor olive will Its terms(together the"Connect").
I. TERMS AND DEFINITIONS:The terms!Mod ej shall have Ibe respective meaning given them as sot forth minccntto each
tont(o)"Seller", PP Developing Comp./nc. yg' A (aa7'�'p
@)"Buyer's N&ILCmnarnelors ofpnvellovllia.• :atiN 'lis Assigny
(o)"Propoity":'The Novelty shell include all that real(ninth described Ikelow together with nil appurlonmsocs thereto Including the
improvements located thereon. .
Street Address:
City: Cameron
County: Hornell ,North Caroline
(NOTE:Governmental authority overloxes,zoning,school districts,utilities cul mall delivery may differ Rom address shown.)
Legal Description:(Complete tILL applicable)
Plod Reference:Lot(s) All lots looted hiPrt213 of Moors et Lexlnelon PlmMtlmtand Lot 254 in Village at LoxlnutonPlmmallog
Plot Book/Page: 2013/306a07slul Plat Book 336/756.
(d)"Poeheso Price":
S 1.696.500.0g paid ht U.S.Dollen upon the following terms:
S u/a BY DUB DILIGENCE POB made payable to Seller
S BY INITIAL EARNEST MONEY DEPOSIT made payable to Bserow Agent mined
in Paragraph NO with this offer by CI cash O personal check 0 official bank chock
❑other
S By(ADDITIONAL)EARNEST MONEY DEPOSIT made payable to Escrow Agent -
named In Pnragmplr 1(0 by cash or innncdinleiy available Nods such as official bank
. check or who (muster to be delivered to Escrow Agent no Inter Igen
l'ldWC
BEING OP27IRR$SRNCR with regard to sold date.
S BY ASSUMPTIONoftho unpaid principal balance mut all obligations of Seller on dm
existing lonu(s)secured by a decd of best on the Properly in necavlant°with the
clinched Lon Assumption Addendum(Standard Forms 2A64).
5 BY SELLER FINANCING in accordance with the attached Seller Financing
Addendum(Slnndnnl Porus 2AS•T).
S 1696.500.00 BALANCE of Ma Purchase Price In cash al Settlement(souse or all ufwhich may be
paid with the proceeds eta now loan)
Should Buyer fall to deliver either the Due Diligence Freer my Initial Bamesl Money Doposlt by the liftcclivo Dale,or should any
cheek or oilier-Rinds paid by Buyer be dishonored,for my reason,by the Institution upon which Iho payment Is down,Buyer shall
hove ono(I)banking day after wrillon nonce to deliver good hinds to the payee.Ill Iho event Unyer does not timely deliver good
Rinds,Scher sit nll inyethe right to terminate this Contract upon written notice to Buyer.
(o)'Earnest Money Deposit":The Initial Boniest Money Deposit,the Additional Boniest Money Deposit and any other canes(
monies paid In comedlou with this Imnsaellon,hereinafter collectively inferred to as"limos!Money Deposi",shall ho deposited
and hold In escrow by Bsacw Agent until Closing,at Mitch limo It velli he credited to Buys',or until this Control Is otherwise
lonnlmmed.In the oval:(I)this offer Is not accepted;or(2)a condition of any resulting contract Is not satisfied,hien the Barnes!
Money Deposit shall be rehinded to Buyer.In the event of breach of this Contract by Scllor,the Boniest Money Deposit shall be
redmded to Buyer upon Buyers request,but such return shall not affect oily oilier remedies available to Buyer for such broach.II,
llo event of breach afih&Contract by Buyer,the 031 Money Deposit shall be paid to Seller upon Sailor's!equal as Ilgnidated
Buyer liIlials 7" - Seller hdtiols \1
'm
���111___��r Pugs I of ll
AssocWion ForniNo.i20RcvkN7/1001.1/2011 Tnls standard tondos bra glprorcd)oIntlyty:Rosh Carollnn
Fdaled byAFwmml Oh laeN011nrAuoolaion Noatl Caroling rMiooiNlm-NCRarlomWo.12
Nall,(brohins AssacImlauoflteatlos8•Ina-Slmmad l'mnl 12T
damages and as Sellers sole taut oxoluslvo remedy for such breach,but without linrlllllg Seller's rights under Paragraphs 2(c)and
2(d)for dandage to the Property or Seller's right to retain the Due Diligence Pee.II Is acknowledged by the parties Hal payment of
Itielimnost Money Deposit to Roller hi Ilse event eta breach of thisContract by Beyer Iscompensatorymid not punitive,such amount
being a ronsonable eslinmllon ethic actual Toss Ihm Seller would Inures n result of such broach.T7sepayment of da Earnest Money
Deposit to Seller shalt not constitute a penally or forfeiture but actual compensation for Sellets anticipated loss, both parties
acknowledging(lie difficulty taloindning S611er's actual damages fbr such breach. If legal proceedings am brought by Buyer or
Seller against he other to recovertafanresl Money Deposit,the prevailing party lo the proceeding shall be entitled to recover from
the non-prevailing may reasonable attorney fees and court costs Incurred In commotion wvI1h the proceeding.
(Q"Rserowv Agent"(insert ammo); N/A
(NOTE;In Into avail ofa dispute between Seller mid Boyer over the disposition of the Earnest Money Deposit hold In escrow,n
licensed real estate broker('Drokor')Is reunited bystnle law(mid Escrow Agent,If not a Broker,hereby agrees)to retain the tinniest
Money Deposit In He Escrow Agent's trust or aroOw account until Escrow Agent has obtained a written release from He miles
consenting to Rsdispositionoru ntildisburcmne t is entered by court ofco npotenlyirlsdkllon.Alternatively,if a Broker Is holding
11w Umnest Money Deposit,the Broker may deposit He disputed Mottles with the appropriate clerk of court In accordance with the
provisions ofN.C.O.S.§93A•12.)
TDM PARTIES MARE THAT A ILEAL ESTATE BROKRRAOB PIRM ACTING AS ESCROW AGENT MAY PLACE'ITIS
BAIINRST MONBY DBPOSI'1'IN AN INTMUIS 'BEARING 'TRUST ACCOUNT AND THAT ANY INTBRRST EARNBD
THEREON SHALL BE DISBUItSBD TO THE ESCROW AGENT MONTHLY IN CONSIDBRATION OP TIM RXPBNSBS
INCURIIBD BY MAINTAINING SUCH ACCOUNT AND RECORDS ASSOCIATED 11IURBWITH.
(g)"Effective laid':The dale litnt:(I)lite last mot Buyer mid Seller has signed or Initialed this ofibrori1w fluid counteroffer,If
any,and(2)such clguMgor Inlllalhlg is communicated to the patty making Ike offer or counteroffer,as Ho ease may be.
(h) "Dno Blugence": Buyer's opportunity during the Date Diligence Period to investigate He Property mud lite aonsnetion
contemplated by this Caramel,Inclndingbut nal necessarily limited to He matters described hi Pnragtnph 2 below,to decide whether
Buyer,in Buyer's solo discretion,will proceed whin or tofu pato Idle transaction.
(0"D ue Diligence Ped':A negotiated amount,If any,pall)by Buyer to Seller with His Contract for Buyer's right to conduct Due
Diligence during the Due Diligence Period.It shall be the property of Seller upon the EfTollve Dale and shall hen credit to Buyer
nt Closing.The Due Diligence Pee shall be narrotnndnble except In Ho event of a material broach of this Cmlhnct by Seller,or If
this Contract is tonlnated under Paragraph 6(I)orPemgreph 9,eras otherwise provided hi nnyaddendunt heolo. Dnyorned Seller
each expressly waive any tight that me), tiny have to deny He right to conduct Duo Diligence or l0 assert any delouse as to the
enforceability of this Connect based on the absence or alleged hunffole ey of any Dne Diligence Pm,It being the Intent of He
miles to create a legally binding conked for the purchase mid Woof Ho Property without mad to the existence or amount of any
Dim Diligence Pee.
0)"Due Diligence Period":The period bogbnthrg on the flfNmivo Dale mut extending through 5:00 p.un.Iwo weeks after Iho
3ffeellve bale ofhWt Correct TIM?IEfNG OP Tile ltSSENCS wvihu iwtd to said date.
(k)"Settlement":The proper execution and delivery to theseliemmit agent of nil doetnants necessaty to complete He Innlandlon
cuntentpinled by Ills Contract,Including the deed,settlement alatanonl,damn of trust and other loan or conveyance documents,and
the selllertatt agent's receipt oral)Minis)necessary to complete such tr'allsneltoll.
(1)"Settlement Dato'h Tim parties agree that Settlement will take place an 45 days gam the Effective Dale of Iiia Contract
(the"Settlement Date"),unless otherwise agreed in writing,al a limo and place designated by Bayer.
(III)"Closing":The legal process rvhrleh results in the transfer din to the Property Rom Seller to Buyer.Closing inolulles the
following steps:(I)the Settlement(defined above);(2)Ho completion of n satisfactory Idle update to the Property following the
Song (3)the settlement agent's receipt ofnnlhorrzellon to dlsbui n all necessary Rods;and(4)rocoi iatlon In the appropriate
coal'meshy elite deed(s)and deeds)of Mist,irony,which shall lake place as soon as reasonably possible for the settlement
agent nforSettlement,Upon suet)recordation ooldiedeld(s)and deed(s)nflrast,if any,Closing shall be deemed completed and the
Buys•Iuhlals G/, Seller Initials�+1
TTT Page t of 11
Aapohllen papa Na 120!Wind 9/2001,111011 thlsswldeid form In seal p'erowdlainny by;Norlli Catalina
Printed by Agacime x1ulilie NC Be Assodeliel Nmih Camila,Dar Asroelnllon—NC Manna No.12
Nnllli Cnlolbin AsadsltenaflIeaI(orc®,ilio.—Siwaanl Caen 121'
proceeds of saleshall be disbursed by the selllomat agent In actedlanco with ihesellleine t statement and theprovisions of Chapter
45A of dm North Carolina Oeteml Statutes,If the hide update should reveal unexpected liens,onountbronces or other Bile defects,
or if Ike se tlelnool agent Is not naiad Zed to disburse all necessary gelds,Ikon the Closing sling be snspmmed cud the Settlement
deemed delayed under I'arngmph 10(Delay In Settlement/Closing).
(n)"Specht Assessments":A charge against the property by a governmental authority In addition to ad valorem taxes or by tin
owners'association in addition to any jugular nasoseinenl (duos),°inter of%hick may be a Iles against the Propeily.A Spain'
Assessment may be either proposed or continued,
"Proposed Special Assessment":A Special Assessment Ilial Is raider formal consldcn elan but which kms not been approved prior
la Settlement.
"Confirmed Special Assessment":A Special Assessment Mat Ins been approved polo'to Settlement whether or not It Is fully
pNobleat lbw ofSoldentenl.
2. BUYER'S DMIDDILIGENCE PROCESS:
(a)Loan During the Dim Diligence Period,Boyer,al Buyer's expense,shall be entitled to piano qualification formed improve'of
the Loan if any.
(NOTE:Dnyor Is advised to Conseil with Buyer's lender prior to signing this offer to assure(hal Ilio Doe Diligence Period allows
sufficient dine for(lie optimise'to be completed and for Buyer's to iderto provide Buyerstablen lufornsnllon to decide%Shelties to
proceed with or termlllat°the Imilsaelioii.)
(b)Properly Investigation:During the DuoDiligencePeriod,Buyer or Buyer's agents or represanlnllves,at Buyer's expense,stand
be entitled to conduct all tetrad Imes,surveys,nppmisnls, Investigations,examinations and Inspections of Iho Properly as Buyer
deems appropriate,hsotudhig het NOT limited to die Ikllowhig:
(I)Soil,Utilities And Environmental:Reports to determine whether lite sell Is sellable for Buyer's Intended use mrd whether
there Is any onvlronmagal collanthmlion,Ince,rule orrognlntlon Ilint mny mothll,restrict or limit Buyer's Intended use.
(R)Saptle/Sage•System:Any applicable bivesligallon(a)to determine:(I)Ile condllbn otnn existing sewage system,(2)the
costs and oxpmssa to'Minna sewage system approved by an existing Impiavanront Permit,(3)the availability and expense to
convect to n public or momently server system,Anspor(d).whether an improvement Portonor written ovalnnlo11 may bo '
obtained grow IliaComity Health Dopnrlmanl for sellable ground absorption Sewagesysfom.
(III)Wen Any applicable invostignllou(s)to determine:(I)the condition of an existing private drinking water well,(2)the
costs mid expenses to Install it private drinking water well approved by an existing Construction Penult,(3)the availability,costs
and expenses to connect to a publics or community water system,or shared private sell,nu/or(4) whether a Conslnicllon
Permit may be obtains!from the County Health Department fora private drinking%vntar%roll
(Iv)Review of Documents:RovieW of the Deelandon of Restrictive Covasbnts,Bylaws,Attlates ofincorpomgon,dines mrd
Regulations,mud other governing documents ofany applicable owns'association and/orsubdivislo n.If ibo Propony Is subject
to regulation by mi ownem'nsseclallon,Il Is mconnniulod Mat Buyer review the completed Owners'Association Disclosure
And Addentlugm(Stnsdard Penn 2A124)provided by Seller odor to signing hits offer.
(v)Apprnusnls:An appraisal oftho Properly.
(vi)Survey:A survey to determine whether More am any encroachments on the Properly from adjacent properties(fences,
driveways,etc.),encroachments from IlrePropeny mite adjacent properdos,road or oddly oasaiisonlscrossing the Property,lack
of legal access to public rlghl•oftwny,or Indefinite or erroneous legal descriptions in previous sheds to the Propetly.
(vii)Zoning hent Cevorn natal Regulation:Investigation of currant or proposed zoning or other governmental regulation that
may Agee Buyer's Intended use of Ilia Properly, adjacent land uses,planned or proposed road construction, and school
attendant°zones.
(vitt) Flood Dunnet: West Wilms of potential Dooddmznuis on the Ninny, sutler any requirement to pmchme flood
insennco In enter to eblahi the Loan.
(e)Boyar's Obligation to Repair Damage:Boyer shall,at Buyer's expense,promptly repair any damage to the Properly mulling
Iyom any activities of Buyer ninl Buyer's ngonls and contraeois,bel Boyer shall not be responsible for any damage caused by
accepted practices applicable to nay N.C.licensed profossiannl performing reasonable appraisals,tests,surveys,exnndnallo is and
Inspections crib°Property.This epelsobligationshall surviveoily tonnlnnllon otitis Contract
Buyer initials_WI_ Seller intents
Page 3 of 11
Assednion conn No.120 Ranted 2/2001,112011 Tlduundwd bun has Iaen piricwdJoleh'by:sem Carolhln
'doted by Agreement Nth are NC BarAssodalon Nath CeroihailorAuodadom—NC liar feel Nn.12
Nanbgeollnn hocander ofRrmo,s%hi.-Blended roan i2f
(d)Indemnity:Buyer will Indemnify and hold Sellar harmless Rom ninon,damage,claims,sults or cons,which shall arise oat of
any contract,agreement,mining to any person orproperty es n result of tiny nth/111w of Buyer and Buyer's agents and conimdm'a
relating to the I'roperlyaxeopl for any loss,damage,elnim,ail or coo arising out ofpao.oxlsting conditions of the Properly and/or
out of Sollars negligence or villAd eels or omissloiis•'I'his Indemnity shall survive this Contract and may lonninnllon hacof
(o)Boyar's Itlghl to Ter nuhiate:Biyor shall have Ow rigid to terminate lids conlmcl for any reason or no mason,by delivering to
Seller written notice of lemhallmn Oho"Termlualon Notice")during the Duo Diligence Period Or any agreed.upon written
oxtodsiom tithe Duo DlllgeoePerlod),TINE BEING DN THE ESSENCE If Buyer dimly dollvws Iho'termination Notice,this
Contract shall be lonnln vol and the Earliest Money Deposit shall bo refunded lo Mayor.
(WARNING;If Buyer Is not satisfied with the iesulr or progress of Binyer's Due Diligence,Buyer should terminale this Contract,
pilot to the nrphw to n of the Dun DA/gance Period,nntosrHnyer coil obtain a wrrBlon extension Rom Seller. SELLER IS NOT
OBLIGATED TO GRANT AN EXTENSION.Buyer's Adjure lodolivora Termination Notice to Sellerpriorio theoxpimtion orate
Due Diligence Period shall constitute a waiver by Buyer of any right to terminate this Contract based on ally matter totaling to
Buyer's Due Diligence.)
(NOTE: Pollowlug lira Due Diligence Period,Buyer may still exercise n right to terminate this Contract for any other mason
permitted titular the teras of this Conlmol or North Carolina law.)
(0 CLOSING SHALL CONSTITUTE ACCEPTANCE OR TIIE PROPERTY IN ITS'THEN EXISTING CONDITION
UNLESS PROVISION IS arra RWY1$B MADE IN WRITING.
3, BUYER REPRESENTATIONS;
(a)Loan:Buyer O does O docs not have to obtain a new loan In order to!maltase the Properly,If Boyar Is obtaining a mew loan,
Buyer Intends to obtain a loan as follows:O Conventional O Other: loan pin O Fixed Rate Cl Adjustable Rote
In the pdnelpai amount of for n tern of yenr(s),at no Initial Interest=to not to exceed %per
annum rhe"Loam").
(NOTE:IfBuyer roproswds that Boyar does not have to obtain a new loan In adorn,purchase the Property,Seller Is advised,prior
tosigningthis oAehtoobtain documentation tombuyer which demonstrates that tlnycr vflt be able Jo closeon the nonparty without
the necessity of obtaining a now loan.)
•
(b)Other Pnoporty: Utwer Cl does O does not have to sell or lesso oilier real monody in ardor to qunlifj'for n now lona CI to
complete purchase..(NOTE:If Buyer does have to sell,Buyer and Seller should consider Including n Contingent Sole Addendum
(Staudnrl Ponn 2A2-l)with this offer.)
(o)Porformnnvc of Utp'er's IHnnuehd Obligations: To /lie best of Buyer's knowledge, hero am no oilier ohcmnslnmces or
conditions existing as of the dale of MR offer hal would pmhlbil Boyer from perforosing[Wort limmeinl obligations In accordance
with this conlmcl,except as may in(po icallyset firth heroin.
d. BUYRROBLIGATIONS:
(a)Owners'Association Rees/Charges:Buyer shall pay any Res reunited for conllnnlug account payment Information on mums'
association dams or assessments fir Imymonl or monition mid any charge tondo by Iho owners'association in comaction with Ilio
deposition of Ile Property to Bayer,Including any transfer and/or document fee Imposed by lite owners'ossooinllon.Buyer shall
not be responsible for few Mound by Softer In completing the Owners'Association Disclosure nod Adllopdna(Standard Point
2Al2-'1').
(b)IiosponsihllIly for Proppsed Spcelnl Assassin te:Burershell take titleaubJeel to all Proposed Special Assessments disclosed
by Solidi'In Pamgiaph S(b),If any.
(o)Responsibility for Corinhn Coals:Bayer shall be responsible Ibrnll costs with rospecl to oily loan obtained by buyer,appmissd,
Elio search,title insurance,recoiling the deed and forpsolmmllon and recordingorall Islnnaems required to secure the balance(or
die Purchase I'rri(�/'unpaid nt Settlement.
Buyer initials IW' _ Seller Initials
P08°40(11
AssoelNion NMI No.110 lbdsed 7/1007,111011 gds snmdxrd ronnaw bwn npperoi jolnnb by:Noah Cnrotinn
'dnpd by Apeemna 1.1a the Me IWAsecialbn North C.roilmllar MserUdon—NC nes lean No.12
Noah Caroled Association orpenica%lac.—abndmd Pon n21'
5. SELLER IlEPRP.SEN'I'ATIONS:
(n)Ownership:Seller rephosonw dial Seller:
Bl lms owned the Property for at lent ono year.
O has owned the Property for loss limn one year.
❑
does not yet own the Property.
(b)Assessments:to the hest of Seller's knowledge there ore no Proposed Special Assessments except et follows(lined"None"or
the Idonlifieatton of such assessments,If any). None
Seller movie that there am no Confirmed Special Assessments except as follows(Insert"None"or the identification of such
assessments,Ifnny)* None
(o)Owners'AssoeintIor(s)end Dues:To best of Seller's knowledge,ownership Mille Property O subjects O don not suh)eet
Buyer to invitation by ono or nore owners'assooiation(s)mid governing documents,which impose miens mandatory covenants,
conditions and rostrialtons upon the Property and Buyer's enjoyment thereof,Including but not limner to obligotions to pay regular
assessments (duos) mid Spe0ial Assessments.If Nero is an owners' association, then an Owners' Association Dleolosmn and
Addendum(SIandni t Donn 2Al2-T)shall bo eenot0ted by Seller,at Seller's expense,alit must be attached as all ad(1811(111in to this
Coat act.
(d)Sewage System Permit(O Applicable O Not Applicable)Seller wmmnis that the sewage system doserlbed hl the
Improvement Pennhl attached hereto has Ieon hwlnlie d,whish unmanly survives Closing,but makes no further feprosant WOK as to
Ihesy'slen. -
(o)Private Drinking Water Well Permit:(O Applicable O Not Applicable) Seller smnmms dint n private drinking water well
has been hislalled,whiohnvmrnnlysurvives Closing,but:mikes no Anther toprosenlation ns to the well.(Gwen Installed nierJuly
1,2008,attach Improvement Petinit hereto.)
6. SELLER OBLIGATIONS:
(a)Evidence of Title:Seller ogees to use best offers to deliver to Buyer as soon as rensonably possible ager the Eheelivo DMo,
copies of all tide Information in lsouonlon o&or available to Seller,Including but not limited to:INN h,squ neo policies,atlontoy's
opinions on title,smmys,covenants,deeds,cotes and deeds ottani and ensonloillsrelating to Me Property.Seller authorizes(I)ally
attorney presently orpiovio sly representing Seller to release nod disclose any title Insurance policy hi suck attorney's Ole Co Buyer
and both Buyer's and Seller's agents and attornets;and(2)IhePmpedy's title insurer or Its agent to release and disoloso all materials
In the Property's Inge Insmm'.(or title Insures agent's)file to Boyar and both Buyer's mid Sellers agents and attorneys. -
(b)Access to Properly:Seller shall provide reasonable access to(lie Properly(including working,existing utilities)through the
teller of Closing or possession by Buyer.To the omit applicable,Seller shall also be responsible for timely clearing Ilial portion
Mite 1'ropolty rogldred by the County to perform tests,Inspections nuiWor ovntnallons to detomdne the odtobility of thoProporty
for a sewage system andfor private drinking water well.
(o)iXenovnt of Seller's Property:Seller shall remove,by the dale possession Is mimic available to Buyer,all personal Nepali),
which is not aped of Ma pinches°mid all garbage and debris Boni he Property.
(d)Affilnvit and Iuuionsnifenliml Agreement:Seller shall furnish at Settlement an affidavit and indenmdticatton agreement In
form sntsfictoy to Buyer mud Buyer's title Insurer,if any,executed by Seller and any person or entity who has performed or
famished Inbor,servtces,materials or nonfat equipment ns described in N.C.O.S.¢41A4 to the Prepay within 120 days Iulorto lino
dale of Settlement verifying that each such person or entity has boning('hi NII and agreeing to Indemnify Boyer,Buyer's dondcr(s)
and Buyers title humor against all loss from any cause or claim arising Meson-am.
(o)Payment and Sulisfnellen pf Lions:All deeds oculist,liens nod other charges whist the Properly,not Assumed by Buyer,insist
be paid and satisfied by Seller prior to or al Settlement such Ilial concellnliou may be promptly obtained following Clos0rg.Seiler
shall rolnnhn obligated to Solo wench emlcelintlons following Closing.
Buyer Inllinls 16a2 Seller initials
Page 5 of l 1
AstoMllaa I'mumNo.120 Revised 712007,I/1011 71A,slenA,,d roan bes beennsprosdyolmly by:Nerlh Caroline
PtInIcit by Agaenhen!with ere NC Bar Association North[Walton Rn Assadalion-NC Bot Peal No.12
NonhCm011nn Anaimion ofItonitor ,iia-SIuWmA I'onu 1IT
(Q Title,Legal Access:Seller shall execute and deliver a GENERAL WARRANTY DEED for the Property Al Settlement unless
ollienvls.,Mated heroin,which shall convey fee simple marketable and hlsumblo title,goo of all encumbrances except:ml colorant
taxes forIlieclllreut year(pinatcd through the date of Settlement);utility easements and nnvloluiel restrictive covenants that do not
materially Weal the value alba Prorely;nod suet other encumbrances ns may be°ssuiled or siooiheolly approved by Buyer hi
writing.ThePropolty must hove logo access to n public right or way.
(NOTE: if wry sale of urn Property any be a"short sale,'consideration should be given to attaching a Short Selo Addendum
(Standard Porn 2A14-T)as no addendum to Iib Contract).
(g)Deed,Excise Tuxes:Sollorshall pay for preparation eta deed and nil other documents necessary to parietal Seller's obligations
under Itis Contract,and far Mato mid county oxolso taxes required by low.The deed Is to be Indo to: fns directed by Duver!.
(10 Agreement toPnyBuyer Expenses;Seller shall pay atSettlement$ N/A toward any ofeuyer'sexpenses assODialed
with the purchase of the Property loss any potion disapproved by Deyer's lender.
(NOTE:Examples of Buyer's expenses associated whit thepnmtase ofihe novelly Include,but am not limited to,discount points,
loan origination Res,approlmi fees,attonley's hos, inspection Res,and"pwpalds"(taxes,insurance,owners'association duos,
etc.)).
(Q Pnymmtit of Confirmed Special Asfes01e1100:Seller shall pay oil Confirmed Special Assessments,if inky,provided that the
amount thereof can be mnsonably determined or estimated.
(I)Late Listing Penalties:MI properly ax Iola listing penalties,Irony,shall be paid by Seller.
(k)Owners'Association Disclosure and Addendum(Slandmd Porn 2412-T):Ifopplionble,Seller shall provide Iho convicted
Owners'Assodnllo nDisciosmn and Addendum(Standard Form 2AI2-1)to Buyer on or Wove the Effective Dale.
(I)Sadler's Pollute to Comply or Drench:'Moller fills to materially comply with nny a&Sollars obligations aider this Pativeph
6 or Seller materially breaches this Contract,and Buyer elects le terminale tris Contract as a result of such falhlro or Wench,then
Oke tinniest Money Deposit and thoDueDlllgencepeeshall be regaled to Purr and Sellar shall roimbnmc to-Buyer lhereasonable _
costs actually acutnd by Buyer hi commotion with Buyer's Duo Diligence without nfiboting nny other remedies.
7. PROBATIONS AND ADJUSTMENTS:Unless otherwise provided, the following Items shell be prorated through Iho dale of
Settlement and either adjusted between the parties or phi at Selllentent:
(n)Tnxes on Real Properly:Ad valorem taxes on real property shall be prorated on a Mender year basis;
(b)Bouts:Iona,Ifoly,for the Properly;
(a)Dues:Owners'Association regular assessments(dues)and other like chutes.
8. CONDITION OF PROPERTY AT CLOSING:ThoProperly must bo W substantially the smile or bettor condlilou nt Closing as
on the date oftdds offer,reasonable wear nod tenrexcepted.
9 RISK OPLOSS:The tisk orlon or damage by lire or other casualty prior to Closing shall be upon Sellar.Ifllro Improvements oil
the Property aro destroyed or materially damaged prior to Closing,Buyer may terminate this Contact by written notice delivered to
Seller or Seller's agent and the Boniest Money Deposll and any DueDlligenco Fee shall be minded to Boyer.In the event Buyer dens
NO7'aloe!to Nonionic Ills Contact,Buyer shall be entitled to receive,In addition to he Prepoity,any of Seller's Insurance proceeds
payable on account of the damage or destruction applicable to the Property being purchased.Seller is advised not to cancel exhaling
Insurance on the Properly until after continuing recwdnllot(011ie decd.
10. DELAY IN SETTLEMENT/CLOSING:Absent agreement to the contrary In this Contract or Any subsequent modification
thereto,Ifo petty Is nimble to complete Settlement by the Settlement Date but Intends to complete the Irnnsnclion and Is noting in good
faith and with reasonable diligence to proceed to Settlement("Dolny'big Porky"),and If the other party Is ready,willing and able to
complete Settlement on the Settlement Date("Non-Delaying Per )Nn the Delaying Patty shall give as nmol mace as possible to
the Non-DelnylllgParty Buttsettlemet agent and droll be entitled to a delay hs Settlement.Vibe pontes Pall to complete Settlement npd
Closing within faoteen (14)days of the Settlement Dale,or to further extend the Settlement Date by wrlltea agreement,then the
Buyer Initials Seller Initials%). _
Page 6 of I I
Mettnlnn Pee No.12O nodus 7/Sam,1/2011 eine imiderd ram hes bun wiwowdlotnttyby:Heidi Gillam
and by Apeemenl ni0 the Ne Liar Arodotkn Noah Citolta LinrAssodatlom-NC Bar Fortino.11
NoriliCaotlna Aueelmlen ofllmlio&W,Inc.—.Stmdnrd!bun 121'
Delaying Party stall he hi breach and the Non-Dolayt:g Pony may Lemdnate Itis Contract and shell bo entitled to enforce any remedies
available to such party ander this Contend forIhe bleach.
I I. POSSESSION:Unless otherwise provided herein,possession shell ho delivered at Closing.No ellcmtlons,excavations,tree or
vegetation removal or other such aclivllles maybe dorm bofare possession is delivered.
12. OTHER PROVISIONS AND CONDTEIONS:CHECK Al.!.STANDARD ADDENDA THAT MAY nE A PART 011 THIS
CONTRACf, II' ANY, AND ATTACH HERETO. ITEMIZE Al.!.OTHER ADDENDA TO THIS CONTRACT, IF ANY,AND
ATTACH 1HERE'TO. (NOTE: UNDER NORTH CAROLINA LAW, REAL ES'T'ATE BROKERS AItE NOT PERMITTED 1'O
DRAFT CONDI'T'IONS Olt CONTINGENCIES TO'1111$CON'T'RACT.)
(1 Additional Provisions Addendum(Penn 2A1 l-0) 0 Loan Assumption Addendnns(Form 2A6.1)
OBank-Up Contract Addendum(Poon 2A1-1) U Owners'Association Disclosure Awl Addendum(Porro 2Al2.1)
CI Contingent Solo Addendum(Form 2A2-T) U Seller PhanoingAddendum (Perm 2A5-T)
U Short Sale Addendum(Penn 2A14-T)
❑O'riitm• See Exhibit A and D attached hereto for additional(onus of this Cannel
13. ASSIGNMENTS:This Contract may not be assigned without the written consent of'di Imrties except in connection with a lox-
deform('exdiniige,bel if assigned by agreement,then lids Conlmbl shill he binding on Ilse assignee and assignee's holm and successors.
14, TAX-DEFERRED EXCHANGE:In the event Buyer or Seiler desires to Wool a tux-ddbrsed exchange In connection will'the
conveyance of Ike Properly,Buyer and Seller agree to cooperate In of(Cding such exchange;provided,however,that the exchanging
party/dull be responsible thrall additional costs associated with stick exchange,and provided further,that a norl•oxehnngingpadys0ell
not assume any additional liability with respect to such Inc-doRirod exchange.Etworand Sellorshnll execute such addi0onal documents,
inohlding assignment ofudeContract In ornedlon Motowtlu,al no cost to Ilie nomeXchmiging pony,as shall be required to give effect
to this provision.
15. PARTIES: This Contact shall ho bind0mg upon and shall hens to the benefit of Beyer and Seller and their respective holm,
successors and assigns.As used hereto,words In the singular include the plural ngd die masculine Includes the Iondnino and neuter
ge de's,as appropriate.
16. SURVIVAL:Iran provision herein contained tAllah by Its nature mid effect is manlier'to be observed,kept or performed ager
the Closing,II shall survive the Closing mid remain binding upon and for Iho benefit of Ie parties hereto until folly observed,kept or
performed.
17. ENTIRE ACREP,MENT:Tido Cmhlmol conlnlns the outih'oagr
cement°fliteparties and 111010 RID no ropmsentallons,Indicmnonls
or other provislons other gums those expressed heroin.All changes,addllloru or deletions hereto nuns be in writing and signed by ell
panics.Nothing contained booth shall alloy any agreement between a It1iA1;1'CR°or broker and Sailer or Buyer as contained In any
listing agreement,buyer agency l%leonnonl,ora any other agency agreement between them.
IS, NOTICE:Any notice or coiinualcalloit to be given to a patty heroin nay be given to the party or to such party's agent.Any
wrillcn notice or coimntniemies In connection ills Ito transaction contemplated by this Contract may be given to 0 party dr a party's
agent by sending or transmitting it to any mailing eddress,eanall oddness or Ihx Renter set font:In the"Notice,Information"section
below.Seller and gayer agree Ikxl the"Notice Information"and"Escrow Acknowledgment"sections below shell nol constitute n
nutorinl pet of this Contact,and that the addition or tiedIh enllon of any Inlbnnalionn therein shall not constitute a injection of nn offer
or the creation of a counteroffer.
19. EXECUTION:ThisConlrnel maybesignued In multiple originals orrceiaepads,ell of which together constitute one mud the smile
instrument,mid the parties adopt as Moir seals Elio word"SEAL"beside theirsigieluros below.
20, COMPUTATION OE DAYS:Unless otherwise provided,for mimeses of this Coulomb the term"days"shall mea,consecutive
calender dem,lrclnrling Saturdays,Sundays,mid holidays,whether federal,slate,local or religious.Fortlse purposes of onloilaling
Buyer initials( Seiler Inillnls_�T
Page of 12
Aswtnhoi sotmbe..12 DRedrdlI10m,I/lel Mksa lard foal has bun npprowdlornnyby':Norlh Molina
Pawed norAsrodailoi Noah Casella furAs:Deletian-NC tin,Earn,No.12
Noma Colina Assodellen ofnenitouA,lam-Anhui drawer 12'I'
days,the count of"days"shall bog In on Ihoelay followingllie day upon Mitch any net ornolIco as pray Med In 11th Cantrnel was ixgnlloil
to bo porfinned minds.
1'I IS NORTH CAROLINA ASSOCIATION OPREALTORS°,INC,AND MB NORTH CAROLINA DAR ASSOCIATION MAK II
NO REPRRSENTATION AS TO THD LSAT. VALIDITY OR ADUQUACY OP ANY PROVISION OP TIIIS FORM IN ANY
SI'UCII'IC TRANSACTION.IF YOU DO NOT UNDERSTAND THIS FORM OR FEW,MAT IT DOHS NOT PROVIDE FOR
YOUR LEOAL NEEDS,YOU SHOULD CONSULT A NORTH CAROLINA REAL DSTATH ATTORNEY IEI'ORE YOU SION
•
This offer shell beeonto n binding comae;on Rio Hlfeellvo Dnle,
BUYER: SELLER: f� /;
HMI Coys�l nelo/rrs of (tevIlle,LLC $oifH4ol)MrLr) '6 Pr DegelcybV*'s� CAT,
By: "p�/d //(/. V By: �•� JJJp llyyvl�
Print Nwno:�C/� k � 14 7'� Print linow: *0AKA n1 l V",
Tina: S. 1< Tlllo: 0 Ir71h�
Dole: _$i/py,/I I Dnlo: S ,SII '
Wiper 1 v Seller Ildlinls {'i _
%%% 777��-
Pogo 8of12
AnnolnlmH'mmNo.D ORaviscd 711007,IOU lLlsalnW°d lona has lxtn ogqrtovcdJololly by:14010)Colina
Minted by Ayeartnl u101IAe NC Dor Amor-lotion Ninth Caroling ilnr&cockatoo-NC lam No.I2
Norah Cowling A°aclonoi oflNdlenb,Inn.-Standard Kum 12T
NOVICE INFORMATION
(NOTE: INSERT TIM ADDIIBSS AND/OR ELECTRONIC DELIVERY ADDRESS EACH PARTY AND AGENT APPROVES
FOR THE RECEIPT OF ANY NOTICE CONTEMPLATED BY THIS CONTRACT.INSEII'I 'N/A"FOR ANY WHICH ARE NOT
APPROVED.)
BUYER NOTICE ADDRESS: SELLER NOTICE ADDRESS:
Mailing Address: fl&II Homes e/o Keay AvOW Mailing Address:
2919 Breomwood Ave SnIlo 400 Pnvollavllb.NC 25191
Buyer FDA: (9101485.0463 SellerPnxll:
Boyar 13-mall:KunvAyanI( l,Wwnles.cmn SellerBvnall:
SELLING AGENT NOTICE ADDRESS: LISTING AGENT NOTICE ADDRESS:
Firm Name: Flo Name:
Aeliltg as CI Bnyoi s Agent CI Seller's(siib)Agent CI Dual Acting as❑Seller's Agent O Dual Agent
Agent Mailing Address:
Mailing Address:
Individual Listing Agent:
Individual Selling Agent: ❑Acling as n Designated Dual Agent(chock only Ifnlgdlaable)
C!Acting as n Deslgunlcd Dual Agent(check only if LlcMno ll:
applicable) Listing Agan(Phonon: _
License Listing Agent Pnxg:
ll: Listing Aged E
Selling Agent Phenol!: mall•
Selling Agent ----
Pnxl/:
Soiling Agent Fr
mall:
ESCROW ACICNOWLEDOM ENT OF INITIAL EARNEST MONEY DEPOSI.1'
Escrow Agent aeisnowledges receipt of the Inlllal Earnest Money Doposil and agicet to hold null disburse die Sane hi accordance
BEI]Tho torous hereof.
Dale Pirm:
By:_.
(Signior/1)
linin)
Buyer ifIlIMs_id Sollor inlllnls 1
Page 9 ell I
AnodaiIon PorniNo.129 Wine 7I2007,112011 'Ihl itemle'J loan has Ona ezpercdJolnlly by:Nolle Carolina
Mull by AMnano nth sle NC Dar AssosiMbn Noah Oudpla DMAssacinlIon—NC liar Penn No.12
MA Carolina AssociotlelvDkatWst%In -Miami Pout 121
) XNIfiTPA
A drawing Ihnllnaro specifically hle1011es the Property
_X_Is allnol0cd
1s not nllached
Burr lulllals ^";2 Sailor 1011101s ")>
Page 10 or 11
Assocltlon Porn No.12O Itcvlsed 7/200),111011 ihh sInndardtamt las Iain npyrosnlloinlly I'y:North()make
Pdmtd LyA9rcemenl with We NC Ilnr AstoAnlion Notlh Malian lin Asocinllon-NC lint Form Ne.12
North Clrollnn Assoclulmm(naliamO,Inc.--SwNad Ibmt 12T
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EXHIOIT U
(Additional Terms)
I. Pnrelmso Price: Buyer shall pay Porty-TlntoThousand Five tlnndredDollars(543,500)for each Lot In The MM'S Pad
213,Pad 2C and Part 21). Buyer agrees ton Ilnce portent(3%)mutant e,enintor on the purchase price for lots In The Moms
Port 213.
2. Settlement Date:Buyer agrees to pgrchue the iridal ton(10)lots within forlyfivo(45)days otlbe Motive Data of this
contract. Those lots will be lots 638,639,340,730,731,753,754,755,756,757 hi Manor at Lexington Plantation plus lot
254 In Village al Lexington Planlodon which will be the Mosel Homo forDayar. tlnthennore,Duyeragreos to keep tel(10)
unsold homes built at Ml lines by closing on an additional lot within thirty(30)days niter the sale ofon Inventory houso
ponding to nlllhd party, Buyer Anther agrees to porcheso n Minimum of twenty-four(24)lots every evolve(12)moths.
3. Buyer's Rights:
n. Buyer skit have the dgld to Iisl,soil and market their homes In Lexington Plantation.
b. Buyer shell have Seller's permission to construct hwontoiy homes,and a model home on tot 254 prior to the lot
501110111021 Hato mid Solna earns to assist Buyer in obtaining,at Drayer expense,building penults goat Iho county.
c. buyer will be(ho solo builder err the Manes at Lexington Plantations Pad 213 08 Lots).
d. Notwithstanding anything to the canonry to Section 12 of Ma OftbtIo Purohnso,Boyar haroby reserves Iho right to
assign this Contract to another party,without rcgniring written pennlsslon of Seller;however,upon any such Buyer
assignment,IDryorshali not be relieved otatty liability tinder lids Ofhr'To Parchnsa,absent n written release from
Seller.
4. Seller's Obligations:
a. Lot confers shall ho stoked mut marked prior to the Settlement Dote.
h. All lot Improvements,Includingwalorsorviees,soworservices,wed alreels,alrce lighting,erosion control,
electrical,telephone,cable,altconnnon area landscaping and amenities shall be completed prior to the Sellloment •
Date.
o. The plat for Tho Manors Part 211shall be tscordcd.
d. Sailor warming that all streets have beencantnicied to NCDOT standards and agrees to cause such streets to be
malntalnel until such limo as Sailor applies!brand receives NCDOTacceptance.
/ �)\e.. -8olloli+w oo1avddm uiiu1E enrya opRw1payht44041imeonrymrolmscd edmllil boa,dx
merorhonsotirindlt
rnnd add la„ ud patty.
f: If any pad of a Lot receiv0s any Dli material,the bane lot shell have been compacted by mechanical swans and stall
twat orexecod ninety-fivepercent(95%)compaction,calculated by the Proctor lost.
5. Duycr'a Option to Purchase The Manors at Lexington Plantation Part 2C(56 lots)and Part 21)(30 tots):
a. Seller mauls to Dnyorille Option to Mohan the 56 lots In Part 2O and the 30 lots In Pau 2D. Upon notification
from Seller of Its Intent to develop the next phase,ehhorPail 2C mal/or Part 21),Buyer shall Imo thirty(30)days to
present to Seller nit Offer to Pnrohaso for the Lots to be developed. Tim Ofibr to Purchase shall contain Iho soma
Minis and conditions as slated In Offer to Purchase.
Bayer inhinls e Seller Intima 4_.
Page ll of II
Asseeklla lea,No.12O 1Iarlsed712007,112011 'this slendad Can lms been opryore4J(114 by:Noah Cedilla
trialed by Agrwnaal will,Ott NC Ha Aueelellna Noel,Co,oline llerasseclallon—NC par Poon No.12
Nota Caroler Assalatmmf Reston,Inc.—Slnndud Form 121'
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 wwwharnett.org/permits
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: HAH Constructors of Fayetteville LLC. yDaatte:] /
Site Address: S • I �f"QI Phone. —y��thq
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.
Subdivision: The Manor(off Lexington Plantation Lot: '
Description ofnProposed Work: New Single Family Dwelling #of Bedrooms:3
Heated SF: DOI Unheated SF:S"S '7 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 Leannahairng,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 Contractor's Company Name Telephone
409 Chatham Street Sanford, NC 27330 electricpopeawindstream.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 carolinacomfortair5vahoo.corn
Address Email Address
29077 H-3-I
License#
Plumbing Contractor Information
Description of Work #Baths .5
Dell Haire Plumbing 910-429-9939
Plumbing Contractor's Company Name Telephone
PO Box 65048,620 Gillespie St. Fay, NC 28306 dellhaireplumbinw hotmail.com
Address Email Address
32886P-1
License#
Insulation Contractor Information
Trinity Insulation, Inc. 418 Person St. Fay., NC 28301 910-486-8855
Insulation Contractor's Company Name 8 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.
01.4,A_A ,o. 1 I5 I 7
1
Signature of Owner/Contra r/Officer(s) of Corporation 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. 1 n
Sign w/Titl t OQ..4%.A4Q w.. /Permitting Coordinator Dater 15\ I - 1
Appointment of Lien Agent: Details - LiensNC Lien Service Page 1 of I
DO NOT REMOVE!
Details: Appointment of Lien Agent Flied on: 01/05/2017
Entry Si: 681067
Initially filed by: meagaobradahaw
Designated Llen Agent Project Property Print & Post
Firm Amencen Title ICompany MIY0W2541. 254 MrM Lexinpmo
Plantation
CORNER LO1 CENTENNIAL PKWY AND
w hine,19 w Wan ce waitcymyRaleighcep 1APLOW TRAIL
21601Cameron,NC 28326
Hamer County Contractors:
P hone:Xxxm➢
eXJ Please post this notice on the lob Sue
Pn',913-469-5231
Suppliers and Suhennlrvebn:
lemma,sae Qn dh„„,„„,.o. . . Sean this image with your smart phone to
Property Type
view this filing You can then file a Notice
to Lien Agent for this projeci
Owner Information I2 Family Dwelling
H&H Consmaors of Fayetteville.LLC. D ate of First Furnishing
2919 Rrtaewood Avenue Sic 400
Fayetteville,NC 28303
united States
Emailleanahau@hhhomes coot 06/19/2017
Phone 910-486-4864
View Commenla l0)
Technical Support Hotline:
https://apps.liensnc.com/scr/appointment/detaiIs.html?entryNumber=68 1067&printable= 7/5/2017