DOCUMENTS Initial Application DaterCl Application# � `S3042.4°I 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.hamett.org/permits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER:Derek Henson Mailing Address:25 Scotland Dr
City: Spring Lake State:NC Zip:28390 Contact No: 910-476-6777 Email: talia_henson@yahoo.com
APPLICANT*:Bryan D Law Mailing Address:919 N Main St
City: Mooresville State:NC Zip:28115 Contact No: 704-800-6780 Email: blaw@powerhome.com
*Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE:Bryan D Law Phone#704-800-
PROPERTY LOCATION:Subdivision: Overhills Creek .i. (� Lot#: 1 16780
Lot Size: • � I AS"
C
State Road#G14 P State Road Name: 5C.c3+1 C GI 1J r C . Map Book&Page:d �/
t/ a V
0514-46-0497 •Pci/ 101050`401 0002 24
Zoning Flood Zone: )c Watershed -> Deed Book&Pager 7(1 / 79 Power Company*: South River
.
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
Monolithic
❑ SFD:(Size x )#Bedrooms:_#Baths:_Basement(w/wo bath):_Garage:_Deck:_Crawl Space:_Slab:_Slab:_
(Is the bonus room finished?(_)yes (_)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
❑ 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: 'r7�-^-1T .I NA-a3 Hours of Operation: #Employees:
D/Alh+
ddition/Accessory/Other:(Size x )Use: 56 'OClosets in addition?(_)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 land that contains a manufactured home within five hundred feet(500')of tract listed above?(_)yes (_)no
Does the property contain any easements whether underground or overhead(_)yes (_)no
Structures(existing or proposed):Single family dwellings: ` Manufactured Homes: Other(specify): S Ol v✓
tirt 12c.v.e..Is
Required Residential Property Line Setb ks: Comments:
Front Minimum Actual
Rear
Closest Side
Sidestreet/corner lot
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: Head S on S Main St toward E Front St//Turn R onto NC-210S//Turn R
onto Overhills Rd//Turn L onto Lenoir Dr//Turn R onto B J Palmer Dr//Turn L at the 1st cross street onto Scotland Dr//
If permits are granted I agree to conform to all ordin. es and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing_59Jereepts are act r d correct to the best of my knowledge. Permit subject to revocation if false information is provided.
9,441 8/8/2017
Signature of Owner or Owner's Agent Date
***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
Application#
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546 - Ph:910-893-7525 - Fx:910-893-2793 - www.harnett.org/permits
Certification of Work Performed By Owner/Contractor
(Individual Trade Application)
Owner(s)of Structure: Derek Henson Phone:910-476-6777
Owner(s)Mailing Address:25 Scotland Dr Spring Lake, NC 28390
Land Owner Name(s): Phone:
Construction or Site Address:25 Scotland Drive Spring Lake, NC 28390
PIN# Parcel#
Job Cost: 31350 Description of Work to be done 23 roof mounted modules,grid-tied,6.9kw solar install
on existing residence.
Mechanical: New Unit With Ductwork_ New Unit Without Ductwork Gas Piping Other
Electrical*: 200 Amp_<200 Amp Service Change Service Reconnect_ Other
* For Progress Energy customers we need the premise number
Plumbing: Water/Sewer Tap Number of Baths Water Heater
Specific Directions to Job from Lillington:
Head S on S Main St toward E Front St//Turn R onto NC-210 S//Turn R onto Overhills Rd//Turn L onto Lenoir Dr//
Turn R onto B J Palmer Dr//Turn L at the 1st cross street onto Scotland Dr//
Subdivision: Lot#:
I Bryan D Law will provide the electrical labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is 26074-U ,which entitles me to
perform such work on the above structure legally. All work shall comply with the State Building Code and all
other applicable State and local laws, ordinances and regulations.
Power Home Solar,LLC 704-800-6780
Contractor's Company Name Telephone
919 N Main Street, Mooresville, NC 28115 Blaw@powerhome.com
Address Email Address
26074-U
License#
�'-gui1 -'' , 8/7/2017
Structure Owner/Contractor Signature: Date:
By signing this application you affirm that you have obtained permission from the above listed license holder to
purchase permits on their behalf. If doing the work as owner you understand that you cannot rent, lease or sell
the listed property for 12 months after completion of the listed work.
*Company name, address, & phone must match information on license