DOCUMENTS Initial Application Dab: _ \ IR 1 1,n Application# I 1.SerJ 1 ,gC)
664 cU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPUCATION
Central Permitting 108 E.Front Street,Lillington,NC 27548 Phone:(910)893-7525 oxt:2 Fax:(910)883-2793 www.hametLorg/per its
**A RECORDED SURVEY YAP,RECORDED(� � DEED(OR OFFERTTO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMDTNG A LAND USE APPLICATION^
LANDOWNER: I ' QMI1\ Id91�LLC f(UJ Mailing Address:
City: State:_Zip: Contact No: r1 Email:
APPLICANT: Lai kiltLLC Mailing Address:3375 eJ4.4-I Lcgj lid.AUL S-FZ Z3c)
City: CIfyii i*bar» state: .V(e ap:Z741n Contact No:Gl KI_QGS Sc.SU Emartlegi i+7 lQ i iJGdt Sr t/►�gy1
'Prima Si out applicant information I dllarent than landoaeer V%OMC.6.C.OHb1
CONTACT NAME APPLYING N OFFICE: -12-s,t, C1.Y.a_bI t-7 Phone# QIQ ZGQS SSL.SCI
PROPERTY LOCATION:Subdivision:_ _ L#L_'+_L Lot#: LA 1 Lot Size:6,58
Slab Road#X(0s(i State Road Name: l'I3u,Q.,Vat ` �O Map Book&Page:1/S" 1 !ern
Parcel: n�-iO��tli 'l (� 'ys PIN: �OG'Fs4
Zoning:9X/O Flood Zone: )(7. Watershed: -Deed Book&Page: 144(-1 '? 4LS Power Company':
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
Monolithic
SFD:(Size x`r)#Bedrooms4 #Baths?SBasement(whwo beth):_Garage:V Deck:.1k) Crawl Space:_Slab:_ _Slab: X
(Is the bonus room finished?( )yes (_)no wi a closet?( 1 yes (J no(N yes add in with#bedrooms)
❑ Mad:(Size_x )ti Bedrooms_#Baths_Basement(w/wo bath) Garage: Site Built Deck:_ On Frame Off Frame_
(Is the second floor finished?( )yes ( )no My other site built additions?( }Yes (J no
❑ Manufactured Home:_SW_OW_TW(Size x_)#Bedrooms:_Garage: (site built? )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 ( )no
Water Supply: V County _Existing Well _New Wall(#of dwellings using well )'Must have operable water before Mel
Sewage Supply: New Septic Tank(Complete Checklist) _Existing Septic Tank(Complete Checklist) x 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 (Y)no
Does the property contain any easements whether underground or overhead(( )yes ( )no
Structures(existing o rposa :Single family dwellings: 1 Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 2q_]� Actual r)•
Rear � n• "
Closest Side i 'J
_91,=O
Sidestreet/comer lot 20
Nearest Building
on same lot
•
APPLICATION CONTINUES ON BACK
SPECIFIC'DIRECTIONS-TTO�THE PROPERTY FROM LILLINGTON! 1 ((,�.L Al�jli I���c�10 , CGS' '
La. l^i4O '6 1�'11ij L1 -7+ ��11./.Vl it'rr1 IL 0 t C✓77Y14-�r-.
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 state that foregoing s �m�e� nf�nare�ac�cu��ra,te and carted to the best of my Imowiedge. Permit subject to revocation If false information la provided.
/
Signature of Owner oar's Agent Date
"'t Is the ownedappllcants 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 those applications."'
"This application expires a months from the initial dale If permits have not been Issued"
APPROVAL FOR STAKING:
THIS PLOT PLAN AS PREPARED BY RESIDENTIAL LAND SERVICES,
IS CORRECT AND IS HEREBY APPROVED FOR STAKING ON THE
DATE SHOWN BELOW.
GL SITE WADE JURRNEE�YpHOMES REPRESENTATIVE DATE
Bv¢ !LLL
ADIMENSIONS, LOCATORS AND FEATURES SHOWN ON
THIS PLOT PLAN ARE APPROXIMATE AND ARE ONLY AN
ARTISTS RENDITION, EXACT LOCATION OF ALL FEATURES
ARE SUBJECT TO CHANGE AND MAY NOT BE INSTALLED
NAAHlr Wo EXACTLY AS SHOWN ON PLANS AND/OR IN MODELS.
XL, PLACEMENT OF HONE. DRIVEWAY, SIDEWALHS AND
EXTERIOR FEATURES ARE SUBJECT TO MODIFICATION AS
DEEMED NECESSARY BY FIELD PERSONNEL.
CUSTOMER DATE
VICINITY MAP \ CUSTOMER DATE
Not To Scale ct'a /
SETRACES. ooA
09G WADE JURNEY REPRESENTATIVE DATE
FRONT - 35' ri'
REAR - IMPERVIOUS SURFACE AREA
SIDE - 10'0.
CORNER SIDE - 20' DESCRIPTION AREA
a
HOUSE w/ PORCH 1,780 S.F.
jj DECK/PATIO/HVAC 27 S.F.
\`IIS DRIVEWAY & WALKS 657 S.F.
(A� TOTAL (PROPOSED)= 2,464 S.F.
to i V i`,1 LOT AREA = 25,359 S.F.
—c co % IMPERVIOUS AREA =9.7%
Z 534'35'37"W
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PERER
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PLAN
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COTTLE LAKE DRIVE
50' PUBLIC RAW
NAME: (�(/ILJ APPLICATION#:
*This application to be tilled 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 I CONFIRMATION N
❑ Environmental Health New Septic System Code 8 00
• All property irons must be made visible. Place"pink p roperty flags" o n 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.
• Race 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 confined 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 En vironmental 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.
❑ Environmental Health Existing Tank Inspections Cod e 800
• Follow above instructions for placing flags and card on property.
• Prepare for inspection by removing soil over over outlet end as diagram indicates, and lift lid straight up(if
possible) and then close back down. (Unless inspection is for a septic tank in a mobile home park)
• After uncovering outlet end call the voice permitting system at 910-893-7525 option 1 &select notification permit if
multiple permits, then u se code 800 for Environmental Health ins pection. 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 system typelsl: can be ranked in order of preference,must choose one.
{_} Accepted { } Innovative ([} Conventional (J Any
1 } Alternative { 1 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. lithe answer is'-yes",applicant must attach supporting documentation.
I )YES { } NO Does the site contain any Jurisdictional Wetlands?
I YES Il} NO Do you plan to have an irrigation system now or in the future?
{—I YES IK1 NO Does or will the building contain any drains? Please explain.
, ;YES ; d NO Are there any existing wells, springs,waterlines or Wastewater Systems on this property?
I I YES { } NO Is any wastewater going to be generated on the site other than domestic sewage?
I }YES I j} NO Is the site subject to approval by any other Public Agency?
YES NO Are there any Easements or Right of Ways on this property?
I 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 Is 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 For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site Accessible So That A Complete Site Evaluation Can Be Performed. �7
PROPERTY OWNERS OWNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE
AGREEMENT TO PURCHASE AND SELL LOTJS)OR VACANT LAND
THIS AGREEMENT TO PURL SE AND SELL LOT(S) OR VACANT LAND (the
"Agreement") is made this...TS day of 20 /1,by and between WJH LLC, a
Delaware limited liability company ( einafter, "WJH"), and Mastin Baker Investments, LLC
(hereinafter,the"Seller").
WITNESSETH:
WHEREAS,Seller is the owner of certain real property commonly known as Cottlestone Estates,
and more particularly described on Exhibit "A", which is attached hereto and incorporated by reference
(the"Property",or each individual lot being referred to as a"Lot");
WHEREAS, WJH is engaged in the business of building and selling residential real properties in
the southeastern United States,among other places,and acquires vacant lots or land from time to time in
furtherance of that business;and
WHEREAS, WJH desires to purchase the Property from Seller, and Seller desires to sell the
Property to WJH.
NOW THEREFORE,in and for good and valuable consideration,the receipt and sufficiency of
which is hereby acknowledged,the parties hereby acknowledge,agree and covenant as follows:
I. DEFINITIONS. The following defined terms shall have the meanings set forth below:
a. "Seller": Mastin Baker Investments,LLC
b. "Purchaser"or"WJH": WJH LLC,a Delaware limited liability company,
and/or any of its successors or assigns;
c. "Purchase Price":
($224,000)
d. "Earnest Money": ($4,000),to be deposited in accordance Section 4,below.
e. "Escrow Agent": Black,Slaughter,&Black,PA
3623 N. Elm Street,Suite 200
Greensboro,NC 27455
I "Effective Date": The date on which this Agreement is executed by the
laver to sign of Purchaser or Seller,as indicated on the
Seller WJH it
EXHIBIT"A"
Lot# Address Street City State Zip
2 45 Cottle Lake Dr Coats NC 27521
7 71 Gillis Ct Coats NC 27521
13 50 Gillis a Coats NC 27521
16 39 Modlin Ct Coats NC 27521
21 40 Modlin Ct Coats NC 27521
30 78 Vic McLoud Ct Coats NC 27521
35 385 Cottle Lake Dr Coats NC 27521
41 366 Cottle Lake Dr Coats NC 27521
Seller WJH
II
Detain Ermines ID:IEBCFIFCO24-404132381E1522FEM?5
CONFIRMATION OF AGENCY RELATIONSHIP,APPOINTMENT&COMPENSATION
NOTE:When working with on Unrepresented Seller(For Sale By Owner)you should use Form 750
See Guidelines(Standard Fonn 2200)on proper use of this form.
TO LISTING AGENT: Luorteit Jackson
FIRM NAME: Ann Clarkin Rtaltp, Inc
FAX*: Email: lucraciajsckaonlpahoo.amt
FROM SELLING AGENT: JermnQ Carroll
FIRM NAME: Tres11M Properties i Realty
FAX*. Email: 1carro11gt1Prealtp.cam
Thank you for checking with your seller mid permitting me to show your listing asa® buyer agent Q subagent of seller.
Cottletoma estates (Lott Listed on
PROPERTY DESCRWTION: esbibit A)- Coats, NC 27521
NAME OF BUYER: IfJE LIZ
APPOINTMENT DATE TIME:
WE ARRANGEMENT:
(a) You hereby confine that your offer of compensation to my firm regarding any sale of the Property to Buyer shall he as
follows: 3.St of purchase price
I understand that my Emil milkmen to the competuatbo ret firth above will be determined by my performance as the pawing
cause of any sale of the Property to Buyer. Your ttgnatme on this document don not constitute an acknowledgment that I am the
prattling nine of any such sale.
(b) III have received or am to receive any other feels) in connection with the sale of the Property.I hereby confirm that
such feels)am as follows:
Please sign below and fax or email this Confirmation back to me at your artiest convenience. Please call me at my office:
or at if there am any further instructions or communications
prior to the showing.Thank you for your coopmtion.
THE NORTH CAROLINA ASSOCIATION OF REALTORS®. INC. MAKES NO REPRESENTATION AS TO THE LEGAL
V IS OR AQEQUA ANY °VISION OF THFORM IN ANY SPECIFIC TRANSACTION.• (.o-/- IPI
��++�^� C�ry.Y
mL Agent Ly@tai► tom Date
5/31/2017 May 31, 2017
33�L- t Jeremy Carroll D�
0 Buyer agent Q Subagent of Seller
ACKNOWLEDGEMENT BY BUYER AND/OR SELLER(Opolonaf-+e Gulddlnn)
Seller hereby acknowledges receipt of a yafll;fern and Buyer hereby acknowledges receipt of a copy of this form and
raters tq.(I)f$e J fray na herein. consents to the fee arrangements set forth hrein.
Seller: Buyer
Date: E-I-1i ate:
Seller Buyer
Date: Dare:
Entity Seller. (Ara N gm.' Zan ht mLf�' Entity Buyer
(Name of LLC/CwWsedmUPatmen Nee.) (Name of LLC/Corporuion/Parmenhipflluehtc.)
By: By:
Name: Nom:
Title: 'Ode
Date: Date:
Page I of I STANDARD FORM 120
North Carolina Auoc4ton of REALTORS®,Inc. a Revised 7/2014
MEW OD 7/2,0111
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DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 09/01/2017
Entry A: 714419 Initially filed by: wJh2013
Duignated Lien Agent PraJect Property
Print & Post
Investors Tide Insurance Com pang CSEA1
366 Coil e Lake Dr 0"t ❑
nnlln.:4w4 Lmme.COM Coats,NC 27521 e d
Harnett County
Andres la W ll.ryni s.,Sone sm a,leiy=n]C �7
„cul
Phone:xxxnno-7m4 Property Type Contractors:
Fav eD-mws2 r I Please pest this notice on the Job Site.
Email:.1411D011,1 6vmac nen 1-2 Family Duelling Suppliers and Subcontractors:
Scan this image with your man phone o
ew this f ling.You can then ale a Notice
mLien Agent tor his project.
Owner Information
WJH.LLC
3300 Battleground Ave Suite 230
(ircensboro, NC 27410
Limbs'Stales
Email.oohiurywaJ jumeyhomes om
Phone:419-405-5654
View Connects l 0)
Technical Support Hotline:IaSa F6n0-7ta4