DOCUMENTS Initial Application Date: I I�9'� I / Application# ' 1 SCO4 12 0(4
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street,Lillington,NC 27546 Phone:(910)B93-7525 ext:2 Fax:(910)893-2793 www.harnett.org/permits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED�WHEN SUBMITTING A LAND USE APPLICATION'
LANDOWNER: g �P�Toc+ /( IO'Mailing Address: /� hJ/Le z eLGT C( (('. fid yCii �
City�(ij(Q ('1CCu 5tate:M- Zip: dlU 3 Contact No: 9/c)'Vt& -��� Email:'�uLF)C\�rlir Qhhhor>n,,c .Ctiar
APPLICANT`: SAcU. AS (14k)0t\WA)F-2 Mailing Address:
City: State: Zip: Contact No'. Email:
'Please fill cut applicant information if different tan landowner�1 + n/1 /� L
CONTACT NAME APPLYING IN OFFICE:) Le xn ) L c1� ( / / 9/C0-W, 6-VI�r'V 11xx�� ''CC
PROPERTY LOCATION:Subdivision: iIc 111A114 A (PX//)(1�0l //((/)/Gfjeb, Lot#:(15q Lot xSize: , ❑foacre�T
Sate fa) # /�,) State Road Name: Map Book&Paget:b I I /q0
'g5a5 LI 1 56
' °l
51D511G068 38/ /
Zoning:(44-70X Flood Zone: /C Watershed:NT YDeed Book&Page. cY '14 / '1ower Company': l W7''G/C/e(
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE: 03
11' r �l b' Cr wl Mot/
IL SFO:(SizO `I x`IO.�I#Bedrooms: #Bathsa asement(w/wa bath):a) Garage: Deck:FL Crawl Space: Slab:_Slab:�/
(Is the bonus room finished?L)yes (_)no w/a closet?I )yes ( )no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms #Baths_Basement(w/co bath) Garage: Site Built Deck: On Frame Off Frame
(Is the second floor finished?( )yes I )no Any other site built additions?( )yes ( )no
❑ Manufactured Home:_SW_DW_TW(Size x )#Bedrooms: Garage: (site built? )Deck: (site built? )
❑ Duplex:(Size x )No.Buildings: No.Bedrooms Per Unit:
❑ Home Occupation:#Rooms: Use: Hours of Operation: #Employees:
❑ Addition/Accessory/Other:(Size x )Use: Closets in addition?( )yes ( )no
Water Supply: m/ 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 land that contains a manufactured home within five hundred feet(500')of tract listed above?( )yes (Zino
Does the property contain any easements whether underground or overhead( )yes ( no
Structures(existing orropose Single family dwellings: [ M ❑factured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual Si.^ I
Rear r)5 ' 15
Closest Side h (o a I I
SidestreeVcorner lot c)()
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:
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l L.E(1),(Ic M. �l,inn /61/ las/cc/ nn Oc�nl2,//t/
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71/in If on � 7/,F 7. /,i ! -E an laL,G.yr,- , tee, clitfeSA,d .
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 stateaants are accurate and correct to the best of my knowledge. Permit sub'ect to revocation if false information is provided.
c . o, x., �a1/`
Signature of Owner or ner's Agent D e
"'ll 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
C MICHAEL P. GRIFFIN . certify that under my direction and
stperiaM his map was clown from an actual/b'd'army' Mat the Ilia of
closure of the suety as calculated by coordinates he t 14000+ : thee the 2d�'
area shown hereon was calculated by coordinates -2 ddJ'%
Means my hand and sed this day of MOWN 201Z t
f�0GQ6 GGi C
66
/
1752'
N 24°4908"E— E30.00'
9,600 Sq.FT.
0.22 AC.
c___ 1 U
mm
o rnno a
ti Na
N o3400 Na
If m
FD
MOOR: fi�
\
It 755/ I 1753
N v
P
p 200+ .4.X. Z3.P O
0 `---_ —;-k J 5
=hoer
.0 UNDERGROUND fA°T
URU TY EASEMENT oDe-
r.
5 24°49'06'W—8¢00'
PITTFIELD RUN
50 PUBLIC/UTILITY R/N/
;ITE PLANAPPROVm
- 'ICJ_l ' n`e— SETBACKS
FRONT 35
tab JH(ll)td4_ _._ . - REAR
SIDE(ONE SIO[) 5'
1 SIDE
COR ER SO DE) 10'
Gale Zoning Ad Fel, CORNER SIDE 20'
I LEGEND
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.org/permits
by whomever performing work.
Must be owner or licensed
contractor. Address,company Application for Residential Building and Trades Permit
name&phone must match
Owner's Name: H&H Constructorsr+ of Fayetteville, LLC. Date: / 7
Site
Address: .30 I P1i+c ad11Uf1 Phone t4'
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( Lexington Plantation Lot: -s I
Description of Proposed Work: New Single Family Dwelling #of Bedrooms:
Heated SFp7Q/to Unheated SF:/nFQl 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(dhhhomes.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 electricpope(g�windstream.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 carolinacomfortairavahoo.com
Address Email Address
29077 H-3-I
License#
Plumbing Contractor Information !�
Description of Work #Baths LY ,5
Dell Haire Plumbing 910-429-9939
Plumbing Contractor's Company Name Telephone
PO Box 65048 620 Gillespie St. Fay, NC 28306 dellhaireplumbinq(rphotmail.com
Address Email Address
32886P-1
License#
Insulation Contractor Information
Tricitv Insulation Inc. 418 Person St. Fay., NC 28301 910-486-8855
Insulation Contractor's Company Name&Address Telephone
*NOTE: General Contractor I 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 guy 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 Ownerwner/Caontr )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.
Sign w/Title&Q.CMA....00A. L s-. /Permitting Coordinator Date:
Appointment of Lien Agent: Details - LiensNC Lien Service Page 1 of I
DO NOT REMOVE!
Details: Appointment of Lien Agent
Flied on: 07705l2017
Entry k: 880970 Initially filed by: meagenbradehaw
De.Igneted Llen Agent Protect Property Print & Post
Flet Amerman Title Imurance Company MLP0007S1 Lot 754 Manor@ Lexington la. El
e y
Plantation
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. vo Lrcorn )01 pI PrP111M1ItLn NUS god,„„ OW'14ugm 5t,SuiSD1/Rcish,NC Cameron,NC 28325 Q
xfepl Hamen Caunry
conrnnon:
mane,5(8-690.73(4 Plane poll Jos notice on Me Job Site
Fu 913-(59-323I BUPPIim and Subcontractors:
Sean own. Property Type Sean this Image with your smart phone 0
view Ihu filing You can then file a Notice
to Lien Agent for this project
1-2 Fame] Dwelling
Owner Information
or Fayetteville,tic Date of First Furnishing
Will Constructors
2910 Breezewood Avenue Ste 400
Fayenerille,NC 28303
Unita!Mater 0512312012
Email Iemnahmr@@hhhomeamm
Phone 91p-086-4564
View Comments WI
Technical Support Hotline:(MO 690-7184
https://apps.liensnc.com/scr/appointment/details.html?entryNnmber=680974&printable= 7/5/2017