DOCUMENTS Initial Application Date:l O'S 11-1 Application# f '7.S(30— cl4P.1
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.harnetterg/permits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIREDWHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER:H&H Constructors of Fayetteville, LLC. Mailing Address:2919 Breezewood Ave.,Ste.400
City: Fayetteville state:NC Z1p.26303 Contact No: 910-486-4864 Email: Leannahair@hhhomes.com
APPLICANT':Same As Owner Mailing Address:Same
City: Same State:_Zip: Contact No: Same Email: Same
'Please fill out applicant Information it different than landowner
CONTACT NAME APPLYING IN OFFICE: Leanne Hair Phone#910-086-48644f� ;/.,���/�]/�yp�
PROPERTY LOCATION:Subdivision: Anderson Creek Club Lot#ao� 1 LotLIoty�lSizeey_Y/J�� `lir W
State Road#1117 State eRRoad Name:MNursery Road ��/� M ..Maa B00000k&PagJ I(Qi '3 1
Parcel:yrIO,r� WSt�o( bIc 1 .QO PIN:V�J1.'.t5 -111i p 3
Zoning: l6Flood Zone: /— Watershed:A .n 1 Deed Book&Paget)45aN `'ower Company': South River
'New structures with Progress Energy as service provider need to supply premise number from Progress Enemy.
PROPOSED USE:)1., 1 p 5
��/� �/� enolithic
14 SED:(Size`flJ xl.�l#Bedrooms:4 #Baths• Basement(w/wo bath): Garage: Deck_Crawl Space:_Slab:PPPPPP_Slab:_
(Is the bonus mom finished?( 1 yes J no w/a closet?(J yes (_)no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms_#BathsBasement(w/wo bath)_Garage:_Site Built Deck:_ On Frame_Off Frame_
(Is the second floor finished?( 1 yes ( no Any other site built additions?( )yes (_)no
❑ Manufactured Home:_SW_DW_11N(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?(J yes (J 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?I )yes (✓)no
Does the property contain any easements whether underground or overhead yes ( 1 no
Structures(existing or proposed):Single family dwellings: Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 30 Actual 31
25
Rear
4a. /
0 QQ' I Closest Side
Sldestreet'camer lot 20 __
Nearest Building 10
on same lot
Residential Land Use Application Page 1 of 2 03/11
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: Hwy.27 to Nursery Road,turn left and follow Ray Road.Turn left and
follow to Anderson Creek Drive.
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 foregol�@5lalements are accurate an car
IO ct to the best of my knowledge. Permit subject toorrevocation if false information Is provided.
11J1-(`1 Signature of Owner or ner'swAgent ate
"'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 B months from the initial date If permits have not been Issued"
Residential Land Use Application Page 2 oft 03/11
t MICHAEL P. GRIFFIN cagily Mal wrnrmy wr.cllaa and
.a rwla. MN mm was drawn from an actual SW awns mal the ma'of
closure of M.survey as calculated by ca tatty Is I: 10.0000 : that the
arta show hereon was cd[Wal.d by am'tlhaM1n V
*Finns my hand and sem' MN day of MONTH X117
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K 7 w 2�4. PATIO FORCE 5.00',.55! 22
5'1 / \ PARK ACCE55
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I ` OPEN 5PACE
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/ PROPOSED \
/ IIATTERAS \
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4 _ FORCEpb. _ _ J
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CONC
DRIVE
07 5'UTILITY
O EA5EMENT
11,981 50.ET, M
0.27 AC.
17.52
N a5° 1 E C3
CI
SCHOOL SIDE DRIVE
SETBACKS
50' PRIVATE UTILITY R/W
FRONT 30'
REAR 25'
5100 10
CORNER 510£ 20'
CI R=205.00'L=95, I 7'562°05'26'W 97.23'
C2 R=75,00' L=35,9 I'562°0526"W 35.57'
C3 R=205.00'L=10.70'546°52'25"W 10.70'
1 LEGEND H'Iya4
Application#
Harnett County Central Permitting
PO Box 65 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 for Residential Building and Trades Permit
name 8phone must match I I
Owner's Name: H&H Constr^uc1tors�of Fayetteville, LLC. Date:16 5
Site Address: i a J SC)-n& 1 S test. D r vte, Phone: 910-486-4864
Directions to job site from Lillington: Hwy 27 to Nursery Road.Turn left,follow to Ray Road, turn left and
follow to Anderson Creek Drive.
Subdivision: Anderson Creek Crossing Lot: 1011 y
Description of Proposed Work: SFD #of Bedrooms: y
Heated SFPLl4 Unheated SF:tilt Finished Bonus
Crawl Space:_.Slab:
General Contractor
H&H Constructors of Fayetteville, LLC. 910-486-4864
Building Contractor's Company Name Telephone
2919 Breezewood Avenue Ste.400,FaV, NC 28303 LeannahairGOhhhomes.com
Address Email Address
74158
License#
Electrical Contractor Information
Description of Work Service Size: 200 Amps T-Pole: X Yes_No
JM Pope Electric LLC. 919-776-5144
Electrical Contractor's Company Name Telephone
409 Chatham Street Sanford, NC 27330 electricoope(dwindstream.net.com
Address Email Address
21326
License#
jylechanIcal1HVAC Contractor Information
Description of Work
Carolina Comfort Air.Inc. 919-934-1060
Mechanical Contractor's Company Name Telephone
5212 US Hwy 70 Business, Clavton,NC 27520 carolinacomfortair(olyahoo.com
Address Email Address
29077 H-3-I
License#
Plumbing Contractor Information I� C
Description of Work #Baths .5
Vance Johnson Plumbing Co., Inc. 910-424-6712
Plumbing Contractor's Company Name Telephone
3242 Mid Pine Dr. Fayetteville, NC 28306 etoepferaiviplumbinq.com
Address Email Address
07756-P-I
License#
Insulation Contractor Information
Tri-City Insulation 418 Person St. Fay. NC 28301 910-486-8855
Insulation Contractor's Company Name&Address Telephone
*NOTE: General Contractor 1 owner 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 by sinning below I have obtained all subcontractors
permission to obtain these permits and if any 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 current fee schedule.
10k 1 11
Signature of Owner/Contractor/0 of Corporation Date
Affidavit for Worker's Compensation N.C.G.S. 87-14
The undersigned applicant being the:
X General Contractor _Owner X 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:
X 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.
X 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
Des of coverage of worker's compensation insurance
to issuance nce of the permit and at anyay rtime rdur ne g the fprior
permitted work from any person, firm or corporation
carrying out the work.
Company or Name: H&H Constructors of Fayetteville, LLC. I �I
Sign w/Title:�%`^,tD_Vu�— S1 / Permitting Coordinator Date: Ic (5 l [ 1
Appointment of Lien Agent: Details - LiensNC Lien Service Page 1 of 1
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 10/04/2017
Entry 4: 732882 Initially flied by: meeganbredshaw
Designated Lien Agent Project Property Print & Post
First American Title Insurance Company ACAI077 Loi 11177 Anderson Geek Academy El -
CI
125 School Side Dnrc .j-,[e
xx ism Spring Lake NC 28390 b .�
Ada si 14 W Hwy S :WI.Raleigh.SC Hamet County ❑ #
17601 Contractors:
Phone xdx-90-13 I Please post this nonce on the lob Sile
F..:913-14A5231 Property Type
suppers and Suh.omnoo..:
Em.a:ytpAnu luxnr mm._,. Scan a image with your smart phone m
view this filing You can then file a Notice
19 Family Dwelling to Lien Agent fortis protect.
Owner Information
Date of First Furnishing
I1&Il Constructors of Fayetteville,LLC
29191ireesswod Awme Ste 4 I
Fayetteville. NC 28301 06101.2017
Email Icannahai[@hhhmnesnom
none:910486-4864
View Comments l0)
Technical Support Hotline:(88S)690-7254
https://apps.liensnc.com/scr/appointment/details.html?entryNumber 732882&printable 10/4/2017