DOCUMENTS Initial Application Date: Gr3``
_11 1 1 r 6 si.F.,i1sto ApB#Application# � l s> y 3
CU Si
� -a33COMMERCIALYf
COUNTY OF HARNETT LAND USE APPLICATION
Central Pe/Mlrmg (Physical))108 E Frani Steel,Llllingion,NO 27546 maim,PO Bor ES Lilymgion NC 27546 Phone'.(910)6937525 o01#2 Fax:(910)893-2793 wxxaamml oq/permits
LANDOWNER: Harnett County School Mailing Address: P.O.Box 1029
City: LilllnCItOn State: NC Zip: 27546 Contact# 910-985-1003 Email: rgregory1(Wharnett.k12.nc.us
APPLICANT': Harnett County School Mailing Address: P.O Box 1029
City: Lillinoton State: NC Zip: 27546 Contact it 910-985-1003 Email: rgregoryl@harnett.k12.nc.us
'Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE: Rodney Gregory Phone# 910-985-1003
PROPERTY LOCATION:1asp
215 Maynard
d Lake
^Road,
-Erwin NC- 283393Lot#:_ — Lot Size lC�rp
State Road/I
1�7 asp State Road Name: f "\ylt• % rel LMJ# . c—_. a�Map Book&Page: '—I
Parcel: U—c L�7 904,E �A PIN'. Lan — Err# b Sx��# ' liV
Zonin Flood Zone: (- Watershed:/—T Deed Book&Page: -->— Power Company':
'New cur th Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: Take Hwy 421 to Erwin turn left onto Maynard Lake Rd.
Left
PROPOSED USE:
U Multi-Family Dwelling No.Units: No. Bedrooms/Unit:
❑ Business Sq.Ft. Retail Space: Type: #Employees: Hours of Operation:
❑ Daycare #Preschoolers: #Afterschoolers: it Employees: Hours of Operation:
U Industry Sq.Ft: Type: #Employees: Hours of Operation:
❑ Church Seating Capacity: #Bathrooms: Kitchen:
ElAccessory/Addition/Other(Size 24 x 36 )Use: Mobile Classroom with no plumbing
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
Comments:
StAnD & S-YD t-A' 11 -1St vx_Sn_Q_a \ y-eQv -
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 are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
4 7— 6 -l7
SI‘41. re of Owna�or O era Agent Date
"Thle application expires 6 months from the initial date if permits have not been issued"
A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION
Application# 3
•Each section below must be filled out by Harnett County Central Permitting
whoever is performing the work. Must be PO Box 65 Lillington,NG 27546
owner or licensed contractor. Address, 916693-7525 Fax 910-893-2793 w.aw.harnetl.org/permits
company name & phone must match COMMERCIAL
information on state license.
Application for Building and Trades Permit
Owner's Name: Harnett County School Date:
Site Address: 215 Maynard Lake Rd. Erwin, NC 28339 Phone:
Directions to job site from Lillington: Take 421 to Erwin turn left onto maynard lake school on right hut location on
Subdivision: Lot:
Description of Proposed Work: Building a mobile classroom 24'x 36'
Heated SF 864 Unheated SF 10000.00
General Contractor Information: Building Cost$
Harnett County school 910-8933808
Building Contractor's Company Name Telephone
1500 South main SI.Lillington, NC 27546 rgregory1Qharnett.k12.nc.us
Addre s , Email Address
Signature Owner/ ontractor/Officer(s) of Corporation License#
Electrical Contractor Information: Electrical Cost$ 500.00
Description of Work install a 100 amp panel Service Size: 100 Amps #T-Poles
Harnett County School
Electrical Contractor's Company Name Telephone
1500 South main St.Lillington, NC 27546
Addre s Email Address
7
Signature o •caner/C. tractor •fficer(s)of Corporation License#
Mechanical Contractor Information: Mechanical Cost$
Description of Work #Units
Mechanical Contractor's Company Name Telephone
Address Email Address
Signature of Owner/Contractor/Officer(s) of Corporation License#
Plumbing Contractor Information: Plumbing Cost$
Description of Work #Baths
Plumbing Contractor's Company Name Telephone
Address Email Address
Signature of Owner/Contractor/Officer(s)of Corporation License#
Insulation Contractor Information
Insulation Inc. 919-772-9000
Insulation Contractor's Company Name &Address Telephone
*NOTE: General Contractor must fill out and sign the second page of this application
Sprinkler Contractor Information
Sprinkler Contractor's Company Name Telephone
Address Email Address
Signature of Officer(s)of Corporation License#
Fire Alarm Contractor Information
Fire Alarm Contractor's Company Name Telephone
Address Email Address
Signature of Officer(s)of Corporation License#
Driveway Access- NC Department ofTransponation Driveway Access/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 if jay 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 charged at full price per current fee schedule.
Signature f Owner/Co tract /Officer(s)of Corporation Date
Affidavit for Worker's Compensation N.C.G.S. 87-14
The undersigned applicant being the:
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: //14441-1//14441-1`- f 6m«.-v ' 111/ 5c4cn
/
AP
Sign Ai/Title: Date: 9— 6 - /7
Harnett M.
` C 0 II NTY ow Eww•wwr SwansD•Mwret
f i. . wwwh.•m.•••
Fire Marshal Division
P.O. Box 370
Lillington,NC 27546
910-893-7580
Application for
/Plan'Review
�
Application# i'1 - Sly J`4 a 3 ?
Date Received: °1. 1 aL '1 Received By:
Name of Project: Harnet County School \rl-�p,n
Physical Address of Project: 215 Maynard Lake Rd.
Erwin NC 28339
Plans Submitted By: Harnett County School
Project Phone: (910 )-893 4808
Contact Person/Address: Rodney Gregory
1500 South Main St.
Contact Phone: (910 )_985 1003 ( )- _
Contractor's Name/Info: Harnett County School
Contractor's Phone: (910 985- 1003
• Plans that are submitted will be reviewed as quickly as possible with an
average time of review between 7-10 working days.
• Status checks may be conducted on plan reviews by visiting the website
htta://hteweb.harnett.ore/Click2GovBP/tndex.iso or by calling the Harnett
County Central Permitting Office(910-893-4759),or the Harnett County
Fire Marshal's Office(910-893-7580).
• Approved plans must be picked up from the Central Permitting Office and
all fees paid before any required inspections can be conducted.
Jennifer Brock
From: townmanager <townmanager@erwin-nc.org>
Sent: Wednesday,April 20, 2016 11:10 AM
To: Jennifer Brock
Subject: High School Carprentry
Attachments: Richard N Hicks.vcf
This email is to notify Harnett County Central Permitting that the Town of Erwin will no longer require a zoning
compliance certificate for the sheds and buildings being constructed at Triton High School by the carpentry or building
classes. Please let me know if you have any questions,or if you need any additional information.
Richard N. Hicks
Town of Erwin
Interim Town Manager
010)897-3073'Work
1252)341-6815 Mobile
(25217534411 Home
townmanager@erwin-nc.org
rhickstof®gmail.corn
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