DOCUMENTS Initial Application Dale; l\C) al I / ApplicadonY 1 l sum4ascia
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COUNTY OFT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street.LlBtnglen,NCC 27548 21518 Phone:(910)893-7525 est:2 Fax:(910)893.2193 twetv.hawD.aSipenMts
^A RECORDED SURVEY IMP,RECORDED DEED(OR OFFER TO PURCNME)S SITE PIAN ARE REQUIRED WHEN SUMMING A LAND USE APPUCATIW
r
LANDOWNER MCKee Hames,LW Mailing Address:109 Hay Street,Suite 301
CityFayetteville Supe.NC Zip:28301 Contact No:NC 4151100 ext 727 Email: Mlera®mduehomesnc<pn
APPLICANT:McKee Homes,LLC Mailing Address:109 Hay Street.Suite 301
City. Fayettevife Sb1e: Zip:28301 COMct No'. (910)415-7100 ate 122 EpaR: knvereemdnemrrcanccom
ePln n II Wt appMb4 Wc.ma kx,it dIRvent than(snowiest
Josh Pecten Phone N(910)475-7100114 722
CONTACT NAME APPLYING IN OFFICE: 1, to ���y e
PROPERTY LOCATION::SSubdiviaion: D4hslv'1t1111 Lot R- ICS Lots e: O'(o�5-�H
State Roadtt 4�4 State Road Name: FS!LO VC brit ire Map Book A Page:14/111 17
Parcel:
�/sQ5958901 (ao� -‘ of , PIN: o5o7-3'd— q
987 •o❑o
zaninsMa gFkood zone: $ watershed:f% A ...claw,A Page: 33L4 1 .010 ii, power company: Central Electric
'New structures with Progress Energy as service provider need to supply Premke number horn Progress Energy
PROPOSED USE:
��yy Monolithic
B SED:(Size 541,441)h Bedrooms)_St Balhsa Basement((w/wo bath):_Garage: ✓Desk:_Crawl Space:✓Slab:_Slab:_
(Is the bonus room loaned?L)yes (Zoo we a dost')L)lee Lim(Ryes add In with S bedrooms)
O Mod:(Ste a )S Bedrooms S Botha Basement(wive,bath)_Garage:_Site Bull Deck:_ On Frame_Off Frame_
(is the seond floor finished?Li les L)no My other BM burn Malone?L_)yes L)no
❑ Manufactured Home: SW_OW_TW(Size_x )s Bedrooms: Gang.: (site bulli?_)Deck: (site built? 1
❑ DuP'ex:(Size_x )No.Buildings: No.Bedrooms Per Unit
D Home Occupation:F Rooms: Use: Hours of Operaton: "Employees:_
O Addition/Accessory/Other(Size_x )Use: Closets In addition?( )yes Li no
Wear Supply: County _Existing Well New Well(Sof dwellings using well )'Must hen operable water bon final
Sewage Supply_New Septic Tank(Complete Checdls0 Existing Seek Tank(Compbb Checklist) _County Sewer
Don owner of this tract M lend.own land that contains a manufactured home wet five hundred feet(500')of tract Inked above?(_)yes L no
Doe the property contain any easements whether underground or overhead(Dyes Um
Structures(existing.S.- Shale bamll dwellings: l Manufactured tomes( Other(specify):
Required Residential Property Line Setbacks: Comments:Je
Front Minimum 5 Actual IpcI
Rear
—25 I47l
clomat Bide to 3)'
SWeveaagwmer lot ] _yy_�
Nearest Building / Nth
on same lot
Res dent,.1 L[nd Lc..PGY,eatim I 'age I o'2 CCP-1
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTORS TO THE PROPERTY FROM LILISVOTON:
boc5 Rd . -to EKtw+iv( b(•
If porn*.are granted I agree b conform to WI ordinances and laws of the Slab of Norm Carolina regulating such work and the specificaPons of plan.submitted.
I hereby state Net foregoing statements are eovrab and vaned to the best of my knowledge.knowledPermit subject to Information It false Infoation is provided.
irkwil par.- to/Li/17
Signature of Owner or Owners Agent Oats
"^It Is IIB owner/applicants responsibility to prouMe the county with any applicbb Information about the subject property,including but not Ilmllad
b:boundary information,house location,underground or ovadwed easements.etc.The county or Its employess we not responsible for any
incomd or missing Information that Is contained within these applications.""
'This application expires d months from the India!date If permits have not been issued^
ios de rola Lind J=_e renes^sn_n _e 2n2 03/11
09109/11 Application#
Hamed County Central Permitting S.)a
PO Box 6E Winton NC 27618
Each mho Wow to OHS out 910 803 7626 Fix 010 893 2793 www Moat org/pemm
M whnmave darkening work
Mun be on or Bowed
worm Addle.. htdl Application for Residential Budding and Trades Permit
ISM 6 phone must mach
Owner•Name McKee Homes, LLC Date 10111117
Site Address 424 Executive Drive phone 910-475-7100
Directions to job site from Lillinglon 127 to Docs Road, development on the left
Subdivision Oakmont Lot 158
Desorption of Proposed work Single Family Home #of Bedrooms 4
Heated SF 2252 Unheated SF 671 Finished Bonus Room'+ No Crew)Space _Slab X
Owerel Centraator IMermatian
GML Development, Inc 910-475-7100,727
Building Contractors Company Name Telephone
109 Hay Street, Ste 301, Fayetteville, NC 28301 krivera@mckeehomesnc.com
Address Email Address
63970
LOONS#
Electrical Contractor Informatigft
•
Description of Work Single Famuv Home Service Size 200 Amps T-Pole 0 SS No
J.M. Pope Electric 919-776-5144
Electrical Contractors Company Name Telephone
409 Chatham St.,Sanford, NC 27330 jmpopeelectric@gmail.com
Address Email Address
21326-L
License#
Mechanical/HVAC Contractor Information
Description of work Single Family Homes
Certified Heating&Air 910-858-0000
Mechanical Contractors Company Name Telephone
P.O. Box 1071, Hope Mills, NC 28348 certifiedheatair@embargmail.com
Address Email Address
20012- H3-1
License#
Plumbing Contractor Information
Description of Work Single Family Home #Baths 2.5
Dell Haire Pluming 910-8184863
Plumbing Contractors Company Name Telephone
7612 Documentary Drive, Fayetteville, NC 28306 dellhaireplumbing@hotmail.com
Address Email Address
32886 P1
Lanae I
Insulation Contractor Information
Cumberland Insulation 910-484-7118
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 authonty to make necessary application that the application is sorted
and that-the construction wdl 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 end that pv alumna below I have obtained all suboontraetora
SEA obtain thea aamtEA and if spit changes occur including listed contractors site plan
number of bedrooms budding and trade plans Environmental Health permit changes or proposed use
changes I certify it a my responsibility to notify the Harnett County Central Permitting Department of
any and all changes
EXPIRED PERMIT FEES-S Months to 2 years permit reissue fes is$150 00 After 2 years re-issue fee
ass per current fee schedule
Kelsey Rivera Digitally 04e z 1 :1300 10/11/17
Signature of owner/Contractor/Officer(s)of Corporation Date
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
X 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 pond
_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
White working an the project for which this permit is sought d a understood that the Central Pending
Department issuing the permit may require certificates of coverage of workers compensation insurance prior
to issuance of the permit and at any time dunng the permitted work from any person firm or corporation
carrying out the work
Company or Name McKee Homes, LLC
sign wRNe
Kelsey Rivera Drg,o,"„';wL`ta Date 10/11/17
LIEN AGENT INFORMATION
Effective April 1, 2013
In accordance with North Carolina General Assembly Session Law 2012-158,
Inspection Departments are not allowed to issue any permit where the project cost
is $30,000 or more unless the application is for improvements to an existing
dwelling that the applicant uses as a residence OR the property owner has
designated a lien agent and provided the inspections office with the information
below:
Name of Lien Agent First American Title Insurance Company
Mailing address of Agent 19 W. Hargett St. , Suite 507
Raleigh, NC 27601
Physical address of Agent same as above
Telephone 888-690-7384 Fax 913-489-5231
Email support@liensnc.com
The information will be attached to the permit record and a copy provided to the
applicant. The applicant is required to post a copy on the construction site.
Excerpt from North Carolina G.S. 160A-417:
"(Effective April 1,2013)No permit shall be issued pursuant to subdivision(1)of subsection(a) of
this section where the cost of the work is thirty thousand dollars($30,000) or more, other than for
improvements to an existing single-family residential dwelling unit as defined in G.S. 87-15.5(7)that
the applicant uses as a residence, unless the name,physical and mailing address, telephone number,
facsimile number, and electronic mail address of the lien agent designated by the owner pursuant to
G.S.44A•11.1(a) is conspicuously set forth in the permit or in an attachment thereto. The building
permit may contain the lien agent's electronic mail address. The lien agent information for each
permit issued pursuant to this subsection shall be maintained by the inspection department in the
same manner and in the same location in which it maintains its record of building permits issued."
www.liensnc.com
Appointment of Lien Agent: Details-LiensNC Lien Service haps://apps.liensnc.com/ser/appointmentldelails.html?entryNumb...
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 10/09/1017
Entry d: 735071 Initially flied by: jbuckwalter
Dealgaated Lies Agent Project Propane Print & Pout
First American Title Insurance Company Oakmont lot 155 Harnett County • O
Online:woo.l lrn+nc.cum,u,_.rk0.
Adams:IV W.Hargett St,Suite 507 i Raleigh.NC O-
nnol Propene Tope Contractor:
Phone:hsE 690.7354 Please post this notice on the Job Site.
Ac 913-489-5231 Suppling and Subcontractors:
Enna ummn(bm.nc.com,- cant W 14 Family Dwelling Scan this image with your man phone to
view this filing.You can then file a Notice
to Lien Agent for this project.
Owner blert3toues Date of First Furnishes,
McKee Homes,LLC 10/302019
109 lay Street
Suite 301
Fayetteville. NC 38301
United States
F nail'.knvera@ymekeehomesne.com
Phone:910-475-7100
View Comments(0)
Technical Support llotlinr.(8SS)690-7384
1 of 1 10/9/17, 12:55 PM
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PLOT PLAN :*..10• Rl¢e�i•9,
SUBDIVISION: OAKMONT SUBDIVISION
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SOUTHEASTERN SOIL&ENVIRONMENTAL ASSOC., INC.
PROPOSED SUBSURFACE WASTE DISPOSAL SYSTEM DETAIL SHEET
SUBDIVISION: OAKMONT LOT /f8
INITIAL SYSTEM:APPROVED 25% RECUCTION REPAIR FIP(AA raw WA Reaktrieri
DISTRIBUTION: CE-M1.A.. DISTRIBUTION f Sit,A.
BENCHMARK: 100.0 LOCATION e .- ..ME 1r8/.rf
NO. BEDROOMS: 3 LTAR 0 y G/O!F-r`
LINE FLAG COLOR ELEVATION LENGTH
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BY 4.4 E*c&A DATE c 3/l'/./"
TYPICAL PROFILE THERE SHALL BE NO GRADING,
o - / - ti /I (v,c .-34 CUTTING, LOGGING OR OTHER SOIL
)2 _ a y re-( 7f w 1 d/•J DISTURBANCE IN SEPTIC AREA
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A(, KQ, �rf\ES LLC. APPLICATION#:
NAME: -
•This application to be filled 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 fpr either 60 months or without expiration
depending upon documentation submitted. (Complete site plan=60 months;Complete plat•without expiration)
910-893-7525 option I CONFIRMATJONe ..
O Environmental Health New Septic Svstemeade 800
• All properly Irons must be made visible. Place "pink property flags' on 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.
• Place orange Environmental Health card in location that is easily viewed Irons road to assist in locating property.
• If property is thickly wooded, Environmental Health requires that you clean out the pnderarowth 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 withM 10 business days atter confirmation.$25.00 return trio fee may be incurred
for failure to uncover outlet lid.mark house corners and property lines.etc.once lot confirmed 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 Environmental Health inspection. Please note
confirmation number(liven at end of recordino for proof of request.
• Use Click2Gov or IVR to verify results. Once approved,proceed to Central Permitting for permits.
O Environmental Health Ealstlna Tank Inspections Code 8D0
• Follow above instructions for placing flags and card on property.
• Prepare for inspection by removing soil over outlet end of tank as diagram indicates, and lift lid straight up (If
possible)and then put lid back In piece.(Unless Inspection Is for a septic tank In a mobile home park)
• DO NOT LEAVE U08 OFF OF SEM TANK
• After uncovering outlet end call the voice permitting system at 910-893-7525 option 1 &select notification permit
if multiple permits, then use code 800 for Environmental Health inspection. 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 desiredesedsystem type(s). can be ranked in order of preference.must choose one.
i01 Accepted {DI Innovative (LYI Conventional Ip)Any
I�Altemative iQi 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. If the answerDOCUMENTATION;
is'yes",applicant MUST ATTACH SUPPORTING
CI YES 1E'aNO Does the site contain any Jurisdictional Wetlands?
CIYES fz�//NO Do you plan to have an jfgvgijon sysism now or in the future?
i�IYES p9JIO Does or will the building contain any dojo?Please explain.
la YES IL,!/l fN0 Are there any existing wells,springs,waterlines or Wastewater Systems on this property?
la YES il`�JII NO Is any wastewater going to be generated on the site other than domestic sewage?
1DIYES 1L��]I//NNO Is the site subject to approval by any other Public Agency?
IDI YES ibal Are there any Easements or Right of Ways on this property?
(LIVES f NO Does the site contain any existing water,cable,phone or underground electric lines?
If yes please call No Cuts at 800-632-4949 m locate the lines. This is a free service.
I Have Read This Application And Certify flat'11w Information Provided Herein b True,Complete And Correa Authorized County And
State Officials Are Granted Right Of Entry To Conduct Necessary Inspections Tu Determine Compliance With ApplicableLaws And Rules.
I Understand That I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Comets And Making
The Site Accessible So That A implete Site Evaluation Can Be Performed.
_ (o/ r7
PROPERTY 0 NERS( R OWNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) A
10/IU
w
C_)AKMI )l V �
09/29/2017
To Whom It May Concern,
Oakmont Development Partners, LLC herby gives McKee Homes, LLC the right to
begin applying for permits&beginning construction of lot 158 in Oakmont before
the lot is purchased.
Sincerely,
Patrick McKee
Managing Member
5112 Pine Birch Dr
Raleigh,NC 27606
919-793-5237