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DOCUMENTS Initial Application Dater) I 11 Application# IS-Y J 1aSti 1 CU# COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION Central Permitting 108 E.Front Street,Llliington,NC 27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.hamett.orglpermits ^A RECORDEDL1SURVEY/1���MAP, ..REECCOORD��EDD,,DEED(OR OFFER' TO PURCHASE)S &SITE PLAN ARE REQUIRED WHEN&DEBUTING A LAND USE APPLICATION' �4k)4CoJ$f/ l•aocs-hT )iSlaiin9 Address:, C)1 c e)reere u cti Ate Nlr' L/f)11 LANDOWNER: l� e (�p� 1 ' // KIC ri/�- yh" Ygikmall: ICf m'Y.IYIII P hilInun)e3,i 301) city: (�(t.yr-1-Fi' Vi [ IP State: ZIp:dS. �7Contad No:riff)" cOwn /rll/1 aref'eeLZ (t(1 I\ve . Sic• Litt)0 APPLICANT'`f•tI lC As `JL4llK � Melling Address: r + K)C Zip/XD 1 ontactNeelln4b1,' t1 Q Email:\e4-n/YJ�'d& h'hhhivele3:(. 11/1 City: �t:outhpI-I-YVI ale State: Pkew#Il out pplipminKKmallw 11 different han landowner (�) (� Lett n t. HRil� Phone# ('i13 (.-1OIf Cf ��'� CONTACT NAME APPLYING IN OFFICE: i .l /' (j //��4 PROPERTY LOCATION:Subdivision:(�ftf f`IAc�t (TIei)( AIKIF'('1:A1I (�Yf- ll.�.ilb Lot#�QO Lot Size: MannnBBBoak&Pagezlt I `/•([('1/ Statel: 01 ¢ State Road Name: la 505-27— lob r Parcel: 01035a3 OI&\ I `^ PIN:�W J F.-� ,p dpa Power Company': y tt 2Iyer Zoning:-OF Flood Zone k Watershed:/�- \ Oeetl Book&Pager / from Progress Energy. 'New structures with Progress Energy as service provider need to supply p remise number PROPOSED USE: I O Monolithic IrSFD:(Size Ti x4y2j#Bedrooms:#Baths:49 Basement(wlwo bath):_Garage: /Deck:_Crawl Space:_Slab:_Slab:_ (Is the bonus room finished?( 1 yes ( no wl a closet?L yes (J no Of yes add in with#bedrooms) ❑ Mod:(Size_x )#Bedrooms_ft Baths_Basement(wlwo bath)_Garage:_Site Built Deck:_ On Frame_Off Frame_ (Is the second floor finished?( 1 yes ( )no My other site built additions?( )yes ( )no ❑ Manufactured Home: SW DW_TW(Size x )#Bedrooms:_Garage: (site built? )Deck: (site built? ) U Duplex:(Siz) x )No.Buildings: No.Bedrooms Per Unit: O Home Occupatlan'.#Rooms: Use: Hours of Operation: #Employees: ❑ AddigaNAccesso�rylONec(Size_x )Use: Closets in addition?( )yes (i no Water Supply: ✓ (%Dunt 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 (161-10 *Does the property contain any easements Whether undergrounds r overhead yes (.�no Structures(existing • •mpose. ;Single family dwellings: Manufactured Homes: Other(specify): 4.Required Residential Property Line Setbacks: 1 Comments: �`[ Front Minimum e�`. 1 Actual' ?I� A•Lv RearaC 6 1 _ Closest Sitle SideslreeVcomer(- f5 . I- Nearest Building ) on same lot Page 1 of 2 03111 Residential Land Use Application APPLICATION CONTINUES ON BACK SPECIFIC DIRECTIONS TO THE PRO ERTv FROM LILLINOTAW: 1-1_ -'1 (`+ ri ! C� M (L/",' I f i Cirt TL"( 1 . V.'±-± c_ I4OLC Iefti (Ail . 7 V ? r'(1 1E"1- + Cii�(�� -V-n1.\ c)Lti -VC) &\ Y yjt 3nr-, (Lir 'eCK_ F) rl 'u 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 foregob' statements are accurate and correct to the best of my knowledge. Permit subj ct to revo tion if false Information Is provided. Signature of Owner or oar's Agent GI �D '� "'It 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 application."' "This application expires S months from the initial date if permits have not been Issued" Residential Land Use Application Page 2 of 2 03111 1. MICHAEL P. GRIFFIN fortify that undo,my direction one supervision M/s mop was anon from on actual fi#d swat Mot the error of doeu/o of the sunny oe calculated by cotvd4otes Is 1.: 144%41: that the onto Non hereon wo colculoN0 by coo.Chatea MMen my hand and sed this Loy of MOWN 2017 Ai OPEN iS 5PACE 7 7\.. / p �� N7g0659"E �� / 167.57' 01,, (n / / Way.NP5 — AA ib HAA K — --_,//T N /\ 07 980 a ro RC12,326 50.F(. / P8' 0.25 AC. / \ [ / 0. g PATIO p m •ti 9.0' Y' 5.0' y- COV, 0 a \ % / .//K g PORCH • U' zo'oeMNNT EASEMENT 13.00' �'_ m \ 0C24 /— \ 5'UTILITY PROPOSED 1979` -7 EAseMeNT BLAIR o I \ 11 cc 10 o i N iSD \ N �o`\� ,---- 19,00' 10.0' I v, � Q 1 �P. \ 14.00' 6.00' " PROP C NC (z \9 d DRIVE aQ w 3 g 0 a. irir I III F w tg 6 iL G3 allP.Evrsow. RIGHT HAND FRONT LOAD 7/31/17C� GL I U C T 50 REVISION. NEW PIANS 5/22117 RE �V,/ VISION. BACK 1/I 1/16 CI R=325.00 L=37.4 I'N62°5935"W37,39' C2 R=25.00'L=31.26' N54°293243 29.26 C3 R=125.00'L=35. 12'556°43'1 I"W 35.00' 1 LEGEND "'' -1 B3484 - P102 For Registration Kimberly S. Hargrove Register of Deeds Harnett County, NC Electronically Recorded HARNETT COUNTY TAX ID # 2017 Feb 2804.31 PM NC Rev Stamp. $ 369.00 01053523 0100 12 Book'. 3484 Page:102 - 103 Fee: $26.00 01053523 0100 17 Instrument Number: 2017002982 02-28-2017 BY: SB NORTH CAROLINA GENERAL WARRANTY DEED Pile No.: 11-10729-17-CH Excise Tax: $369.00 Parcel Identifier No.01-0535-23-0100.12(Lot 980) 01.0535.23.0100.17(Lot 984) 01-0535-23-0100-18(Lot 9851 Verified by Harnett County on the 20_ By: Mail/Box to: Single Source Real Estate Services,Inc.,2919 Brentwood Ave.,Suite 300,Fayetteville,NC 28303 This instrument was prepared by: The Real Estate Law Firm 2919 Bre9Zrwood Avenue Ste 300 Faveneville NC 28303 Brief description for the Index: Lot 980 984 985 Anderson Creek Cluh THIS DEED made this 27th day of Febniary,2017,by and between GRANTOR GRANTEE Anderson Creek Partners.L.P.(a Delaware Limited H&H Constructors,inc. Partnership,doing business in North Carolina as Anderson 2919 Breezewoad Avenue,Ste 400 Creek Partners,Limited Partnership) Fayetteville,NC 28303 216 Anderson Creek Drive Spring Lake,NC 28390 Enter in appropriate block for each Grantor and Grantee:name,mailing address,and,if appropriate,character of entity,e.g. corporation or partnership. The designation Grantor and Grantee as used herein shall include said parties, their heirs,successors,and assigns,and shall include singular,plural,masculine,feminine or neuter as required by context. WITNESSETH,that the Grantor,for a valuable consideration paid by the Grantee,the receipt of which Is hereby acknowledged,has and by these presents does grant,bargain,sell and convey unto the Grantee in fee simple,all that certain lot,parcel of land or condominium unit situated in the City of Spring Lake,Anderson Creek Township,Harnett County,North Carolina and more particularly described as follows; BEING ell of Lot 980,984,985,in a subdivision known as Anderson Creek Club.Part 1,Phase 5E,and the same being duly recorded in Book of Plats 2014,Page 244,Harnett County Registry,North Carolina. Parcel ID:01-0535-23-0100-12(980)01-0535-23-0100-17(984)0I-0535.23.0100-18(985) Property Address:Lot 980,984,985 Carriage Glen,Spring Lake,NC 28390 The property hereinabove described was acquired by Grantor by ins ent recorded in Book 1346 page 98. All or a portion of the property herein uunveyed includes or 1/does not include the primary residence of a Grantor, A map showing the above described property is recorded in Plat Book 2014 page 244. 1 NC Bar Association Form No. 3 O 1976.Revised O 1/1/2010,2013 This standard form hie been approved by: Printed by Rimmed with the NC Bar Association North Carolina B.rAssocletion•NC Bar norm No. 3 submitted electronically by "single source Real Estate services" in compliance with North Carolina statutes governing recordable documents and the terms of the submitter agreement with the Harnett county Register of Deeds. a ,"kifi'�'7F ., ,t.A r ;',f _ . ',hTB n2ifA... - ato TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee simple. And the Grantor covenants with the Grantee,that Grantor is seized of the premises in fee simple,has the right to convey the same In fee simple,that title is marketable and Ree and clear of all encumbrances,and that Grantor will warrant and defend the title against the lawful olaims of all persons whomsoever,other than the following exceptions: Subject to restrictive covenants,easements and rights-of-way as they may appear of public record. Subject to ad valorem taxes which are a lien but not yet due and payable. IN WITNESS WHEREOF,the Grantor has duly executed the foregoing as of the day and year first above written. Anderson Creek Partners.L.P..t a Delaware Limited Partnership (SEAL) doing business in North Carolina as Anderson Creek Partners.Limited PrintiType Name: Partnershio) (• tity e ) (SEAL) Print/Type Name: By: Mz W Print/type Name&Title: By David Nevinso resident of Anderson Creek Inc General Partner (SEAL) Print/Type Name: By: Print/Type Name&Title: (SEAL) Print/Type Name: By: Print/Type Name&Title: State of North Carolina—County of 1,the undersigned Notary Public of the County and State aforesaid,certify that personally appeared before me this day and acknowledged the due execution of the foregoing instrument for the purposes therein expressed. Witness my hand and Notarial stamp or seal this day of ,20 My Commission Expires: Notary Public State of North Carolina—County ofMurk I,the undersigned Notary Public of the County and State aforesaid,certify that David N Levinson personally appeared before me this day and acknowledged that he is the president of Anderson Creek_true who Is the General Fortner of Anderson Crept e,P�artners.L.P..(a Delaware Limited Partnership doing business in d that nd as the t of such ,North Chhhali�n@aas l�d the fore op�ri gkst_ruprson ptent in its ers Limited nameao [be aaltas'1'//grPgytt dey authority duly given ecd. Witness my han g d Notarial stamp or seal, this J T' daref��k .so li NOTAT3 CC.. = My Commission Expires: 7070 t7,v COMM S N State of North Carolina—County of y p V C'� I,the undersignedNotary Public of the Coun tatYsaMN fy that %/hi trlll,/tllIrnli" Witness my hand and Notarial stamp or seal,this day of ,20 My Commission Expires: Notary Public The foregoing Certlfieate(s)of Is/are certified to be correct. This instrument and this certificate arc duly registered at the date and time and in the Book and Page shown on the first page hereof. 2 NC Bar Anodatlon Form No. 3 C 1976,Revised 01/1/2010,2013 This standard form h s been approved by: Printed by Agreement with the NC Bar Association North Carolina Bar Association•NC au Form No, 3 NORTH CAROLINA GENERAL WARRANTY DEED File No.: 1J-10729-17-CH Excise Tax: $369.00 Parcel Identifier No.01-0535-23-0100-12(Lot 980),0l-0535-23-0100-17(Lot 984101-0535-23-0100-18(Lot 9851 Verified by Harnett County on the ,20_ By: Mail/Box to: Single Source Real Estate Services,Inc.,2919 Breezewood Ave.,Suite 300,Fayetteville,NC 28303 This instrument was prepared by: TINRepl Estate14w Firm,2919 Breezewood Avenue,Ste 300,Fayetteville,NC 28303 Brief description for the Index: Lot 980.984.985 Anderson Creek Club THIS DEED made this 27th day of February,2017, by and between GRANTOR GRANTEE Anderson Creek Partners.L.P.(a Delaware Limited H&H Constructors,Inc. Partnership,doing business in North Carolina as Anderson 2919 Breezewood Avenue,Ste 400 Creek Partners,Limited Partnership) Fayetteville,NC 28303 216 Anderson Creek Drive Spring Lake,NC 28390 Enter in appropriate block for each Grantor and Grantee:name,mailing address,and,if appropriate,character of entity,e.g. corporation or partnership. The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include singular,plural,masculine, feminine or neuter as required by context. WITNESSETH,that the Grantor, for a valuable consideration paid by the Grantee,the receipt of which is hereby acknowledged,has and by these presents does grant,bargain,sell and convey unto the Grantee in fee simple,all that certain lot,parcel of land or condominium unit situated in the City of Spring Lake,Anderson Creek Township,Harnett County,North Carolina and more particularly described as follows: BEING all of Lot 980,984,985,in a subdivision known as Anderson Creek Club,Part 1,Phase 5E,and the same being duly recorded in Book of Plats 2014,Page 244,Harnett County Registry,North Carolina. Parcel ID:01-0535-23-0100-12(980)01-0535-23-0100-17(984)01-0535-23-0100-18(985) Property Address:Lot 980,984,985 Carriage Glen,Spring Lake,NC 28390 The property hereinabove described was acquired by Grantor by instru ent recorded in Book 1346 page 98. All ora portion of the property herein conveyed includes or does not include the primary residence of a Grantor. A map showing the above described property is recorded ill Plat Book 2014 page 244. NC Bar Association Form No. 3©1976,Revised Pi I/1/2010,2013 This standard Coon has been approved by Printed by Agreement with the NC Bar Association North Carolina Liar Association-NC Bar Fenn No. 3 • • TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee simple. And the Grantor covenants with the Grantee,that Grantor is seized of the premises in fee simple, has the right to convey the same in fee simple,that title is marketable and free and clear of all encumbrances,and that Grantor will warrant and defend the title against the lawful claims of all persons whomsoever,other than the following exceptions: Subject to restrictive covenants,easements and rights-of-way as they may appear of public record. Subject to ad valorem taxes which are a lien but not yet due and payable. IN WITNESS WHEREOF,the Grantor has duly executed the foregoing as of the day and year first above written. Anderson Creek Partners.L.P..(a Delaware Limited Partnership (SEAL) doing_business in North Carolina as Anderson Creek Partners,Limited Print/Type Name: Fanneisnml OCU D THIS MENFA pSLt)'MORN (SEAL) ',S OCUM) ^ / Print/Type Name: E y: nntA ype Name& t me: r nt of Anderson Creek Inc General Partner (SEAL) PrinUfype Name: By: Print/Type Name&Title: (SEAL) Print/Type Name: By: Print/type Name&Title: State of North Carolina—County of aE<st-tA 1"te I,the undersigned Notary Public of the County and State aforesaid,certify that - personally appeared before me this day and acknowledged the due execution of the foregoing instrument for the purposes therein expressed. Witness my hand and Notarial stamp or seal this day of ,20 My Commission Expires: Notary Public State of North Carolina—County of Harnett I,the undersigned Notary Public of the County and State aforesaid,certify that David N Levinson personally appeared before me this day and acknowledged that he is the President of Anderson Creek.Inc who is the General Partner of Anderson Creek Partners.L.P..(a Delaware Limited Partnership,doing business in North Carolina as Anderson Creek Partners.Limited Partn�Yuquunu1[l4pd that by authority duly given and as the act of such entity, Ig� ryed the fore of ' stru tent in its name o�p'tjelaltati4s) t ld deed. Witness my hand :nd Notarial stamp or seal, this 'nf day of wA zo :I t$ NOTARv My Commission Expires: q; COMM JN EXPIR = . fl�fCi7fJ d'. State of North Carolina—County of 9 1I ‘C, 2$ I,the undersigned Notary Public of the Count? talE'I�resqOreify that 4'4 rr wmatimitiow Witness my hand and Notarial stamp or seal,this day of ,20 My Commission Expires: Notary Public The foregoing Certificate(s)of is/are certified to be correct. This instrument and this certificate are duly registered at the date and time and in the Book and Page shown on the first page hereof. 2 NC Bar Assucialion Form No. 3®1976,Revised C 1/I/2010,2013 This standard form has been approved by. Printed by Agreement with the NC Bar Association NoitlI Carolina Bar Association.NC Bar Form No. 3 00109/11 Application# Harnett County Central Permitting PO Box 65 Lillington NC 27546 Each Becton below to be Med out 910 893 7525 Fax 910 993 2793 www hamett org/permits by whomever performing work Must be owner or licensed contractor Address company Application for Residential Building and Trades Permit name 8 phone must match (� ..'I� OwnersName .1-Se ( nfflr �rS /1Rt.!`etkeC�W IIP, LIQ!. , Dat: 1 Site Address Y len `�t T • Phone • (directions to Job site from Lillington '13 ' ' *.i I +' t I ma voxVsv.3 RCi,l.. iGQC<l ±'kt Bird 0IIOi.& \- c(\� re3Cie- - I G t lv . /'��,� Subdivision( ? Uf rraPC-' L nit Aa lf",' �^ • � ' .- 1� Lt � Description of Proposed Work Me (Y jIC.,I'[.L191 lit LA l t/ Yg1C� #of Bedrooms *Heated SF IO !` /Unheated SE'7&O *Finished Bonus Room? 'Crawl Space _Slab /� e1 a Co t lac or do k IJhnSkt-OciO S n} ( Eiali) C'V• lie 11 Tale hone Nog Building Contractors Company Name P r11�larty#te-iiAvrS4•L/33gal ACC- Xi-n3 krindalre.rP111-41.)r. l• nY1 Address Email Address y1C) License# Electrical Contractor Information / Description of Wnrk Service Size i0 •mps T-Pole ✓ Yes_No J(L\ Pop ¶C_ItetrrC 11-rt,c . a1t1-11r1le` S19 Electrical Contractors Cdhtpany Name Telephone atttlrttrcl Street ` inicorOR 493, Ftea6cix:f Q t IrciStrezo .Ott, rworess Email Address 13a(c— MechanlcallHVAC Contractor Information Description of Work y ( (Ut�l'rne. (?lm-hlr4 Air enc . 411(i- X130 - 136,3 Mechanical Contractor s Company Name Telephone old �SNILil 3ON..)SineSS f jail;ton,ti�- ertroll naky-n- r-+Q.r Lyay l .COnl Address7Jr " Email Address v� � 41311N - 3- I License# Plumbing Contractor Information Description of Work #Baths Vnrxr lbh ,-tn PI Dmb; net Cl 41K, . (710-gag-4lla Plumbing Contractors Company Name Telephone 1941 ti4d pine Livid ratjEfh vi Ile, k (-- o)k,:0(o vd.pl .CD n Address Emelt Address - P- i • License# Insulation Contractor Information _ Trr7-j-FL Ti iCTh3 1Jr1.- uIS rsui5t. e��'y" ./J- ' I3--q o- 25<5 Insulation Contractor s Company Name&Address c 3.i 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 to me and that in/mama below I have obtained all sybcontractore permission to obtain these perntds and if gay 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 current fee schedule Cloca ald11 t1 Signature of Owner/Contractor/ icer(s)of Corporation Date Affidavit for Worker's Compensation N C G S 87-14 The and igned applicant being the General Contractor Owner Officer/Agent of the Contractor or Owner Do hereby confirm under penalties of penury that the person(s) firm(s)or corporation(s)performing the work set fo 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 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 If lk] / / n Company or � -me ttE /1�L1'UCS of- �Q{�ls111//'6"1 4.7 /y( Sign wlTit';� .�1‘. � a . _ ��/. _ f/y . . 's.` Thrid -iva Appointment of Lien Agent: Details - LiensNC Lien Service Page 1 of I DO NOT REMOVE! Details: Appointment of Lien Agent Filed on: 09/20/2011 Entry #: 126512 Initially filed by: meagenbradahew Dnlgnated Lien Agent Project Properly Print & Post First Ameneen Ii:leInsurance Company CGA000980 LCarnage Olen b]Anderson Or Creek Club CLoi( (lien Dr Glen Online. sw lien _ and Ci. Art,19 is Huecosi Snip rot IN,*- ' GLEN BEND COURT Spring Lake,NC 28390 nnol Harnett Courcy Con Phone XxX�wo➢A4 Pleax post this nntiee on the Job Soo Far 91,J5113I Suppliers and Subcontractors Ern ne{yppoduummo ow: Property Type sen this image wish your smart phos view this filing Youendt n file a Nonce to Lien Amthis gr forproject Owner Information 1-2 Family Dwelling H&H Constructors of ayneviva LLC. Date of First Furnishing 2919 Breezewood Avenue Sie 40{1 Fayetteville NC 28303 Email leatmahaii iihhomes corn 01/02/2016 Phone n10-456-4564 View Comments 101 technical Support Hotline:188816404354 https://apps.liensnc.com/scr/appointment/details.html?entryNumber=724512&printable= 9/20/2017 • ((�� ((�,, Date A I PLO I ) Plan Box # R Rel Job Name }4 ? H Plan Name Rc Js sr' App # 4 ] q Valuation/ /Wen) SQ Feet /OS-- Garage OSGarage 2/ 45 = ALIT Inspections for SFD/SFA Crawl_ Slab_ Mond,/ Basement_ Footing Footing Plum Under Slab Footing Foundation Foundation Ele. Under Slab Foundation Address Address Address Waterproofing Open Floor Slab Mono Slab Plum Under slab Rough In Rough In Rough In Address Insulation Insulation Insulation Slab Final 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