DOCUMENTSr CI �/ T rte'{
Initial Application Date'. ) f� I —1 I I 1 Application# I I�_RJv ` asen
CU!
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street,Lillinglon,NC 27548 Phone:(910)893-7525 ext:2 Fax:(910)093-2793 www.hemett.org/permits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER: Mailing Address:
City: I'II'' State:_Zip: Contact No: L Email:_ �
APPLICANT*: WM. LLC �l '' Mailing Address:33�C']4/�� -ILGeiIhI/C1 AUL
City: (Aar_ lonrt State: 4/ ip:Z)4IO Contact No:Q 44QS EmallTf6�OL�ZG7(A��/ _(rff►TOri
'Please nil out applicant intmmatlon if different than landowner MEWS•CORN
4
CONTACT NAME APPLYING IN OFFICE: &YYA. 1 F7 Phone N QICI-QQs-SCa SU
PROPERTY LOCATION:qSubdivision: OICIIl`�` �l1ing/ tsrI,i��t teusP, Lot#: /3 Lot Size:0 IV
State Road# )(1.2. State Road Name: AtlSWi) Cat S 1• �,y �j,., Map Book 8 Page ZOO I _
Parcel: (,/}�,�TD�S�sb�s.-.� O\?SQl_a PIN: O24.ThR Seu
Zoning'�T'PV flood Zone: Ni Watershed: Y Deed Book&Page:3540 / PowerCompany':50(a):00.2„actri `-
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
/'t Monolithic
SFD:(Size JO x .O )#Bedrooms:i 1 #Baths._Basement(w/wo bath): N Garage:\' Deck:u Crawl Space:_Slab: Slab: X
(Is the bonus room finished?(_)yes (_)no w/a closet?1 )yes ( )no(if yes add in with#bedrooms)
❑ Mod:(Size x )#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? )
❑ Duplex:(Size x )No.Buildings: No.Bedrooms Per Unit:
❑ Home Occupation.#Rooms: Use: Hours of Operation: #Employees:
❑ Addition/Accessary/Other',(Size x )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 and,own land that contains a manufactured home within five hundred feet(5001 of tract listed above?( )yes ()E)no
Does the property contain any easements whether underground or overhead(I)yes (_)no
Structures(existing arepose :Single family dwellings: l Manufactured Homes: Other(specify):
Required Residential2Property Line Setbacks:t-�7� Comments:
Front Minimum_3)"roGl Actual/9 J
Rear Z#� 56'1
Closest Side ' 0
Sidestreedcomer lot 20
Nearest Building
on same lot
. ., r APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILUNGTON:'I &v r. Alli ITWCiC 7 IO 6, l (/JC.0 .
LQ.GF QnI 6. Y aw%�+ `rl uan Tvrh 2. 001-O ` Cntn4-S-..
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 menta are accurate and correct to the best of my knowledge. Permit subject to revocation if false Information is provided.
ioluIi1
Signature of Owner ner's Agent Date
'It Is the ownerlapplicants 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 misting Information that Is contained within these applications."
"Th Is application expires 6 months from the Initial date If permits have not been Issued"
f MICHAEL P. GRIFFIN . witty dot condor my dacha and
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Y4aa my MOM ow/.W MH cloy o/MOWN NMy.
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5 2 1°0707" E — 55.00'
F- *V 280-
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40
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SITE PLAN APPROVAL
DISTRICTI • w 4 ' 1USE LLO W OAK STREET
*BEDROOMSq 50' PUBLIC REW S E T e A C K 5
FRONT 35'
�V
O� "t1 Ii REAR 25'
510E MIN. 5'
)n1n oni EmiNtlhMoh 510E AGG. I5'
LEGEND Is ovj..02.--V
r
09/09111 Application#
Harnett County Central Permitting
PC Box 85 Lillington NC 27546
Each section below to be filled out
910 893 7525 Fax 910 893 2793 www hamett orglpenmts
by whomever performing work
Must be owner or licensed
contractor ;waren company Application for Residential Building and Trades Permit
name 8 phone must match
Owners Name LAJaiatJUrhLL( Ir15Wth L X. Date 10(Li in
Site Address I ltd I\Olnta) O C-Srl- Phone QIQ-445•Sr.S_
Directions to job site from Lillington ate, ,UC. t+uxj Z 1 Q'S 14-c4 es446
5.mat'vt h+-. 4c n 4urre_ Q rime r in+664.
Subdivision Otr'1 Gash 1 tit L1%L Lot L3
Description off,Proposed Work S�� #of Bedrooms L{
Heated SF Z38--I Unheated SF °Ct3 Finished Bonus Room's Li Crawl Space _Slab V
General Contractor Information
�llu 1c. 33GZS2: 3[,ace
Building Colrtractors Company Name Telephone �" �
5 � tkilasndAI12,44,73o Girt/ thIowTr
o hb;+zetthdA+ngi# .fhome5.
Address 2./4-110 Email Address C-0/1,
yCa-4Z
License#
• Electrics Con rac or orm //
Description of Work LltL4 rICOA V16+�,!1 Service Size 7i» Amps T-Pole I7Yes No
Cite F Ltr �niµ� �i.Is-5k'-1.40Qn
Electrical Contractor s Company Name Telephone
I t I-(rn il_na.51Lzoo 8ljril Nye vi 1-iZt 3
Address Email Address
License #
7dechaplcal/HVAC Contractor Information
Description of Work 1-1L41.tnt3 S Air
e.nry Qn*Air 331.es 141-I 4130
Mechanical Contractor s Company Name Telephone
9.D• Eo,. 57-7 C(tr>,mans,2:7017
Address Email Address
y7LS
License#
Plumbing Contractor Information
Description of Work PluMbi VIS 11114-i-ett t #Baths
Salk1 PlurruoIngtelt- 33G • 476•ral
Plumbing Contractor s Company-Name Telephone
1-153g LCw4s C.4K.c. PA.
Address Email Address
tU¶cG
License#
Insulation Contractor Information
l( ( SZV75u I4rnvt @k •1��•�%&q
Insula ion Contractors Company Name 8 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 waning 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-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__
Oftb-12-4(1-16 10(gill
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 (/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 UJ&tLicirnu.j t4bra6 1 I 1
Sign wrritle/f arnihtW!YirimetioV Date YO I'"LIl-i
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 10/02/2017
Entry #: 731080 Initially filed by: wjh2013
Designated Lien Agent Project Property Print & Post
Investors Title Insurance Company OFV 23 Q"..-.- �
162'tallow Oak St F';w,N
Online,v.wwlenenoaoia - - Spring Lake,NC 28390 Ih wi
Adams.l 9 W Hargett SI Suite 501 Ra]oih,NC Harnett County 11 8-8 o
27601 Contractors:
Phone:88g-90.7384 Please post his notice on the lob Silo.
Fax:913489-5231 Property Type
Suppliers and Suhcnntradon:
Email:mnnotaraIenmomm - - Scan this image with your man phone to
view this filing.You can Then file a Notice
Other to Lien Agent for this project
Owner Information
Will.LLC
3300 Battleground Ave Suite 230
Greensboro, NC 27410
United States
Email.trabitz1awadejumcyhamC.com
Phone.919!195-5654
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Technical Support Hotline:(888)690-7384