DOCUMENTS Initial Application Date:` 0( .J' I 1 Application# I l JC)( )Lc.Y 0(0
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 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"
11,
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LANDOWNER: UJaOiI AJunin,) IM.LS Mailing Address'. �� .. - /! / .I v /l ta
city: �GIri.1y\C)ItCWfl state:St zip: . 441&ontact No:an 42s.g.5C.1 Email: 1??).bf/L Q rA..b/J1s itn.C&j
/y/ka �+ ^ 1 / I•td„,.„
APPLICANT'.` 1{y.,+� ,,wI-��'�f� O �(T�� Mailing Address: 101�IGJ AS"Y JAIdILJ�(/ IOD
City: �VilQ(nwyy� State: NCziprIS4SContact No: ,S'JM1 Email !
*Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE: ������ II�� /; 1 EVILS
C /}��'z] �/ Phone#
PROPERTY LOCATION:1I1Subdivision JA(ATX41114,1+
�j' as- EVnI1LS Cruz_ Lot#: t 4 Lot Size: O LR
State Road# U K State Road Name: .�,11I G FF _Nit • Map Book&Page:Zan /Aja y
Parcel: II Ott gOd roan 1 11`-i PIN: OUR° .25 ' inc C
Zonings ThFlood Zone: N Watershed Deed Book&Page. 35AS i Q(J'\lPower Company'. 4'l( 6IL cs
'New structurestrwith Progress Energy as service provider need to supply premise number from Progress Energy.
PRq►OSED USE: s
ift�(( ''11 9 Mobolitltic
SFD:(SIze 2.'[ xTJw )#Bedrocros #BathsZ�Basement(w/wo bath): Garage:ll Deck: Crawl Space:_Slab:_slab=Xi
(Is the bonus room finished?( )yes ( )no w/a closet?(_)yes ( )no(if yes add in with It bedrooms)
❑ Mod:(Size_ _)#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
❑ 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:It Rooms: Use: Hours of Operation: #Employees.
❑ Addition/Accessory/Other:(Size x )Use: Closets in addition?(_)yes ( )no
Water Supply' X 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) !opCounty 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 ,(�)no
Does the property contain any easements whether underground or overheado ( )yes (_)no
Structures(existing or proposed): Single family dwellings: V Manufactured Homes: Other(specify):
Required Residential P1
Property Line Setbacks:accComments:
Front Minimum 15 Actual V
Rear 2•5 2.5
Closest Side _JO JO
SidestreeUcornerlot LO U)
Nearest Building
on same lot
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 1416/1 mien E +4ou Oieli IS'1.
Tk� ( S 4ZtS +6ItSIit Q&srrtAl Aut ni A t11j5 CY7 Y.
enn-1-invo_ oN l/Slit e ,ploF,Ii -t-O Jntno 4}-,
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 state ants are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
Ig3 nature of Owner orrs 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"
NOTE:
ALL DIMENSIONS. LOCA11 S ANO E ANRES SHOWN ON
TMS PLOT PLAN ARE APPROXIMATE AND ARE ONLY AN
W 1 ARTSTS RENDITON, EXACT LOCATON OF ALL FEANRES
9 PE SUBJECT TO CHARGE AND MAY NOL BE INSTALLED
CO E%ACRY AS FHOOK ON PLANS ANO/M IN MODELS,
SITE Y PLACEMENT OF HOME. DRIVEWAY, SIDEWALKS OMODIFICATION
AND
g EXTERIOR FEATURES ARE SUBJECT TO MODIFICAPCN AS
DEEMED NECESSARY BY FIELD PERSONNEL.
O
d
CUSTOMER DATE
p
% cnCUSTOMER DALE
Us J .--I*
20 1
WADE AFNEY REPRESENTATYf DAR
I APPROVAL FOR STAKING:
ISTHIS PLOT PLAN AS CORRECT AND IS HEREBY PREPARED PPROVED FOR ASTANNG ONAL LAND NNEES.
VICINITY MAPDAR SHOYM BELOW.
Not To Scale
WADE JURNEY HOMES REPRESENTATIVE DAR
SETBACKS: IMPERVIOUS SURFACE AREA
DESCRIPTION AREA
FRONT - 15 w/PARKING IN REAR
HOUSE w/ PORCH 600 S.F.
FRONT - 55' w/PARKING IN FRONT PATIO/HVAC/MISC.
REAR - 25' -
NEAR SIDE - 0.5' MIN 5' MAX DRIVEWAY & WALKS 615 S.F.
OPEN SIDE - 10' ALLEY PAVEMENT 1,797 S.F.
WINDOW/DOOR - 6' TOTAL (PROPOSED) 3,021 S.F.
LOT AREA = 7.943 S.F.
Z IMPERVIOUS AREA =38.1%
o 0
.5'
:3. :—
1 . 4.
ID
26' DRIVEWAY EASEMENT (PB 2007, PG 1021) O p
P
_ O W
6.5' SETBALKLiY� J
4 I U 189 �
°i m1 7,943 S.F.
p
24.0 0.18 AC
O.
' ,w� i200 ®r
< 190 V i c SLAB e /
z N %FOUNDATION'0 /
g p�
Q. U 8 20 // niS
I- ¢ o z l /
W � g J
(/1 0 46 d 3 .B%/ O
5' MAINTENANCE - - Q-
EASEMENT ` G
10' J
N77 9 W V�O Q
09109111 Application#
Harnett County Central Permitting
PO Box 85 Lillington NC 27546
Each section below to be filled out 910 893 7525 Fax 910 893 2793 www harnett org/permits
by whomever performing work
Must be owner or licensed
contractor Address company Application far Residential Building and Trades Permit
name 3 phone must match
Owners Name l/J4tlLJurnt.c f Mvlt2� Date £ 7sL n
Site Address 44 Altai^ CE" l Phone 411Q-QQ5:5(45C/
Directions to job site from Lillington 14)44 rv. Oil £CYQN'F St .d?p.Ip 0 C 1St SI-.
<0,1CP. U S v7 t 5 . -to /LSILe CA 'Mite tI ANL in .11(41 IS Cat(
_ Caltinvl oil I/51td eaksyhtf) 40 anra.Sf-
Subdivision M trclaalS 114- Bows owe Lot LBCt
Description of Proposed Work 5r-P, #of Bedrooms 3
Heated SF VW Unheated SF Finished Bonus Room9 Crawl Space _Slab X
IL
I General Contractor Information
034ILEI. L - 33U Zrl-'-soap
Building Contractors Company Name Telephone
e 13C-013 l'rlvr/Au! ca 77r) 61nIYK4✓JKr1 <rot;-Val&eLk)019 kanf3 Ct'M
A dress J Z.-(-i 1v Email Address
cense#
License#
Electrical Con roe or at
Description of Work El/(.l-nrAl 21451.41l Service Sizetc Amps T-Pole✓ Yes_No
W-3 Q74.550--7 -i1
Electrical Contractors Company Name Telephone
Clw0in t O1 fol 3e1(�.lrt"tnu1)
Address Email Adressrens
II4, 1
License#
` � M9[chanical/HVAC Contractor Information
Description of Work Ntdµttl%t? L Air
<1.om:Corl-A or { 11 336• 7Q4.c137)
Mechanical Contractors Company Name Telephone
p0 en fi 57.7 ClLn tnoyt5 AIL77n7Z . Yr1,tnLLN41KaAlmi�Lodi
Address EmailAddress
(-42-.1g.
License#
Plumbing Contractor Information
Description� of Work VluYvlbltn1 —C tc- u( #Baths
�I horinln DO loninOnG GIgY,a •443
Plumbing Contractors Compant Name Telephone
31110 .4UiA5ovlZn. Pith -kW/ 2157O -rt,a.lmnsoitraahtticr�nxabglIWaL•
Address Email Addres cam.
w SZ
License#
Insulation Contractor Information
1) �/1
1111 dflhS L,/UL�11 ta.44011 4tC1*188 'Cl.
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 to me and thatpv alumna below I have obtained all subcontractors
permission to obtain these permits and if 9Dy 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 cu ent fee ached IL
Signature of Owner/Contractor er(s)of Corporation Date
Affidavit for Worker's Compensation N C G S 87-14
The unddofsigned applicant being the
General Contractor _Owner l/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 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 II -C
Company or NameU. J(4arnC(,' . (fld ✓onet15
Sign w/Title/Y' - n "� .I�tSt PLn11 / CinafODate 41i S l7
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 09/07/2017
Entry N: 717286 Initially flied by: wjh2013
Designated Lien Agent Project Property
Print & Post
Investors Title Insurance Company NAC INS
44 Aleah C't El T 0
Online:non home cmm Liii inglon.NC 27546f :
eaurme 19 w 1140900 66,Suite 507 Raleigh NC Hamot County .3'y.�'t
27611 Q cy?'o
phone:xss-n40-711u Property Type Contractors:
Fee:913-48n-9J I Please post this notice on the Job Site.
Em.ib.nunonn bonne cool - 1-2 Annuls Dwelling Suppliers and Subconlraclon
Scan this image with your smart phone to
Few this tiling_Sou call then lite a Notice
Owner Information to Lien Agent for this project
WIH.LIC
3300 Battleground Ave Suite 230
Greensboro. NC 27410
Untied States
EmeiL trahiteawaa iunterhomes.cem
Phone:919-995-5554
Vie'.Commcnn 10)
Technical Support Hotline:igen()690-73N4