DOCUMENTS Initial Application Data: VO I Q. l l n Application# i 1 SCe14 994
1
CUP
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)L SITE PLAN ARE REQUIRED WHEN SUBMRTMG A LAND USE APPLICATION"
LANDOWNER:GO-AP .R- 0.2biz XOJr Mailing Address:
City: State:_Zip: Contact No: Email:
APPLICANT`: LW14-ILLC. Mailing Address: •a `: If 1 & Ili. . 64..4
city: (2raiWnbort State:_.V zip:Z1410ContactNo:Mf-g4Su, '�-LEmaiObt42__P11Ist_urfrnat
*pleased;out applicant information If different than landowner/ 1� /y n voiMc4 C.04VI
CONTACT NAME APPLYING IN OFFICE: --fit c ..2CLJQI t Phone# `•I IY-gcs-SCE S`_./
PROPERTY LOCATION:Subdivision: 00C-it-WI 011 I O, Lot#: I G Lot Size: Q.t"'1x�
State Road#'rS�I , StatetaRoad Name: KQt\bLJ COX Map Book&Page: 2011 1 3to
Parcel: 010500 OILS 35 PIN: f5O9 1Q^�so�gJ
Zoning)'fY+RJI- Flood Zone: NI Watershed: 1 Deed Book&Page: JJ /046( Power Company:5)Ul-k\_Q,theri 'IL
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
g_ Monolithic
SFD:(Size 3x I )#Bedrooms#Baths. Basement(w/wo bath): N Garage:� Deck: Crawl Space:_Slab:_ _Slab: X SIab: X
IIs the bonus room finished?(_)yes (_)no w/a closet?( )yes ( )no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms_#Baths_Basement(wtvo bath) Garage:_Site Built Deck: On Frame OR Frame_
(Is the second floor finished?(_)yes ( 1 no Any other site built additions?( )yes ( )no
❑ Manufactured Home: SW_DW TW(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 (_)no
Water Supply: V County Existing Well New Well(#of dwellings using well flaunt have operable water before final
Sewage Supply: New Septic Tank(Complete Checklist) Existing Septic Tank(Complete Checklist) X County Sewer
Does owner of this tract of land,own land that contains a manufactured home within five hundred feet(5003 of tract listed above?( )yes O()no
Does the property contain any easements whether underground or overhead( K)yes ( )no
Structures(existing o ropose :Single family dwellings: I Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:ro
Front Minimum JActual
Rear f) ZS
Closest Side ID stS
Sidestreeticomerlt 2.0 7�
Nearest Building
on same lot
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON✓I ayZ_ Allam 11WK Z JO 6, -17;JLt.
LILA- of 4o 6. ►VloJ In€!- 1tt n it e l 2. O&-n rrnn1
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 s aments are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
Signature of Owner nets Agent Date
"'It Is the owner/applicant,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 dab N permits have not been issued"
4 MICHAEL P. GRIFFIN . carr*that maw my m.ataa and
eprtm thb mm theg tam awn at KIWI aw s that Me erre-of
blown of/M Army m ml Yatad by cantatas b I: WOO..: that tin
no Moon.ter was mgmred by aro'ebe..
INmw my.m0 es ad Mb Sr of WM112011
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FFf 270.35 11 0 iZ
PAD 21 .7 C ,C
20 I 38.00' El I Cl
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N PROPOSED N
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6'S °b 38.00' PORCH
1 PROP co-.--
_ _______i
CONIC
DRIVE
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a80
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N 2 I°07'07" W -- 43.22' 1 ,I
SITE PLAN(APPPROVVAL
51RM
DISTRICT *-' tgl i OW OAK STREET
• 50'PUBLIC RAM SETBACK S
YBEDROOMS FRONT 35'
10I/� I '/ SEAR 25'
—1 SIDE MIN. 5'
Otrb n AEmiNatrmor SIDE AGO. 15'
C I R=25.00' L=40.37' 567°22'55"E 36. 13'
-- -- LEGEND SIT• w ".
Ea' ' �
09/09/11 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 hamett org/permits
by whomever performing work
Must be owner or licensed
contractor Address company Application for Residential Building and Trades Permit
name&phone must match
Owners Name u)aat it)(-Kai lrlovvitJ LLL Date *gin
tu)
Site Address ID Nti l lOOPhoneQ14_4�15•S___
Directions to job site from Lillington �1 Lie. A1C. 14'1.ai Z 105 Le44. On-Id
5.r cuin5+. ,Ift in 4urri L nvt+p A. Cfebr1+54-...
Subdivision Did conn tit 1.1 Lot Ki
CI
Description of Proposed Work SGS #of Bedrooms -
Heated SF &)4S-
Unheated SF .3A 5- Finished Bonus Room9 Crawl Space Slab V
General Contractor Information
�11uJ1L 53(,•ZfrZ- 3[.ac"
Building Co tractors Company Name Telephone
33.y) 644MLa'aundA0.54173o &TM ASIcateo "ratioaelaidocingli4,.hnmes.
Address Z7(-l10 Email Address Can,
4L.42
License#
` ""'' �
Electrical Contractor Information
Description of Work tttc4-rtCa.Vigb+sl l Service Size 7M Amps T-Pole 1/ Yes_No
Chit,'r y Elect-rtio1 3311-56tl•QO0n
Electrical Contractors Company Name Telephone
;L. Syil tgtn In itat
Address J Email Address
Melt/
License#
Mechatlrcal/HVAC Contractor Information
Description of Work I-�1#lln f3 t Air
nnnCar+Air 33tt'1GN 4'73D
Mechanical Contractors Company Name Telephone
p D. box 5zi ClU r>,man5, z?01Z
Address Email Address
�7 IFS
License#
Plumbing Contractor Information
Description of Work plumb;nq ti64-aJ I #Baths
-361 4-1-1 PIurn101;fl 1716.- 3&G • '-1-7s. aJ
Plumbing Contractor s Company-Name Telephone
463g Lotat Lscat Po .
Address Email Address
Z1) 104
License#
Insulation Contractor Information
Soo Idt/S1Vl5u Idrntn GlcA •1��L %ckJ
Insula ion 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 that pv sianrna 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�eFEES-6 Months to 2 years permit re-issue fee is$150 00 After 2 years re-issue fee
is as per cu nt fee sched ale
o,t¢I t olf-tt rl
Signature of Owner/Contractor er(s)of Corporation Date
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
General Contractor _Owner l/Officer/Agent of the Contractor or Owner
Do here confirm under penalties of perjury 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 -C
Company or Name LJa4LJOrn -1 t-tbm6
Sign wfTitle/I /A�Qt2& �` P.LrrYNFt_I ,(Y.rta)b?i4Ur- Date 1oluti7
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 10/02/2017
Entry #: 731075 Initially filed by: wJh2013
Designated Lien Agent Project Property Print & Post
Inestors Tale Insurance Company OFV 19 Er'
TBD Hallow Oak St. '•.
trine:www.tiensoc cum-, Spring Lake,NC 22390
Addresn19 R.Hargett St,Since 507:Raleigh,NC Harnett County
21601 Contractors:
Phone:588-690-7384 Please post this notice on the Job Site.
P..,O13-459-5211SuppliersType
Suppliers and Subcontractors:
Emaa::unw'flamnmc corn —. . Sean this image with your smart phone to
view this filing.You can then file a Notice
1-2 Family Dwelling to Lien Agent for this project.
Owner Information
WJH,LLC
3300 Battleground Ave Suite 230
Greensboro, NC 27410
United States
Email:rtabitn(r{wadejumeyhomes.00m
Phone.919-995-5654
View Comments 103
Technical Support Hotline:(SSB)690-7354