DOCUMWNTS Initial Application Date \ t I In Application# I ' 7-5C')t4T`'R
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION CUSS
Central Permitting 108 E.Front Street,Lillington,NC 27568 Phone:(910)893-7525 ext2 Fax:(910)893-2793 A v.hamett.org/perm its
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)A SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER:McKee Homes, LLC Mailing Address: 109 Hay Street, Ste 301
City: Fayetteville state: NC Zip:28301 ContectNo: 9104757100 Email: krivera@mckeehomesnccom
APPLICANT':McKee Homes, LLC Mailing Address: 109 Hay Street, Ste 301
City: Fayetteville Btare,NC 4,28301 contact No; 9104757100 Email: krivera@mckeehomesnccom
'Plana fill out applicant INormflon adwered:than landowner
CONTACT NAME APPLYING IN OFFICE:Kelsey Rivera phone#9104757100,727
PROPERTY LOCATION:Subdivision: Anderson Creek Lol#:72 LotSize' .22A
stamRoad#493 Stam Road Name: Timber Skip Drive Map BookSPape:iss/ 0/Sy f2S >
Parcel; 01053524010038 PIN: 0505-83-4035.000
Zoning: RA-20R Flood Zone; K Watershed: /Ute Deed Book&Page:3343 ,0040 power Company: Progress
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
``
POSED USE: Q tf
FO:(Size 40'8 x58'6")#Bedrooms:4 #Balhs.3 --sement(wNro bath):_Geree.X k:_Crawl Spain ISlab�la T
lis the bonus roan finished?igi yes no w/a closet?l V yes no(if yes add in with#bedrooms)
U Mod:(Size_x_)0 Bedrooms_it Baths_Basement(wtwo bath)_Garage:_Site Built Deck:_ On Frame_Off Frame_
(Is the second Door finished?(_)yes (_)no Any other site built additions?(_]yes (J no
U Manufactured Home,_SW_DW TW(Size x )0 Bedrooms:_Garage: (site built? )Deck: (site built?_)
❑ Duplex:(Size—x_)No.Buildings. No. Bedrooms Per Unit:
U Home Occupation:0 Rooms: Use: Hours of Operation: #Employees
U Addition/Accessory/Other:(Size_x )Use: Closets in addition?(_)yes (_)no
Water Supply: X 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) x County Sewer
D oes 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 (X )no
Structures(existing or proposed):Single family dwellings:X Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum Actual
Rear _ b .6� 0(
Closest Site 1fl '.5`C
Sidesueetconwr tet
Nearest Building
on same lot
Residential Land Use Application Page 1 of 2 03111
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINOTON: Nursery Road to Enterance
If permits are granted I agree to conlom to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby slate that foregoing statements are accurate and correct to the best of my knowledge. Permit subject to revocation If false Information Is provided.
Kelsey Rivera Daea'201;°oassa„R Rivera 8/15/17
Signature of Owner or Owners Agent Date
"Mt is the ownerlapplicants 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 S months from the Initial date If permits have not been Issued"
Residential Land Use Application Page 2 o12 03/11
I.
HOUSE PLAN: BROOKS - CLASSIC - LH
NOF
ANDERSON CREEK PARTNERS, LP
PIN-0505-86-8897
DB 1 346 PG 98 ��i
G 52119'34"E I
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75.75'
( 71\ PROP. N 7z
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PROP.
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a d j to PROP. S/W
O EE 40 SF
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• 5.75'
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TIMBER SKIP DRIVE
(50' R/W)
PLOT PLAN °o(2`-NE 5?•.<
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HOUSE PLAN: BROOKS - CLASSIC - LH
I
NOF
ANDERSON CREEK PARTNERS, LP
PIN-0505-86-8897 (74\
DB 1346 PG 98
O 521119'34"E I O
75.75'
171 1 PROP. 0
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PORCH (73\
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17.54' r---
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PORCH
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rii01et E0 40 SF
i 75.75 G
S2119'34"E
TIMBER SKIP DRIVE
(50' R/W)
PLOT PLAN ,fit"..'CA de,.
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06108111
Application#
Hamed County Central Permitting
bah eeman bebwb Mhilad out PoBox 06 Lamport NC 27548
by whomever gni eat
910 893 7825 Fax 616 862 2762 axis hamlet aype m p
Mutbe aaner or havereed
COnem AMMO company' Application for Residential Bwldrnc and Trades Psrmlj
phone must match
Owners Name McKee Homes, LLC Date 8/15/17
Site Address 493 Timber Skip Drive phone 9104757100 727
Directions to lob site from Lillington Nursery Road to enterance
Subdivision Anderson Creek Crossing
Lot 72
Desorption of Proposed Work Sinale Family Home #of Bedrooms 4
Heated SF 2927 Unheated SF 1478 Finished Bonus Room'/__Crawl Space Slab X
Gmarel Contraptpr- .r ..—--
GML Development, Inc 910-475-7100,727
Building Contractor a Company Name Telephone
109 Hay Street, Ste 301, Fayetteville, NC 28301 krivera@mckeehomesnc.com
Address Email Address
63970
License#
•
flatlet Contractor Information
Description of Work Single Family Home Service Size 2o_Amps T-Pole X Yes_No
J.M. Pope Electric 919-776-58144
Electrical Contractors Company Name Telephone
409 Chatham Street, Sanford, NC 27330 jmpopeelectric
Address @gmailcom
21326-L
Email Address
License#
MPofuglgalMYAC Contractor Information
Desorption of Work Single Family Home
Certified Heating and Air 910-858-0000
Mechanical Contractor a Company Name Telephone
P.O. Box 1071, Hope Mills, NC 28348 certified heatair@embargmail.mm
Address Email Address
2012 H3-1
License#
plumbing Contractor Information
Descnplion of Work Single Family Home #Baths 3
Dell Haire Plumbing 910-818-4663
Plumbing Contractora Company Name Telephone
7612 Documentary Drive, Fayetteville, NC 28306 dellhaireplumbing@hotmail.com
Address Email Address
32886 P1
License 0
Insulation Contractor Information
Cumberland Insulation 910-484-7118
Insulation Contractor a Company Name&Address Telephone
'NOTE General Contractor must till 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 to the Building Electrical Plumbing and
Mechanical codes and the Harriett County Zoning Ordinance I state the mformabon on the above
contractors is correct as known to me and that by eranrna below I have obtained all suboontraotora
ae®wen to abient thre sag •end if spy changes occur including listed contractors site plan
number of bedrooms building and trade plana Environmental Health permit changes or proposed use
changes I candy a is my responsibility to notify the Harnett County Central Permitting Department of
any and all changes
EXPIRED PERMIT FEES-0 Months to 2 years permit re-issue fee is$150 00 Mer 2 yean re-issue fee
is as per currant fee schedule
8/15/17
Kelsey Rivera a 8. nr Keiser -O40
Dale zan Dens 1=7-onroo'
Signature of Owner/Contractor/Officer(e)of Corporation Dale
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
XGeneral Contractor _Owner _Officer/Agent of the Contractor or Owner
Do hereby confirm under penalties of perjury that the person(s) finn(s)or corporation(s)performing the work
set forth in the pend
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 thea 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,understood that the Central Permitting
D
Department
ar went issuing
sse the permit may require certificates of coverage of workers compensation insurance prior
carryingrssua ncDetof t uew it and at any time dunng the permitted work from any person firm or corporation
Company or Name McKee Homes, LLC
Kelse Rivera =0,106nis:�n
Sign w/Toa Y „� �reConstruction Coordinator Date 8/15/17
Appointment of Lien Agent: Details-LiensNC Lien Service
hops;//apps.]iensnccom/scr/appointmenUdetails.html^entpNnm b_.
DO NOT REMOVE!
Details: Appointment of Lien Agent
Entry #: 704701 Filed on: 08/15/2017
Initially filed by: Jbutkw/30er
Desi Lien Agent Project Property
Print & Post
First American tile Insurance Cmnryan) Anderson Creek Crossing Lot 72 Haman Counts oy 17
NC . .
AJareis 10 p' Hargett St Suiie 907.Ralagle Nt +I'rr
27601 Q:F'SJ.�a
Penne:1138-601373MProperly Type Conti-anon:
r..: n3-4ensa3l Please post this notice on the lob Site
ra:.n:mnnem'newarca „._,., ?Family DxYllinB Suppliers and Subcontractors:
Scan this image with your smart phone to
em this flingYou can then file a Notice
101ien Agent for this project
Owner Information Date of First Furnishing
McKee l tomes.LI C 09/28/20])
IOU Hay Slael
Nude 301
Fapettc t ie. NC 28301
Caned States
Email.kris era/i mckeehomesnc com
Phone:910-475-7100
Vico Comments
Technical Support Hotline:1888)690-7384
of I
8/15117,4:17 PM
LIEN AGENT INFORMATION
Effective April 1,2013
In accordance with North Carolina General Assembly Session Law 2012-158,
Inspection Departments are not allowed to issue any permit where the project cost
is $30,000 or more unless the application is for improvements to an existing
dwelling that the applicant uses as a residence OR the property owner has
designated a lien agent and provided the inspections office with the information
below:
Name of Lien Agent First American Title Insurance Company
Mailing address of Agent 19 W. Hargett St, Ste 507
Ralerigh, NC 27601
Physical address of Agent Same as above
Telephone 888-690-7384 Fax 913-489-5231
Email support@liensnc.com
The information will be attached to the permit record and a copy provided to the
applicant. The applicant is required to post a copy on the construction site.
Excerpt from North Carolina G.S. 160A-417:
"(Effective April 1,2013) No permit shall be issued pursuant to subdivision(I)of subsection (a)of
this section where the cost of the work is thirty thousand dollars($30,000)or more, other than for
improvements to an existing single-family residential dwelling unit as defined in G.S. 87-15,5(7)that
the applicant uses as a residence, unless the name, physical and mailing address, telephone number,
facsimile number, and electronic mail address of the lien agent designated by the owner pursuant to
G.S. 44A-11.1(a) is conspicuously set forth in the permit or in an attachment thereto, The building
permit may contain the lien agent's electronic mail address. The lien agent information for each
permit issued pursuant to this subsection shall be maintained by the inspection department in the
same manner and in the same location in which it maintains its record of building permits issued."
www.liensnc.com
Plan Box# Date Qt ')
CC Job Name
App #mss ) ValuafonE
SQFeetala-]
Garage
InsoecdonsforSFV SFA
Crawl SlabMono✓ Basement_
Footing Footing
Foundation plum Under Slab Footing
Foundation Ele. Under Slab
Address Address Foundationp
Open Floor Slab Slabss Waterproofing
Rough In Mono Plum Under slab
Rough In Rough In
Insulation Insulation Aabress
Final Insulation Slab
Final Final
Open Floor
Rough In
Insulation
Final
Foundation Survey Envir. Health
__ Other
Additions Other
Footing_
Foundation_
Slab_
Mono_
Open Floor
Rough In
Insulation_
Final