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DOCUMENTS el Initial Application Date: /121-4117 Application# I Isob • i -1 P DRB# CU# COMMERCIAL COUNTY OF HARNETT LAND USE APPLICATION Cermal Permleng lPhycxl lm E Rani Street ullinglM,NC 27546 (Mailing)PO Box 66 n14nglon NC 27546 Phone (910)894]526 opt#2 Fax(910)89327990 wum harneti 0(9permiltsss LANDOWNER. )S 7; ..aC e ALL Mailing Address: f?.c Lim, /Oa+i� p5,(r/ p/ S/y 4Y /y+{�.v Ni�Z f(��v City: Srfr••y L^�A' .,K^ c.��l State'.NLzip.2�lO1 Contact# tit�l-4C'( ,VCS/Email: 0t#�'�tOwe]/C��yt`/c.AlaO is APPLICANT':) 1 DS Rola-Act LLCwailing Address': Satlif +a ti-toy I" City: 1 State: Zip. Contact# Email. *Please Ml out applicant information it different than landownere CONTACT NAME APPLYING IN OFFICE: At Eon- CLPhone# 1/s' Y.TY- Y6 FP (J PROPERTY LOCATION:Subdivision: N 7.4 1 Lot#: Lot /2• / State Road# !III Stale Road Name: 'Ze ` 12-4 Map Book6PageP"1q / P. Parcel: 0I053SZ2. 6tot) 11 /� PIN. ncoc - iccr2o• nOd Zoning:PA 2012 Flood Zone: h Watershed/ Pt Deed Book&Page tg)9a i 1661 Power Company Soa+4111 r nice (cc. . 'New structures with Progress Energy as service provider need to supply premise/lnumber from Progress Energy. SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 11J a n MA;A 4. Oat 7 7i.-, / Lc-4. o1n1IYarseni LF-t on 2° 1 Hgyo gel Rct a1-1 la1/�1t ra.S, An oA. (nail cI4, 4.,...o.;•1 rn�f.-wuLGe PROPOSED USE: ❑ Multi-Family Dwelling No.Units: No,Bedrooms/Unit: J Business Sq.Ft.Retail Space: Type: #Employees: Hours of Operation: ❑ Daycare I Preschoolers: it Alterschoolers: #Employees: Hours of Operation: ❑ Industry Sq.Ft: Type: #Employees: Hours of Operation: ❑i Church Seating Capacity: #Bathrooms:IHK' hen'. el' Accessory/Addition/Ocher(Size 1R 141)Use: .4.awEC'i Icn IC Pt'IPC 1�1/4.-4-Arm..._ ✓ 2�( iJ�`{2— f4de�e�L�\ LPInc c- tafr{, eae�C 'rr,a^ Water Supply. _County Existing Well New Well(t of dwellings using well ) 'MUST have operable water be final Sewage Supply: New Septic Tank(Complete Checklist) Existing Septic Tank(Complete Checklist) vir. County Sewer Comments: 4 Wait 1 - etc-evince. A-Fp# Il-SDDHlc a1 fix Finnic 2 * - W+ ak If permits are granted I agree to conform to all ordinances and laws of the Slate of North Carolina regulating such work and the specifications of plans submitted. I hereby state that foregoing statements are accurate and c rect to the best of my knowledge. Permit subject to revocation it false information is provided. 7-zo - I'1 Signature . Ow, ,r or Owner's Agent Date "This ap• atlon expires 6 months from the Initial date if permits have not been issued" A RECORDED SURVEY MAP.RECORDED DEED(OR OFFER TO PURCHASE)AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION ° N45' 14' 31"W TOTAL= 567473 L9 424.41' 6I Q 112-09' ° 1 i/ � ly <,..‘, / I ,NPe I , <1,- / 81 Iw 6..1,4 e fi °e I m f p, 6e Q < W43P ° i]2 4• 2 O* o lk' 1 Pe e Ne e \,,,JIIIIIIIIIIIEHE 1 , 1 b e'P °? °5 pe p'2 °�J�'. W t - QVO. a g - _ Pee ?P? „kr 4, r ffi 1 ,SPS Oh'% -- it-- _ L1 1.1 0 L4 a 18 LS _r____ \ �.� RAY ROAD SR ll21 1 e O I to I 'a I w Q Z Y O = Y U 07 \ / /r- Harnett —.1)":". COUNTY *A 'f A Eerg• cy arvirn MMrar^t !ne fMi +V w�8ernatt re FOrr. DIC. Application for Plan Review sDt11a - /-Y roOss law in - SUU4IGa'1 - 1—+µ��^'� C'•�'CIL� Date Received: /I prww�/ !A A/ Received By: // / �J // / Name of Project: I H yfLcrrw4 Cr. •/t C ..ib C 4.✓,'e.. S e iwr / /4.ei Item Physical Address of Project: (14 'to 47 /-%C , NC 2.9Tg0 Plans Submitted By, bS Fin arts-e `E-C— Project Phone: ( 9/0 )- E'l`l - U.? 7 1 Contact PersonlAddress: 12C __ .*a^y Rotel 46 .fro) ( /CasvL 211 9 0 Contact Email: 4 Vcr Cre— Itvo. o..is-t Contact Phone: ( 310 / )-i'/Y - 8i5r7 ( 9 )- vl/ tf6Po Contractor's Name/Info: 0"ra-f Cir.le— 2 a✓ /1S CJGr.rPr �nec )✓, Sri t0 k-C NL 2#T`�U Contractor's Phone: ( 9/U )- fl't'- 263; Afr' - yJ y- '-i6 Y0 • Plans that are submitted will be reviewed as quickly as possible with an average time of review between 7-10 working days. • Status checks may be conducted on plan reviews by visiting the website http:llhteweb.hamett.oro/Click2GovBP/Index.isp or by calling the Harnett County Central Permitting Office(910-893-7525,Option#2), or the Harnett County Fire Marshal's Office (910-893-7580). • Approved plans must be picked up from the Central Permitting Office and all fees paid before any required inspections can be conducted. 'Each section below must be Idled out by Application # �` G whoever Is performing the work Must bHarnett County Central Permitting owner or licensed contractor. Address PO Box 65 Lillington. NC 27546 ,,11 company name & phone must match 910-893-7525 Fax 910-893-2793 wows harnett orgtpermis y`[� - information on state license COMMERCIAL Pi-- C6' - t- Application for Building and Trades Permit Owners Name. -t'sc �4.,..1(-1.4%.-C-E 1-I- L Date. -I`(-/ 1 Site Address. yq`dO ?o..l (Zt Ctr-a--) L,>f-t n1L2631OPhone9/0-SW-z613 Directions to lob site from LillingtonLF-r net M..0-4. Rt- nn 21/.d r / F7- d r nJ! ft� 'Zit 'V4c +/Ic ,cxn Ccrt (70M0., f/ +1; 4-4/_R 9411-10 en. g4 Subdivision Nle ,A1 Lot: Description of Proposed Work: dzimrn rt 1-ralJrol 0giCr c.d 1,=//rrr. Heated SF $1-L. Unheated SF General Contractor Information: Building Cost$ 1i-1r (11 Anderson Creek Developers, Inc 910-814-2633 Building Contractor's Company Name Telephone 125 Whispering Pines Dr. Spring Lake NC 28390 andybarr40@yahoo corn Address / / Email Address 66285 azure of Own- of Corporation License# rical Contractor Information: Electrical Cost$ 8/ST'{,"' Description of Work Wire/Trim out Service Size: 200 Amps #T-Poles 0 Pioneer Electric Inc 919-499-7767 Electrical Contractor's Company Name Telephone BO Neill Thomas Rd Lillingtan NC 27546 pioneerelectric@earthlink net Address _ _ __ Email Address { / 4 - �` t 216434/ Signature of Owner/Contractor/Officer(s) of Corporation License# Mechanical Contractor Information: Mechanical Cost$ c\430, °" Description of Work Rough in and trim out HVAC # Units I Total Systems Heating and Cooling, Inc 910-436-3450 Mechanical Contractor's Company Name Telephone 13341 Hwy 210 South Spring Lake NC 28390 AddressEmail Address 28846 �Z/.�1 Signatur Own Co tractor/Officer(s) of Corporation License# Plumbing Contractor Information: Plumbing Cost S 'tots, •-- Description of Work Rough In and trim out Plumbing #Baths 0 Wagner Plumbing Inc 910-890-2299 Plumbing Contractor's Company Name Telephone 555 Tirzah Dr. Lillington NC wagnerplumbing©yahoo corn Address Email Address �� 31576 -'Cure of Owner/contr.-tor/Officer(s) of Corporation License# Insulation Contractor Information Tri-City Insulation 910-237-0910 Insulation Contractor's Company Name&Address Telephone *NOTE: General Contractor must fill out and sign the second page of this application Sprinkler Contractor Information Sprinkler Contractor's Company Name ' Teephone Addresp Email Address SignatLVI of 6Corporal on of Corporaon License: 1\11 Fire Alarm Contractor Information -va-.,,E-s 4-i re--Was- SEA-.,moi-t ALO-`1g3 -69Z2_ Fire Alarm Contractors Company Name Telephone ill lJpv ST 'a'eet TF,ie:F NL Z34DI ,Syn eu(tvyv n oC.:et-54�..m(r� 4i., A.. - s �� Email Address t "' certe /0/.717 SPL✓ Signa ure of O,ce';s)of Corporation License t Driveway Access- NC Department of Transportation Driveway Access/Permit? __ 1/ca /o 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 Hamett County Zoning Ordinance. I state the information on the above contractors is correct as known to me and if a>ay 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-€months to 2 years permit re-issue fee is $150.00. After 2 years re-issue fee is charged at full price per curve tetee schedule ________ S gnature of Owner/Contr,clor/ Kcer(s)of Corporation Dale Affidavit for Worker's Compensation N.C.G.S. 87-14 The undersigned applicant being the: .General Contractor _..-_Owner 'V....OUicer/Agent o1 the Contractor or Owner Do hereby confirm under penalties of perjury that the person(s),firni(s)or corperation(s)performing the work F set forth In the permit: Has three(3)or more employees and has ohtained workers'compensation insurance to cover them. I. /Has one(I)or more subcontraclms(s)and has obtained workers'compensation insurance to cover them Has one(1)or more sabcontractors(s)who has their awn policy of workers'compensation insurance covering themselves. _ Has no more than two(2)employees and no subcentactors. While working on the project for which this permit is sought it is understood that the Central Permitting Department issuing the permit may require certificates of coverage of workers compensation insurance prior to issuance of the permit and at any lime during the permitted work from any person,firm or corporation carrying out the work Company or Name. f 1^ oro (irc (."'- Sign wiTitle• '-SignwlTille' ` v� � c---+ frKJc1-T 4r. Date: 7-I1' (1 Cemmu:ia'Bui'iaa Ap !i aeon 2 of 3 110