DOCUMENTS Initial Application Date'. 1 C�1 Q I In Application# 1� Ct) U1 /' I
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/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: State: Zip: Contact No: Email:
APPLICANT: Weill LLC. Mailing Address: •• - tS A . 51-.4
city: Cetriatybnry State: A/ tzip:Z' 4SSContactNo:Q1444SStAl4Eman"rrabi�z 1rniz
'Please nit out applicant information If different than landowner� ;J � VA01t_L5•Ca•MS
CONTACT NAME APPLYING IN OFFICE: l ar(A.Qi.K]� 1 t7 Phone# QIQ`G �cI
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PROPERTY LOCATION:Subdivision: irri Ui11(4650_, Lot it: 54 Lot Size:011
State Road# 1'1\ State Road Name: tAt_sW3litnN LY11L. Map Book&Page: ZOf7 1310
Parcel: C OSOM 01 fl1ZS Ol PIN: 6501C4let 311.14Zoning N Flood Zone: Watershed: Y' y
Deed Book&Page: 44c / 9U7 Power Company':.500AA(34,11dah
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
yy �, p I Monolithic
31. STD:(Size JU ,cy )#Bedrooms:#Bathsz Basement(w/wo bath):Ai Garage:t/ Deck:AJ 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(wrvo bath) Garage: Site Built Deck: On Frame Off Frame_
(Is the second floor finished?( )yes ( Ina My other site built additions?( )yes ( )no
❑ Manufactured Home: SW_DW TW(Size x )#Bedrooms: Garage: (site built? )Deck: (site built? )
❑ Duplex:(Size_x 1 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 ('1)no
Does the property contain any easements whether underground or overhead(X)yes ( 1 no
Structures(existing oropose :Single family dwellings: t Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual Si
Rear
Closest Side 1e0 -!
q
Sidestreet/camerlot 20
Nearest Building
on same lot
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON✓ t a VL iXL ITWU zip _),
Len- Q 4o h. mcujn 5+- Tki n 1t rn 2 01(4o Cr2 b -5(-.
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 best of my knowledge. Permit subject to revocation if false Information is provided.
its-g-�.-1o, 181 q I i7
Signature of Owner oar's Agent Date
^9t 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 6 months from the initial date If permits have not been issuer
f MICHAEL P. GRIFFIN , certify that afar my s.etln and
4 .tar. Ms mm imy to.., Maas n actual axe x that M.error or
awe o/Me may w ede/d.P Oy ronnatn Y I: 14004'; Met Me 6
on hen hen, me eeWbNd by cerelhetea 't
Mfr awl W my Milli aMY MAY DA,WWM Pon /YaRNeyTCO
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SITE PLAN APPROVAL �r7 E 56.62' W�
DISTRICT )2Aar'nUSES)\ I I OW OAK STREET SETBACKS
#BEDROOMS 2, 50' PUBLIC RN✓ FRONT 35'
REAR 25'
1O'Ci l l l SIDE MIN. 5'
" 510E AGG. 15'
Data 2 AtlmMiwaler
REVISION:House cnnuGeo rozioa 8/9n7 — I LEGEND Isi rM 0, 1r .`-
09/09/11 Application#
Harnett County Central Permitting
PO Box 55 MIlington NC 27546
Each section below to be filled 893 752
llatl out WA Fax 9101393 2793 www harnett org/permits
by whomever performingto
Must be owner or licensed
contractor Address company Application for Residential Budding and Trades Permit
name 8 phone must match
Owners Name ul DAL Ju rh.Lij 411wIG5 LL.C. Date 101411
Site Address L-11 V%coAol._l • ' 1 ` Phone 4142 Qrt i5g1
Directions to lob site from Ldlington Q, NC 1-r0A1 21, 05 _'! Ltc?.
6.mat1n414-, 4-urn 0 nM E. li?on-1-5
Subdivision otdd C(..(Yn dill 4.L Lot
Description of Proposed Work 5LZt #of Bedrooms 3
Heated SF 2.1o'- Unheated SF 404 Finished Bonus Room'? Al Crawl Space _Slab u
General Contractor Information
1,lyUJ C- 33G Z?Z: 5bm io
Building Co tractor s Company Name Telephone
533m 9414CA ound Mp,64PZ3o Cpettnf aro Trtd5;411aa kJn a s. hon e6.
Address U 2.14-110 Email Address ' Cow
'-14L4Z
License#
• El�ectncalConractor Information
Description of Work &Lt.rico., LQ'f 6MJ I Service Size 7h7 Amps T-Pole ZYes_No
Orternrtyt Le(-i-vital (1-5614 Q0Qa
Electrical Contractor s Company Name Telephone
1ll�niLT?P.M.z.noPuri(nJ tawa'IL1S
Address Email Address
1Q5Lle
License #
Mschaplcal/HVAC Contractor Information
Description of Work at/;in a L Alr
17nr Icor+Air 331. 1_G/-1 4730
Mechanical Contractors Company Name Telephone
9D. Eo,. 5Z1 .rhmnn5, Z?ol2
Address Email Address
y218
License #
Plumbing Contractor Information
Description of Work PluMb, vtg 14-a4I #Baths
Saikt Plunue i -tCi Tnc 33( • L-116.r411
Plumbing Contractor s Company-Name Telephone
Li 5 3g LatIts 1.4_,v-c, co .
Address Email Address
LO
Licensee ##
Insulation Contractor Information
211( ld Lir'-V15d I4inv, 4v •1S`6•GIso4
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 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 swine below I have obtained all subcontractors
permission to obtain these permits and if tax 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 sched ale
cat--t2c. tat ul ti
O
Signature of Owner/Contractor
tor r(s)of Corporation Date
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
__General Contractor _Owner t/Officer/Agent of the Contractor or Owner
Do her y confirm under penalties of penury 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 �LiJac�L�.c_J/-u—rnut t/
-Horne ./
Sign wiTitle/1 liki-L(X].t-1r, PDate 10Iu It?
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 10/02/2017
Entry it: 731041 Initially flied by: wjh2013
Designated Lien Agent Project Property Print & Post
Investors Title Insurance Company OFV 59
❑I Hallow Oak St
Online uww.liese torn - -.. Spring Lake,NC 28390 •- µ't
Address':19 VQ}Jurgen Si..Suite 507 Raleigh,NC H'dmCtl County O � n
17601 Contractors:
Phone:Rtlg-&90.7354 Please pail this notice on the Job Site
F.=n13484-523I Property Type Suppliers and Subcontractors:
Email:suonrorldesn coot Scan this image with your mart phone to
view this filing You can then file a Notice
I-2 Family Dwelling to Lien Agent for this project.
Owner Information
WJH.LLC
3100 Battleground Me Suite 230
Greensboro. NC 19410
United Sines
Email.trabitzC.wadetumcyhomea.eont
Phone.9W-995-5654
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Technical Support Hotline:HON 690.9384