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Initial Application Date: 8/28/17 Application# I 9 Co CU# COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION Central Permitting 109 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:Caviness Land Development Mailing Address.639 Executive Place Suite 202 Fayetteville NC 28305 910-339-6332 Janine@cavinessland.com City: State: Zip: Contact No: Email' APPLICANT':Caviness Land Development Mailing Address-639 Executive Place Suite 202 FayettevilleNC 28305 910-339-6332 Janine@cavinessland.com City- State: Zip. Contact No: Email_ 'Please fix out applicant informason d different than landowner CONTACT NAME APPLYING IN OFFICE:Janine Lightner Phone#910-339-6330 PROPERTY LOCATION:Subdivision: Forest Oaks Lot#. 3` 5- Lot Size:'37 11,1 1117 Nursery Road Map BookBPage':?PIP./ 54-4- �Sl(a�teRoatlk State Road Name'. " ��''�� t FSCef 0506-95-0820 yy�� 12tr 01053608002864 Zoning:RA20R Flood Zone: ) Watershed N v Deed Book 8 Page:3415 / 01b1 Power Company': South River Electric 'New structures with Progress Energy as service provider need to supply premise number from Progress Energy. PROPOSED USE: Monolithic SFD:(Size 48 x42 )#Bedrooms:4 #Baths:2 Basement(wtwo bath)._Garage: Deck:_Crawl Space._Slab:_Slab: se (Is the bonus room finished?(L yes f )no w/a closet?(✓)yes U no(if yes add in with#bedrooms) ❑ Mod-(Size_x )#Bedrooms it Baths_Basement(wlwo bath)_Garage'._Site Built Deck:_ On Frame Off Frame (Is the second floor finished?(i yes U no Any other site built additions?( 1 yes ( 1 no ❑ Manufactured Home._SW DW TW(Size x )it Bedrooms: Garage: built? g ( )Deck- (site built?_) ❑ Duplex:(Size_x )No.Buildings. No.Bedrooms Per Unit: ❑ Home Occupation:#Rooms'. Use: Hours of Operation: //Employees._ ❑ Addition/Accessory/Other(Size x )Use: Closets in addition?( )yes ( 1 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) 1 County Sewer Does owner of this tract of land,own land that contains a manufactured home within five hundred feet(5009 of tract listed above?( )yes (J no Does the property contain any easements whether underground or verhead( )yes (✓)no Structures(existing o ropose - Ingle family Dwellings'. L Manufactured Homes: Other(specify): Required Residential Properly Line Setbacks: Comments: Address: 50 Burr Oak Circle Front Minimum 25 Actual 26 Rear 20 76 Closest Side 10 11.48 Sidestreet/corner lot Nearest Building on same lot Residential Land Use Application Page 1 oft 03111 APPLICATION CONTINUES ON BACK SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: From 87S make a left onto Nursery Road and then continue to the left on Nursery road. Make right into Forest Oaks subdivision. 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 statements a ate and correct to the best of my knowledge. Permit subject to revocation if false information is provided. 8/23/17 Signature of r 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 verhead easemehts,etc.The county or its employees aro 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 of 2 03/11 r NOTE : CONTRACTOR TO VERIFY ALL BUILDING >`F a. ` ^ SETBACKS PRIOR TO Sod # L / — CONSTRUCTION. s1 S 6,1 4.>> VICINITY MAP (4431 1 ,A d° (442 \\ (`5 (NO SCALE) `./ 1 \ FUTURE \ FUTURE FUTURE 1 W000SHIRE \ W000SHIRE WOOOSHIRE 1 PHASE 8 \ PHASE 6 PHASE 8 1 \ 1 ' 04� 0.28 N ACRES 1 (3461 II 12,028 SQ. Fr. I 341 l yy I I 1$ (�% FOREST OAKS y 1 FOREST OAKS PHASE 4 i 1 I..� 1116 " PHASE 4 MAP 2012. J 1 - .m i d MAP 2012, PG. 544 1 PG. 544 II PROPOSED 1 es HOUSE ' I 1 CL 1600 I I 1t I n na ''-� — j $ fi' UTILITY E19EYENT __ 941'27 20 V 74.40' — BURR OAK CIRCLE 50 Ft. PUBLIC R/W S PLOT PLAN PLOT PLAN FOR: CAVINESS LAND DEVLOPMENT TOWNSHIP OF: ANDERSON CREEK ADDRESS: BURR OAK CIRCLE ,ori}`t�'_"�,.,,, DATE- AUGUST 23RD, 2017 2 .._;_ REV DATE: AUGUST 25TH, 2017 CITY OF: NEAR SPRING LAKE, NC `\ .=,SCA1F: f' = 30' COUNTY OF: HARNF.TT 7,z ;.� _REFERENCE: LOT 345 ,Cg6-ti^ FOREST OAKS yy _ "` " PHASE 4 a 691; "--i'rJ.,., MAP 2012. PG. 544 KyN 6- 25 /7 W. LARRY G, PLS — L-1339 L. IRIS MAP CAR NOT 111 IISAD roe neoRosnox Larry King i Associates. R.LS., P.A. nno 14AR R 1-,o m o v d Ar m.NceTO R1 mini NOT A_ri FOR TEM AND NO MUM"RAT RI P.O.Box 53787 MACRO OR ITI1 1333 Morganton Road,Suite 201 udrow ON _o SNOW ON MI PLOT PLAN la nd0 A wen�Nciw ORM al OW- Fuyeltevllle,NC 28305emon DI- Mnon MAP le I tnur.cr ion MOWN BUILDER.wnNe E®n ®momPhone:19101403-43Wca MT TOMO � o®SmIacawOxNnix ROW TIM AR=reRARTY AND mvvsmR Fox:{910)483-4052 Efilli°11;IREPJANc3 OF KRIM OR wumin- WENT OT CONOTRULTION.SO TITLI Warn WAS www.LKOntlA.com Pwowu ON TWIN PR0Pem1 RI mm BURRITOS NC Firm License C-0887 Each section below to be filled out Application 7j by whomever performing work. Harnett County Central Permitting Must be owner or licensed PO Box 65 Lillington,NC 27546 contractor. Address,company 910-893-7525 Fax 910-893-2793 www.harnett.aro/permits name&phone must match Application for Residential Building and Trades Permit Owner's Name: Caviness Land Development Date: 8/28/17 Site Address:50 Burr Oak Circle Phone: 9103396332 Directions to job site from Lillington: From 875 make a left onto Nursery Rd and then continue to the left on Nursery Rd. Make a right into Forest Oaks subdivision. Subdivision: Forest Oaks Lot: 345 Description of Proposed Work: Building House #of Bedrooms: 4 Heated SF: 1600 Unheated SF:518 Finished Bonus Room? No Crawl Space:_Slab: / General Contractor Information Caviness Land Development 910-339-6330 Building Contractor's Company Name Telephone 839 Executive Place Suite 202 janine©cavinessland.com Address Email Address 37485 License# Electrical Contractor Information Description of Work electrical Service Size:_Amps T-Pole: ✓ Yes_No Southern Pride Electric 919-750-9436 Electrical Contractor's Company Name Telephone 370 Slap Out Road, Mount Olive NC 28365 southernpride.mp@gmail.com Address Email Address 24726 License# Mechanical/HVAC Contractor Information Description of Work heating&air Carolina Comfort Air 919-550-7711 Mechanical Contractor's Company Name Telephone 703 N. Clinton Ave., Dunn, NC 28334 phillip@carolinacomfortair.com Address Email Address 29077 License# Plumbing Contractor Information Description of Work Plumbing #Baths 2 Chris Holloway Plumbing 910-624-2670 Plumbing Contractor's Company Name Telephone 737 Old NC 20 St Pauls NC 28384 chrisholloway©ncrccom Address Email Address 28541 License# Insulation Contractor Information Cumberland Insulation 4205 Clinton Road Fayetteville, NC 28312 910-424-7118 Insulation Contractor's Company Name 8 Address Telephone 'NOTE:General Contractor must fill out and sign the second page of this application. Homeowners Applying to Build Their Own Home Please answer the following questions then see a Permit Technician to determine it you qualify for permit under Owners Exemption. Questionnaire per G.S. 87-14 Regulations as to Issue of Building Permits (Memo available upon request) 1. Do you own the land on which this building will be constructed? _Yes I No 2. Have you hired or intend to hire an individual to superintend and manage construction of the project? _Yes No 3. Do you intend to directly control &supervise construction activities? _Yes No 4. Do you intend to schedule, contract, or directly pay for all phases of construction work to be done? _Yes No 5. Do you intend to personally occupy the building for at least 12 consecutive months following completion of construction and do you understand that if you do not do so, it creates the presumption under law that you fraudulently secured the permit? Yes No 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 Harnett County Zoning Ordinance. I state the information on the above contractors is correct as known to me and that I affirm that I have obtained all listed contractors permission to obtain these permits and if pay 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-6 Months to 2 years permit re-issue fee is$150.00. After 2 years re-issue fee is as per current fe r^ dule. 8/28/17 Signature of Owner/ or/Officer(s)of Corporation Date Affidavit for Worker's Compensation N.C.G.S. 87-14 The undersigned applicant being the: 1 General Contractor Owner 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: 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. 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 to issuance of the permit and at any time during the permitted work from any person,firm or corporation carrying out the work. Company or Name:Caviness Land Development —/, Sign w/Title: �r S/OL2r^�t Date:8/28/17 DO NOT REMOVE! Details: Appointment of Lien Agent Entry 3Y: 710283 Filed on: 08/25/2017 Initially /lied hy: eavland Designated Llan Agent Protect Property Print a Post Investors Title Insurance Company Forest Oaks lot 345 50 Bum Oak Circle ❑toa Onus.: :w.e ... ........... Buanlevel,NC 28323 y ❑ Mdrwe:19W.Hargett St.Suite 50,/Raleigh,NC Harnett Cm* 1 27601o o, Phase:88849043W property Type Pae:913489-5231 Can Please poste : this notice on the lob Site. small:glaiett®IigbnFwm m �. I-2 Family Dwelling Supplier.and Subcontractors: Scan this image with your smart phone to view this filing.You can then file a Notice Owner Information Date of First Furnishing to Lien Agent for this project. Caviness Land Development 08282017 639 Executive Place,Ste 202 Fayetteville, NC 28305 United States Email:jetine@cavinessland.com Phone:910-3396330 View Comments(0) Technical Support Hotline:(888)690-7384