DOCUMENTS Initial Application Date: \b I4 I I r7 Application 1 1 R,-'r Z)S
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/petits
^A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION^
ORnO
LANDOWNER: warns. Cts 1004.+L1....f) Mailing Address:
City: State:_Zip: Contact No: Email:
APPLICANT: WJI4-I LLC Mailing Address:3G4.4-1tLsnxvld.AUL 6-fG L3U
City: GIY1/ylSIon ly stela: AI(I,zip:Z-14IDContact No:Ql444SStu<4Email?ft i4Z„Q1 6,412,41nyz
'Please fill out applicant information if dMerentthan landowner �y •%•COWS
CONTACT NAME APPLYING IN OFFICE: 2iltr, ...Zai 117 Phone k CLfQ`GGS-Sc,SY
PROPERTY LOCATION:[� Subdivision: QRA.1k`7-1,rvyll�(t 1eic�0, Lot X: Lot Slze:(1.1 (/
State Road# 17-S5 StatetaRoad Name: M/l]\OIL) OA c I r �n Map Book&Page:, ZOl(SIo
Parcel: 0IOSO O,tS Ni3 NiPIN: O�,`4 RJIIf1
Zoning. Flood Zone: Watershed: Y Deed Book&Page:39tc / OQO7'awer Company': Lc.
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
h y/ 11 / Monolithic
/'v SFD:(Size 3(,o ,as )#BedroomaR #Bat?Basement(w/wo bath): U Garage:It Deck:A) Crawl Space:_Slab:_. _Slab: X
(Is the bonus room finished?(_)yes ( )no w/a closet?( )yes ( )no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms_#Baths_Basement(wlwa bath) Garage:_Site Built Deck:_ On Frame_Off Frame_
(Is the second floor finished?( )yes ( )no My 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 it )Use: Closets in addition?(___)yes (_)no
Water Supply: V 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) x 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 ()( )no
Does the properly contain any easements whether underground or overhead(X)yes ( )no
Structures(existing o ropose :Single family dwellings: Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks:- Comments:
Front Minimum 35 Actual 37
Rear
Closest Side 0
SidestreeVcomer lot 2.0
Nearest Building
an same lot
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTONK-Cak LL! .UC I-4WU117_I0 6, -i JX ,
LQ QQ\-4o 4. mc,IA5+ `ril t%rl Tvrtn 2 ovn4-o c' Cowl-J.-
If
n n4-If permits ere 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 ements are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
&A LOIMU'1
Signature of Owner ner's 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 8 months from the Initial date If permits have not been Issued"
4 MICHAEL P. GRIFFIN . eMMy mat ander my nth+ as
r pYWhn MY map was train Pm a1 entad MP wa r Oat the MyM of
Wawa al IM any an maculated by roa'tatr Y I: 1410tl#t mat ma
ova Moat hewn am calculated by oondatn
Mmes my hand and see'MY lay oI MO'/TI,XIZ
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44
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i 5 2 I°07'07" E — 55.00'
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ip 7.04050.FT. O \
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NC
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21' LiPROPOSED k1J
J 2In 304 5
SUB 00N
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6.0 27.00' o a I .O
o I 11.0'
°ti u 8.33' 10110.3 I\
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CONC.
280 DRIVE
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CI in1R_ eVA_,......-- 55.00'
I
S TE PLAN APPROVAL
DETAICTZ`�� USE L L O W OAK STREET
50'PUBLIC RAM SET5AC K5
$EDR00A1S FRortr 35'
IbicR I I REAR 29
SIDE MIN. 5'
aim mlNtlrator 510E AGG. 15'
LEGEND I9/X 0e005
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/pemmts
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 Made.Juni% I.bntt5 L.L.C. Date IDIt-lri
Site Address IZ& IkdNotai o PhoneQIQ.Q45'St,SG/
Directions to job site from Lillington a1LQ, ji EL. (}Wti Z IQ 5,"l(ri- Lt64 c444
5•txu.ilet4 -. <4t n _ P nn-lo £. �✓Y,vt4S3-.
Subdivision Otd Cann.lit 1.1%.C. Lot 20
Description of Proposed Work S #of Bedrooms 4
Heated SF j'tU Unheated SF .343 Finished Bonus Room, Crawl Space Slab 1(
General Contractor Information
(JUJ1E - 33(i 2Z: 3ciace
Building Co tractors Company Name Telephone
5355 6Q-144t4✓0tstd Quo,64,73oC rztnsloaro "raJc 4t kv**Jrlr,,..lhome.6.
Address Z.144 IC Email Address Cady
4Z42
License# •
Electrical Contractor Information
Description of Work L' Lit&f t(.QA VrMaj 1 Service Size ,7fl) Amps T-Pole ZYes_No
Grten+c0.4 sjtalf-56i-1•QOQa
Electrical Contractor s Company Name Telephone
111�o jL .64zzoo &yilY�tau ) IL15
Address J Email Address
1051.0
License#
Mechanical/HVAC Contractor Information
Description of Work 14LiLfnc, e• Air
0mvSor+Air 33U .1GL1 Q-730
Mechanical Contractor s Company Name Telephone
a Elm( 57? C(i.rnrvwns 12.7 017
Address Email Address
y718
License#
Plumbing Contractor Information
Description of Work VIVMbi ni.rgi 2'ne-v#411 #Baths
134/ 17luv u i iq tiC 33(i • L-4-76.(141)
Plumbing Contractors CompanyMame Telephone
'-163g taciat.S L4.1tL PX.) .
Address Email Address
ZUSOG
License#
Insulation Contractor Information
)iIdt)/6 1(68 � +nom CtR •ng6•GFso4
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 sigma below I have obtained all subcontractors
permission to obtain these permits and if my 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 PERMITyFEES-0 Months to 2 years permit re-issue fee is$150 00 After 2 years re-issue fee
is as per Cu ent fee schedule__
t d41k1
Signatureeoff OwnewnerlContrador 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 fort 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
Company or Name blia,Z LJQrn ct.i t-tom6
Sign w/Titl= P u. ,u a Date LO(tlll�]
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 10/02/2017
Entry #: 731077 Initially filed by: wJh2013
Designated Lien Agent Project Property Print & Post
Investors Title Insurance Company OPV 20 111:‘_,.. 0
128 Hallow Oak St
Onlinemow mm Spring Lake,NC 28390 �5�lfri}���+
Address:VN.Hagen St Sate 50V Rakish,NC Harnett County . �Tla'J
27601 ContraCtnrs:
Phone:WI-NO-7384 Please post this notice on the Job She,
an:913-AN-SDI Property Type Suppliers and Subcontractors:
Email:sunmrnalienem corn _.. .. • Scan this image with your smart phone to
view this filing.You can then tile 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..trabitzepwadejumeyhomcs.com
Phone:919-995-5654
View Comments NI
Technical Support Hotline:IS85)690-7384