DOCUMENTS Initial Application Dale:—{ { I a 1-7 Application# I I-1 50C( C 4 Q q
1111 CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street,Liltington,NC 27546 Phone:(910)893-7525 ext2 Fax:(910)893-2793 www.harnett.org/permits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION--
LANDOWNER:Wynn Construction, Inc. Mailing Address:2550 Capitol Dr. Ste 105
City: Creedmoor State:NC Zip:27522 Contact No: 919 603-7965 Email: edward@wynncons(mcl.com
APPLICANT':Edward Averett Marling Address:2550 Capitol Dr. Ste 105
City: Creedmoor State:NC Zip:27522 Contact No: 919603-7965 Email: edward(a)wynnconslruct.com
'Please fill out applicant information if different than landowner
JCONTACT NAME APPLYING IN OFFICE: Edward Averett Phone#919 603-79165
PROPERTY LOCATION:^ Subdivision: Avery Pond -- Lot#: J I _Lot Size' ' e°
State Road# bt (p3 Slate Road Name:1n-/Gl1�tf /OL 1,1 3 Map Book
r81Page:Z0/b /Jy/
fire—
Parcel tQ`7C (knS3/ Com_\ ` PIN: V� 1 3/ U (c-.1V-Ni -CS0Q
Zoning: k3O Flood Zone: rC Watershed: l in-Deed Book 8 Page:35/Q 7O`YPower Company*: Duke Energy
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
I_ / ,�.appP Monolithic/
of SEG(Size W V x&O )#Bedrooms: #Baths5 Basement(w/wo beth):_Garage: ✓ Beskag ]ravel Space: _Slab: Slab:✓
(Is the bonus room finished?(_)yes (_)no w/a closet?( )yes (_)no(if yes add in with#bedrooms)
❑ Mad:(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
O Manufactured Home:_SW_DW TW(Size x )#Bedrooms: Garage: (site built?_)Deck: (site built?_)
O Duplex: (Size_x_)No.Buildings: No.Bedrooms Per Unit:
❑ Home Occupation:#Rooms: Use: Hours of Operation: #Employees:
O Addition/Accessory/Other:(Size_x )Use: Closets in addition?( 1 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 (fid
Does the property contain any easements whether underground or overhead( )yes nc
Structures(existing r propose Single family dwellings: 1 Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual 3(0
Rear 25 6ys 2
Closest Side 10
SidestreeUcorner lot 20
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: From HCCP right onto 210 Hwy.3 miles,Left on 401 Hwy. for 15 miles
Left on Chalybeate Rd.for 1/8 mile,Avery Pond on the left
If permits are granted I agree to conform to all ordinan and laws of the S to onh Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoin ateme a ccurete cor to the best knowledge. Permit sut e^t to revocation If false information Is provided.
Signature of Owner or wear'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
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NAME:. k pWL t ighlieY70 / APPLICATION M:
*This application to be filled out when applying for a septic system inspection.*
County Health Department Application for Improvement Permit and/or Authorization to Construct
IF THE INFORMATION IN THIS APPLICATION IS FALSIFIED,CHANGED,OR THE SITE IS ALTERED,THEN THE IMPROVEMENT
PERMIT OR AUTHORIZATION TO CONSTRUCT SHALL BECOME INVALID. The permit is valid for either 60 months or without expiration
depending upon documentation submitted. (Complete site plan=60 months;Complete plat=without expiration)
���!!! 910-893-7525 option 1 CONFIRMATION k
pr, Environmental Health New Septic SvstemCode 800
\ • All property Irons must be made visible. Place "pink property flags" on each corner iron of lot. All property
lines must be clearly flagged approximately every 50 feet between corners.
• Place "orange house corner flags"at each corner of the proposed structure. Also flag driveways, garages, decks,
out buildings, swimming pools, etc. Place flags per site plan developed at/for Central Permitting.
• Place orange Environmental Health card in location that is easily viewed from road to assist in locating property.
• If property is thickly wooded, Environmental Health requires that you clean out the undergrowth to allow the soil
evaluation to be performed. Inspectors should be able to walk freely around site. Do not grade property.
• All lots to be addressed within 10 business days after confirmation. $25.00 return trip fee may be incurred
for failure to uncover outlet lid, mark house corners and property lines, etc. once lot confirmed ready.
• After preparing proposed site call the voice permitting system at 910-893-7525 option 1 to schedule and use code
800 (after selecting notification permit if multiple permits exist) for Environmental Health inspection. Please note
confirmation number given at end of recording for proof of request.
• Use Click2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
0 Environmental Health Existing Tank Inspections Code 800
• Follow above instructions for placing flags and card on property.
• Prepare for inspection by removing soil over outlet end of tank as diagram indicates, and lift lid straight up (if
possible) and then put lid back in place. (Unless inspection is for a septic tank in a mobile home park)
• DO NOT LEAVE LIDS OFF OF SEPTIC TANK
• After uncovering outlet end call the voice permitting system at 910-893-7525 option 1 & select notification permit
if multiple permits, then use code 800 for Environmental Health inspection. Please note confirmation number
given at end of recording for proof of request,
• Use Click2Gov or IVR to hear results. Once approved, proceed to Central Permitting for remaining permits.
SEPTIC
If applying for authorization to construct please indicate desired em type(s): can be ranked in order of preference,must choose one.
(_} Accepted {_} Innovative { Conventional {_} Any
t_} Alternative {_} Other
The applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in
question. If the answer is"yes",applicant MUST ATTACH SUPPORTING DOCUMENTATION:
( }YES {_/O Does the site contain any Jurisdictional Wetlands?
{_}YES {/} NU Do you plan to have an irrigation.vvstegi now or in the future?
{_)YES (z NCO Does or will the building contain any drain`?Please explain.
)YES f /rr'g Are there any existing wells,springs,waterlines or Wastewater Systems on this property?
{_}YES ( NO Is any wastewater going to be generated on the site other than domestic sewage?
("_t/O Is the site subject to approval by any other Public Agency?
{ }YES VICIO Are there any Easements or Right of Ways on this property?
YES { }NO Does the site contain any existing water,cable,phone or underground electric lines?
If yes please call No Cuts at 800-632-4949 to locate the lines. This is a free service.
I Have Read This Application And Certify That The Information Provided Herein Ts True,Complete And Correct. Authorized County And
State Officials Are Granted Right Of Entry To Conduct Necessary Inspections To Determine Compliance With Applicable Laws And Rules.
I Understand That I Am Solely Responsible F. The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site essibl Th Connie,/tion Ca rmed.
eA i7
P P R 0 GAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE
10/10
CowsitnlilAInn on AGREEMENT FOR PURCHASE ADM SALE OF REAL PROPERTY
1t
REALTOR'North Carolina Association
of REALTORS'
THIS AGREEMENT,including any and all addenda attached hereto("Agreement"),is by and between
Wynn Construction, Inc ,
101) lit ("Buyer"),and
(IndMdual or State of formation and type ofentity)
Little Cross, LLC ,
a(n) Mt ("Seller").
(individual or State of formation and type of entity)
POR AND IN CONSIDERATION OF THE MUTUAL PROMISES SET FORTH HEREIN AND OTHER GOOD AND VALUABLE
CONSIDERATION, THE RECEIPT AND SUFFICIENCY OP WHICH ARE HEREBY ACKNOWLEDGED, THE PARTIES
HERETO AGREE AS FOLLOWS:
Section 1.Terms and Demdtlwmt The terms listed below'hell have theroapccive meaning given them as set forth adjacent to each
term.
(a)"Srn.mty"((Adding.)Ph ape 1, Ann Pond
Lot 1 - 35, 67, 68, 68 and 70
Plat Reference:Int(') K1 ,Block or Section Phase 1 ,as shown on Platt Book or Slide
2016 at Page) 141-142 , Barnett C000ty,mndetlng of 35+1- acme.
❑ If this box Is checked, "Property" shall mean that property described on Eddbll A attached hereto and incorporated
herewith by reference,
(For Informed=purposes:(1)the tax parcel number of the Property Is, 0653-36-6533 _
and,(H)some mall of the Property,oondating of approximately 35 waes,is deeated in Deed Book
9928 ,Page No. 980 Barnett County.)
together with all buildings and Impmvemmm them®aid All Balmer and appurtenances thereto and all penooal property, if any,
itemized on Salt A.
$ 01,170,000,00 (b) "Par,h.ao Price"droll mean the rum of One Million, One Bunched Seventy
Thousand Dollars,
payable an the"glowing tern:
$ IDL (f) "Rimed Mann"aniline= Dollars
or twos as follows RA
Upon ihii Agreement becoming a mutest in accordance with Section 14,the Bmaen Money shall be
promptly deposited inmiaow ow with En —foams of
penonlendty with wham deposited),to be applied as part payment of the Parthose Prim of the Property at
Closing,or diehuned as agreed upon under the provisions of Section 10 herein.
Page 1 of S
WNorthMb afetb pore ys STANDARD FORM 580.T
North CarolinaArCamas r dation of 11EA1 TORS®,��j� Revised 712015
.n �(O SellerInitials/I / 07/2012
Buyer bridals1dy](�
br ewbµ'LIDMBOIaIOWmssaaC]141 NOTeaj"n adainiby*Lap tow rem M rlyd . wee a¢9 Amy kW
THE NORTH CAROLINA ASSOCIATION OP REALIORST,INC.AND THE NORTH CAROLINA MR ASSOCIATION MAKS
NO REPRESENTATION AS TO THE LEGAL VALIDITY OR ADEQUACY OP ANY PROVISION OP THIS FORM IN ANY
SPECIFIC TRANSACTION. IP YOU DO NOT UNDERSTAND THIS POEM OR FEEL THAT IT DOES NOT PROVIDE FOR
YOUR LEGAL NEEDS,YOU SHOULD CONSULT A NORTH CAROLINA REAL ESTATE ATTORNEY BEFORE YOU SIGN
IT.
BUYER: SELLER:
Todlddod IndNldesl
Date:
Deb: .._. __. . Daze: __._._._.___._.._.._.._.—_____.—_—_.____
Buten Entity BodoenEntity
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Construction, Inc Lit.Te C m LLC
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Warm of IWi ) tyamo if Entity)
By: "Atte— By._ .qtiP
Name: __—. Nmie:_
Title: __ _.__._..__ Tide: 6/77/g
_____
Due: .----�-- =.L�_.------._..__ Dete: 6/77/8The nndenlp:ed hereby adotowledgn receipt of the Earnest Money set forth herein and apses to hold said Earnest Monty In
aam'danae with the arms hereof.
JAL
(Namo Of Finn)
Date: _ .— —. _.__.__. By: Ms -__ ._..__...
Page S of 8
STANDARD FORM Sed-T
Raised 7/2013
O 7/2015
rectos wM*Fom@ by Tlploalx 160Th Ream MO flood.Feats,Mlohtm 410211 .+'%TTM<a wn Avery Path
moue/11 Hppncauon a
Harnett County Central Permitting -
Each section an below be filled out PO Box 65 Lllhngton NC 27546
by whomever pbelotoinwork 910 893 7525 Fax 910 893 2793 www hornet!arg/permite
Must be owner or licensed
contractor Address company Aonlication for Residential Building and Trades Permit
name 6 phone must match ____W
/� 1
Owners Name 1JJuy%e, . Q,pgs4Qrild;Mt ,/true. Date /--/7
Site Address_ Ar/�y few ///, Phone nir#9j-7nr.
Directions to lob sue from Lillington 'nark //CGP Kikt o ;'IO Italy 3ar les Leff oeJ '/o//tali
for tSavtret, Le))-EFouCinaly6eakr P� dor YRML,te1 AoeryRad.1s /eft,
Subdivision /7UCr1 Pad Lot 3 '7 . 1
Description of Proposed Work nett) COi/S 7trr1C./rotr/ - 510 #of Bedrooms _ '7
Heated SF /937 Unheated SF_ OW Finished Bonus Room? `/ Crawl Space Slab IC
General Contractor Information
G)yynn enAc4rt1.0±et1 Pre. 9/9 603 . 776 S
BuilduAg Contractor s Company Nalrle Telephone
2-,s-so ('a P•►ot fk. Ste /95'Gees4orAt 27s22 edrenlempie cses.etst
Address Email Address /
yG29S
License#
let c C a oti
Description of Work New Cogr/rue rOAI Service Size 700 Amps T-Pole _Yes_No
Q. P. Taaksoa r:/etlr e- 9/t 730- /Zs/
Electrical Contractors Company Name Telephone
92-61 P.a &,kW. Setup, Ne- 275Dif
Address Email Address
21► API
License#
Coast-rata' Contractor Information
Description of Work *id Coast-raet BA/
Pert:tr:el Neat attd A:r 9/0 85-8-6000
Mechanical Contractor As�Company Name Telephone
72'Jayet/akaCd. jgaber3IytNC 1$35_7
Address Email Address
//tzool/2 113 &issl
License#
qq ina Contractor Information
Description of Work //�J / �c _ eDA/ #Baths _
lratrs nu/J/49 9/9.1-5_0- '/833
Plumbing Contractors Company Nate Telephone
3/(0o-4 Oh2rW lt/aq,a ' Alt Z73-2 '7
Address Email Address
Z1/51.-
License#
Insulation Contractor Information
Treem ..Thsa/at o41 9/960-0999
Insulation Contractors Company Name&Address Telephone
*NOTE General Contractor must fill 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 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 tome and that pv sinning below I have obtained all subcontractors
permission to obtain these permits and if Amy 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 Mon s to 2 years permi e-issue fee is $150 00 After 2 years re-issue fee
is as curreh
EEEEEEedule — '7
ig turio Owner/Contractor/Officer(s)of Corporation Date
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
General Contractor _Owner f 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
t
!/ 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
Hae 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 workers 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 Nam- ulna &i&t.4:`�1Ostfvifftc,
'=� - /l��o,� ` L' 7 77
Sign Willa � Date
POST AT JOB SITE - DO NOT REMOVE
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 inspection
department with the required information:
NOTICE TO THE LIEN AGENT
Lien Claimants Name: 1Je6TPs ..,lB- to.
Lien Claimants Mailing Address: 19' id • thry'e/9 cit, S 6V9
to/e;/y4 flCtyx740/
Lien Claimants Physical Address: !! til /Art, b/
,t% A y CG_ aaol
Lien Claimants Telephone it: — qD 8y3- 640— `✓V
y
Lien Claimants Fax#: i� l c i-_t �T - 6-2-31
Lien Claimants E-Mail Address: .,S(4• �OCT g)�'ea�C,C"M
.
Description of the property (include address, lot#, and parcel identification number)
naCri gid a,�\\- /� A?D37
Contractor Name: WyMt I..AA1311'�L0/t r/rl .
Contractor Address: OUJ U dap; Id A••
epteed RWarri Alt 227322.Contractor Telephone it 9//gS2 - /3 /?
Successor Lien Agent Information: In the event that the lien agent revokes its consent to serve
as Hen agent or is removed by the owner, or otherwise becomes unable or unwilling to serve
before the completion of all improvements to the real property, the owner shall within 3 business
days of the notice or such event do the following: (1) Designate a successor lien agent and
provide written notice of designation to the successor lien agent; (2) Provide the contact
information for the successor lien agent to the inspection department that issued any required
building permit and: (3) Display the contact information for the successor lien agent on the
building permit or attachment thereto// posted on the improved property.
•
Date: / � / ! 2
Signed: