DOCUMENTS Initial Application Dale:8/14/17 Application#incSCBCLOR
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.harnetl org/permits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)8 SITE PIAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER:Timothy D.Smith Mailing Address'. 1934 Stroll Circle
City, Fuquay-Varina State'.NC Zip_27526 Contact No: 919 422 5038 Email: our104bunch@hotmail.com
APPLICANT':Comfort Homes, Inc. Mailing Address:P O Box 369
City: Clayson State.NC Zip:27528 Contact No: 919 553 3242 Email: comfrthomes@aol.com
'Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE:Julian Stewart Phone#919 422 1481
PROPERTY LOCATION:Subdivision'. Minor Subdivision for Betty S. Ivey Lot#:1 Lot Size:.576 acre
State Road#1443 State Road Name'. Lafayette Road Map Book 8 Page'. /
Parcel: 080653 0200 01 PIN: 0653-65-6208.000
Zoning:RA-30 Flood Zone: Watershed:IV Deed Book&Page: / Power Company': Duke Progress Energy
'New structures with Progress Energy as service provider need to supply premise number 00605750 from Progress Energy.
PROPOSED USE: (E.?
Monolithic
SFD:(Size 54' *77.4“)#Bedrooms:3 #Baths:2 Basement(w/wo bath):_Garage:_Deck:_Crawl Space'. ✓ Slab:_Slab._
(Is the bonus room finished?( I yes (✓)no w/a closet?Li 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
IIs the second floor finished?Li yes U no My other site built additions?( 1 yes ( )no
❑ Manufactured Home:_SW_DW_TW(Size x 1#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/Acceesory/Oter.(Size x )Use: Closets in addition?( )yes (__J 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( ✓1 yes ( )no
Structures(existing or proposed):Single family dwellings:proposed Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 35' Actual 85
Rear 25' 42'
Closest Side 20 29'
Sidestreet/corner lot n/a
Nearest Building n/a
on same lot
Resident:al Land Lase Application Pageof 2 03'11
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 401 N; right on Lafayette Road
If permits are granted I agree to conform to all ordinances end laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby ste= foregoing stet:dents are acc - e and c• red to the best of my knowledge. Permit subject to revocation if false information is provided.
I Mtn.— 8/14/17
Sigd•.to : • Owner or Owner Agent Date
"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 8 months from the Initial date If permits have not been issued"
Residential Land Use Ap,I cAUon Feiye 2 of 2 031'.1
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SR 1442 I f mr } OW rc 0)11C 49 M € N: ty W 0 WI
August 9, 2017
Comfort Homes, Inc. has my permission to construct and to make all necessary applications for a
single family home that will be located on lot 1 in the Minor Subdivision for Betty S. Ivey, recorded
in Book 2017, page 226, Harnett County Register of Deeds.
Ta- / ,a1:13:4al)
1, Patricia F. Waite, do hereby certify that Timothy Smith, owner of the above mentioned property,
personally appeared before me this day and acknowledged the due execution of the foregoing
instrument.
Witness my hand and Notarial Seal, this 9th day of August 2017.
....,$,t.....
ss.,�QJGIA F Gj''t''
tib 1 i 51 (Notary Public) ¢ ' OTA
My commission expires 4/2/22. " • a '
09rogIT f
Application#
Harnett County Central Permitting
Each Nam below lo N Ned outPO Sex N Lehner NC 21548
M wtom ver pelpr s%yak 910 893 7525 Fix 910 epi 2787 www hornet!orygrmib
Must be cam or hceneed
conbidor Meth company Application for Residential Building and Trades Pe
nems 8 phone must meufi ` X11
Owners Name �.at�oyt� v, e �, Date tC-r1, An
Site Address 1...\9‘i \„d.�`"'*1_kQ `r,C�' uq ua.,)\*NCC done
Direcoo to lob site from Lillmgton \ �.1,Q\ ' 'tAc c dc.,
Subdmswn C`\ NZIS"S d.\V•S;) y
oc xje% S • }Tot
Descnpbon of Proposed Work Q ne6 .C\os. Tg t€.L \.c'xw x of Bedrooms J
Goner° Contractor Informatlort
Building Contractors CompanyNagle Telephone
%H- S\a0 p *' �53� Comdr<hocw. Q&o\,cot
Address Email Address
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License s
�laatngsl Opt/actor Information
Descnptan of Work •_ . �w \ ".m Ov S- Service Size pOQ)Amps T-Pole Yes_No
S1/4>n acxQc tea. \RQ%cc'.P-- 'VS-q'ls • os 99
Electrical Contractors Company Name Telephone
9 S1`e0.��tSoiSa :cam Qom.
Address � � C. Email Address
aalCkac a1S-,LP
License a
MachamcallyVAC Contractor Infonnattolt
Desmpbon of Work\ 'vt‘1\sS.cc \pec Jet�4S42— n
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Mechanics Contractor s Company Name Telephone
S--=K\ � Q a.7S.A
Address r Emad Address
License a
Plumbing Contractor information
Description or WakC'J,4aNA;.ate " )8a--$14%. c) + ' #Bathe pa
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Plumbing^Contr^ac�tor,s Company` _ me Telephone
9S S. ZO Q:\\O Q).n`� ,
Address t 27 -sa,0E mail Address
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License it
Insulatitg Contractor Information
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Insulation Contractors Company Name IL Address\ acc ttc + Telephone
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'NOTE General Contractor mutt fill out and sign the second pegs of this application
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 swine below I have obtained all subcontractors
permission to obtain these permits and if 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 notry 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/Officer( of Corporation Date
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the \/
__General Contractor _Owner Officer/Agent of the Contractor or Owner
Do hereby confirm under penalties of perjury1hat the person(s)ifirm(s)or corporation(s)performing the work
set forth in the permit
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
XHas one(1)or more subcontractors(s)who has thew 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 certifcales of coverage of workers compensabon 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
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Company or Name Oc !/��c ,JNeCpX/N-QSa \CSO
Sign w/Tltle \��,. � f `• Date -D-1n
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Appointment of Lien Agent: Details-LiensNC Lien Service hups://apps,liensnc.com/scr/appointment/details.html?entryNumber=...
DO NOT REMOVE!
Details: Appointment of Lien Agent Piles on: 0e/09/2017
Entry k: 701509 Initially filed by: ComfortHomes
Daelgnated Lien Agent ProJact Property Print & Post
WFG National Title Insurance Company Timothy Smith owner—Minor Subdivision for Oa CI
Belly S.Key—lot I �-r[
Online:www Servile COM map.e ea.r.,m, 481 Lafayette Road :414
Addrns:19 W Hargett St,Suite 507/Rale*,NC Fuquay-Varina,NC 27526 -sa 1
_7W I Harnett County
Contractors:
Phone:**a-6993e4 Please post this notice on the Joh Site
913ae0_523l Suppliers and Subcamnclon:
Email: Lithium cons.....«,....,..... Property Type Scan this image with your span phone to
thew this,ling You can then ale a Notice
-?Family Dwelling to Lien Agent for this proem(
Owner Information
Comfort Homes,Inc
P0dux 364
Clayton, NC 27528
United Stales
Email.cumfnhmnesthe:wlcorn
Phone.919-553-3242
View Comments(0)
Technical Support Hotline:(M8)690-7284
•
I of 1 8/9/17,2:35 PM