DOCUMENTS Initial Application Date: lbl 4 ! l 1 Application# I r-j Li. )S Q j
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street,Lillington,NC 27548 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.hamett.org/permits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ME REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER: Mailing Address:
City: State:_Zip: Contact No: Email:
APPLICANT': (A/Jl'l'I LLG � Mam31:»ngAddress:3 /SG .4ILg ard.AuL 5-6GZ'3C
(441,2.0City: (441,2.0 MI6 l0/Irt) State: e(Iarzlp:ZZ Contact No:"{IQ CIQc.as q ErnarilO,�Ot4'LeJ -lr s Ut z
'Please All out appliwmt Information V different than lan/dowwner. 1� V�rv�s.C0/9'1
CONTACT NAME APPLYING IN OFFICE: l,(ALr(Ar•�.CA-lo l Phone# Ql4-GIGS-Sc..SU
PROPERTY LOCATION:[�I - Subdivision: Oti ViXWI OI I I(ACsccOI,I Lot#: 25 Lot�Siwze: Q•tis
State Road# cRle. //��StateSt�/ Road Name: I.\(.L) Oat S S . ` �T�: , 1',T Map Book S Page:4 tori 13l o .
Parcel::'��yyQx.K�I��L�x4.� 6125 WO PIN: 0� M QC49)
Zanin _'Flood Zone: Ni Watershed: II Deed Book S Page:135y5 )MO Power Company':.50f.104241.2(0cIrCa
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE: 5
xx�� 311)#
'' l` '' 11 1 Monolithic
jit SFD:(Size 3/1 x311)#Bedrooms:14 #Baths:a Basement(w/wo bath): 1. Garage:V Deck:Al Crawl Space:_Slab: Slab: X
(Is the bonus room finished?(_)yes (_)no wl a closet?( )yes (J no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms_#Bats_Basement(wN,o 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/Accessory/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 land,own land that contains a manufactured home within five hundred feet(500)of tract listed above?( )yes (X )no
Does the property contain any easements whether underground or overhead Imo)yes ( )no
Structures(existing oro :Single family dwellings: 1 Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 3S Actual,?-2
Rear 0 I -
Closest Side \ _LC)
Sidestreet/corner lot 2.0
Nearest Building
on same lot
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTONY 1 /(Y1L- All.. I-1wii 7 to 6, -rake,
LLC - c1A4Q 5. maul ` iitu of -rvrn £ o fa-o £. Cn n4-3{-.
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 ements are accurate and correct to the hest of my knowledge. Permit subject to revocation if false information Is provided.
lf—A-64
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Signature of Ownermars 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 mining Information that Is contained within these applications."'
"This application expires S months from the Initial date N permits have not been Issued"
g MICHAEL P. GRIFFIN , rrNry Mat tear my d.attm and
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PROPOSED
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SITE PLAN APPROVAL
DISTRIC ALLOW OAK STREET
t �" U'SE 50' PUBLIC R/W SETBACKS
#BEDROOMS –7 _ FRONT 35'
REAR 25
0 SIDE MIN. 5'
SIDE AGG. I5
1 LEGEND I slrI over+�t�0.0
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 orglpemids
by whomever performing work
Must be owner or licensed
contractor Address company Ago!motion for Residential Building and Trades Permit
name&phone must match
Owners Name uJa.dE.Ju 4411.1tG'7 Date
Site Address t FSA Oct).* O �S • PhoneQ 14.44..55' C/
Directions to job site from Lillington fate, Z IQ's 1 . Lt GLS4- an-le)
6.Malvt414 on 4-urn Q nnap 6. n+53-,
Subdivision &teX 1tflvk 1/LRO4JL Lot Z'
Description of Proposed Work SLP . #of Bedrooms L`
Heated SF ,Unheated SF 5 Finished Bonus Room N1 Crawl Space _Slab V
General Contractor Information
tau tr, 33( Z87,- 5tele
Building Co tractors Company Name Telephone
33 Rhea punct Au1,64,730 Grin 146b%o Thiciidza( J(vp,..there 5.
Address U Z7C{IQ Email Address I aon,
L14L(Z
License#
•
Electrical Contractor Information /
Description of Work LI rico-k tiv61/4.0 I Service Size 7M Amps T-Pole /Yes_No
ate tLL(4 1i0.1 3W(f.564.QOCtn
Electrical Contractors Company Name Telephone
I IIif L.na.Mtzoo eijri1n4ta�t /'IL%5
Address J Email Address
I�hl(t
License#
Mechapical,HVAC Contractor Information
Description of Work i4L/l,nc, L Air
�nMKQrr+Air 33tv 1 t 4-130
Mechanical Contractors Company Name Telephone
P D. Eo,; 5Z7 CIt_rrkmans, Zi o 12.
Address Email Address
License #
Plumbing Contractor Information
Description of Work jI jrvtbi nVA 11,14-3411.1i #Baths
3ailL� Plurq(�jtnci 33(r 2-1-76 r 2.1
Plumbing Contractor s Company-Name Telephone
L 3g c.atits c.GILG DD .
Address Email Address
ZU fsoG
License #
Insulation Contractor Information
&Ild Y 1 i(1Su1av1 cttR 'I�ScScc % Ot
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 by signing below I have obtained all subcontractors
permission to obtain these permit(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 $150 00 After 2 years re-issue fee
is as per cu ent fee schedule._
cuts- _ ir4ulrj
Signature of Owner/Contractor er(s)of Corporation Date
Affidavit for Worker's Compensation NC G S 87-14
The undersigned applicant being the /
__General Contractor _Owner V Officer/Agent of the Contractor or Owner
Do hereby confirm under penalties of perjury that the person(s) firm(s)or corporation(s)performing the work
set for$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 0-1041.---,leu—r en alt-Ome5
Sign w/TitleAlaii- -ka PLfl11t CLfld %t
f 4V UDate wL"i
, I
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DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 10/02/2017
Entry #: 731083 Initially filed by: wjh2013
Designated Lien Agent Project Property Print & Post
Investors 1 file Insurance Company OFV 25 Er..
1g6 Hallow Oak St v."41.1 '
�nline:w»+..ueo.or.ron:-. ,. Spring Luke,N('2X390
Hamed County O V(
AAdam:Adam:10 W Fargo St,Siete 5n1'Raleigh,NC
2700 Contractors:
enemy gaaa40-7354 Please post his notice on the lob Site.
Fut:013-4g7-52.11 Property Type
Suppliers and Subcontractors:
[mall:aonooNxWnmeeorn - . • Scan this image with your man phone to
view this filing.You can then file a Notice
1-2 Family Dwelling to Lien Agent for this protect.
Owner Information
Will,LLC
3300 Battleground Ave Suite 230
Greensboro, NC 294111
United Stales
entalr nahitzra wadciumeyhomes coin
Phone.010.005-5654
View Comments(01
Technical Support Hotline:NOB 690-7384