DOCUMENTS I
Initial Application Dater _ I )
n
Application# I 1 SOt 1. 4I t1•---1
Central Permitting COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION CU#
j g 108 E.Front Street,Llllington,NC 27548 Phone:(910)893-7525 ex1:2 Fax:(910)893-2793
I "A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAN www.hamettorg/permits
IO/permlts
LANDOWNER H&H Constructors of Fayetteville,LLC. D USE APPLICATION"
Mailing Address:2919 Breezewood Ave.,Ste.400
Fayetteville
City: NC 28303
State; Zlp: Contact No: 910-486-4864 Email: Leannahairc@hhhomes.com
APPLICANT';Same As Owner Same
Mailing Address:
Same
C ,;
'Please fill out applicant kiformetlon If different than Stland owner ate: Zip. Contact No: Same Same
Email:
CONTACT NAME APPLYING IN OFFICE: Leanne Hair
/�/ Phone#910-486-4864____
PROPERTY LOCATION:Subdivision: Anderson Creek Club (��. �.i'VJ I
State Road#1117 NurseryV Lot#;_off _ _Lot Size; • �C r
State Road Name: "oad IA, ,/; # It
Ib/a'9
Parcel: J o • • ell PIN:
Map Book Pa e
PIN: + �1� " 1a " di
Zoning: r Flood Zone:____Watershed _ g3�9 /03'1 Power Company*:
Deed Book&Pa South River
Progress Energy
'New structures with Pr
og as service provider need to supply premise number
I from Progress Energy.
PROPOSED USE:
` S D
R( SFD:(Size`,/ X #Bedrooms: #Bathr�„L asement(w/wo bath): V Mon li
Garage: Deck; Crawl Space: Slab: Slab:
1 (Is the bonus room finished?(_)yes (.J no w/a closet?U yB8 (J no Of yes add In with#bedrooms)
0 Mod:(Size x )#Bedrooms *Baths Basement(w/wo bath) Garage: Slte Built Deck: On Frame Off Frame
(Is the second floor finished?U yes U no Any other site built additions?L,_)yes (J no
❑ Manufactured Home: SW DW TW(Size x
#Bedrooms: Garage: (site built? )Deck: (she built )
❑ Duplex:(Size_____x__,__)No.Buildings: No.Bedrooms Per Unit:
O Home Occupation:#Rooms: Use:
Hours of Operation: *Employees:
C116 I(Sizeix TI e: 0^ CC� rof ad ,
Closets in addition?(J yes LJ no
Water Supply: ✓ eS11 " N
County Existing Well New Well(#of dwellings using well �� �.l
"Must have operable water before fin
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?U yes U no
Does the property contain any easements whether underground or overhead yes (_,)no
Structures(existing or proposed):Single family dwellings: 1*---
Manufactured Homes: Other(specify): QNQa
Required Residential Property Line Setbacks: ,s Comments: '��
Front Minimum 30 Actual 1
Rear 25 _7_S�_ 3r*j. !lour—
! Closest Side 10 1
1 Sidestreet/comer lot 20
I Nearest Building 10 —
j on same lot
Residential Land Use Application Page 1 of 2
03/11
APPLICATION CONTINUES ON BACK
7
Hwy.27 to Nursery Road,turn left and follow Ray Road.Turn left and
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
follow to Anderson Creek Drive.
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 st_:ments are accurate and •rrect to the best of my knowledge. Permit sub ct to re ocation If false Information
1 is provided.
Signature of Owner or• L /
War's Agent
Dat
"'It is the owner/applicants responsibility to provide the county with anyapplicable 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 B 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 ,crtuy Mot und.-my drsct/o and
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v EXISTING t
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me9.f7_ 19.50' zn N
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Lr) �M 21.47' s'Q0 _
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N 14°22'45"W -- 60.00' —
TIMBER SKIP DRIVE
Ns?
:
FRONT 3U'
REAR P5'
SIDE IOC
CORNER SIDE 20•
LEGEND ti
THIS PROPERTY IS NOT LOCATED Lt' EXISTING IRON PIPE FES FLARED END SECTION t.M
IPS IRON PIPE SET RIGHT OF WAY WM WATER METER •
IN THE 100 YEAR FLOOD ZONE. NOW OR FORMERLY EH ,LEAH f
EIS EXISTING IRON STAKE FN FIRE FIHYDRANTAIN 1
CB CATCH BASIN
GRIFFfl L,�:1'D SGRVEYING, I,�ti�C, FORM SURVEY
-i-yli---� FOR
FUQUAY- VARINA, NC 27526 H at H HOMES
(919) - 567 - 1963
ANDERSON CREEK CLUB
DRAWN BY KOF DATE 9/9/16 LOT 26
-
TIMBER SKIP DRIVE
CHECKED BY MPG SCALE 1" 20' NORTH CAROLINA
HARNETT COUNTY ANDERSON CREEK TOWNSHIP
Application# ' 01 0-1
Harnett County Central Permitting
*Each section below to be filled out PO Box 65 Lillington,NC 27546
by whomever performing work. 910-893-7525 Fax 910-893-2793 www.harnett.org/permits
Must be owner or licensed
contractor. Address,company Application for Residential Building and Trades Permit
name&phone must match Q
Owner's Name: H&H Constructors of Fa etteville, LLC. Date:8IAM
Site Address: L11I L 1 mix- S I p Or'1 ye, Phone: 910-486-4864
Directions to job site from Lillington: Hwy 27 to Nursery Road, Turn left, follow to Ray Road, turn left and
follow to Anderson Creek Drive.
Subdivision: Anderson Creek Club 11-- Lot: Qf
Description of Proposed Work: SFD V f i} c,1 f 1 Svl 3rd CI #of Bedrooms: 5
Heated SF: tp(v5 Unheated SF: Finished Bonus Room? Crawl Space: Slab:
VGeneral Contractor Information
O ,`
v H&H Constructors of Fayetteville, LLC. 910-486-4864
-!,4 ••
Building Contractor's Company Name Telephone
• 2919 Breezewood Avenue Ste.400,Fa NC 28303
Y� Leannahairahhhomes.com
VO.. Address Email Address
74158
License#
Electrical Contractor Information
Description of Work Service Size: 200 Amps T-Pole: X Yes_No
JM Pope Electric LLC. 919-776-5144
Electrical Contractor's Company Name Telephone
409 Chatham Street Sanford, NC 27330 electricpopeawindstream.net.com
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 carolinacomfortairtc7i.yahoo.com
Address Email Address
29077 H-3-I
License#
Plumbing Contractor Information
Description of Work #Baths 3. 5
Vance Johnson Plumbing Co., Inc. 910-424-6712
Plumbing Contractor's Company Name Telephone
3242 Mid Pine Dr. Fayetteville, NC 28306 etoepfer(a,vjplumbing.com
Address Email Address
07756-P-I
License#
Insulation Contractor Information
Tri-City Insulation 418 Person St. Fay. NC 28301 910-486-8855
Insulation Contractor's Company Name&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 necessaryapplication, that the application i
and that the construction will conform to the regulationsn Building, Electrical, Plumbing
Mechanical codes, and the Harnett County Zoning Ordinance. I state the information on e correct
contractors is correct as known to me and that b below I have obtained all subcontractors
v p p the above
si nin
ermission to obtain these Hermits and if plan,changes occur including listed contractors, site
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
any and all changes. yearsre-issue fee
P use
EXPIRED PERMIT FEES-6 Months to 2 years permit re-issue fee is$150.00. After 2 nt of
is as per current fee schedule.
Signature of Owner/Contrac o fficer(s) of Corporation
Date
Affidavit for Worker's Compensation N.C.G.S. 87-14
The undersigned applicant being the:
X General Contractor Owner X 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.
X 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
or
to issuance of the permit and at any time during the permitted work from any person, firm or corporation
carrying out the work.
CAmpany or Name: H&H Constructors of Fayetteville, LLC.
Sign w/Ti (3I 0 Imo._��\ %_.. I Permittin• Coordinator Date. 1
1 11