DOCUMENTS Initial Application Date:I‘ 19 11 / Application# I 1 l as I
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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: 1I�1I1t1I1, State: Zip: Contact No: bra-tits/tura
_ ' 1 Email:
APPLICANT*: LASt)R1 LLG Mailing Address: 53/)Bbra-LtL�turaAUL. MLZ3o
City: Gnettsl baro State: �vyzip:Z)4Io Contact No:"L IQ qQs-..sq EmallT?sJOs47 o,il AIjr NKO f z
•Please fill out applicant information if different than landownerw � ',S b4
LO1
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CONTACT NAME APPLYING IN OFFICE: { a 1 ft Phone# -Sc,SC-I`'
PROPERTY LOCATION:Subdivision: O\i H 1.fIN1 L)IttaLsO, Lot it IA Lot Size:O.a
State Road cam) State Road Name: ENCU nIVt Si- Map Book&Page:1QIZ / 541
Parcel: 610504 Ot75 G4 PIN:ncd-F 14 3(2L
Zaning{�N'pp', gleed Zone: N Watershed: Y Deed Book&Page:394C i 0 Qin Power Company:504.104tutfunc.
New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
X .r Monolithic
SFD:(Size 3% x JO )#Bedrooms:` #Baths. Basemendw/wo bath):LI Garage:k/ Deck:AJ Crawl Space:_Slab: _Slab: X
(Is the bonus room finished?(_)yes ( )no wl a closet?( )yes ( )no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms_#Baths Basement(wtwo bath)_Garage:_Site Built Deck:_ On Frame Off Flame_
(Is the second floor finished?( )yes ( I no Any other site built additions?I )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.#Roams: Use: Hours of Operation: #Employees:
❑ Addition/Acccessory/Other:(Size x )Use: Closets In addition?( )yes (_)no
Water Supply: x 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 (J)no
Does the property contain any easements whether underground or overhead(e)yes ( )no
Structures(existinga ropose :Single family dwellings: I Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 5s Actual 3-2
Rear 240
Closest Side I 0 / _
SidestreoUcomer It 2.0
Nearest Building
on same lot
APPLICATION CONTINUES ON BACK
SPECIFIC�'DIR�^ 4ECCrTIONS TO THE PROPERTY FROM LILLINGTON:�I (Ott_ s/l.� ITWc 7 /0 3, -rake
L�tc - ov 4o 6. 'wi l l/t s+ ltt4 1 17V Irl a 0040 CoN4 -
If permits are granted f agree to conform to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
hereby state that foregoing s enema are accurate and correct to the best of my knowledge. Permit subject to revocation if false Information is provided.
ea i— lobiil�
Signature of Owner rear's Agent Date
'It is the owner/applicants responsibility to provide the county with any applicable Information about the subject property,Including but nol 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 6 months from the initial date if permits have not been issuer
I MICHAEL P. GRIFFIN . teeny that WOO"MySalm old
ey '*M Me nap m Own hien an actual Ma sumer Mat M.err W
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area Moan Anon a 0 SNG by oo ,o r tIyRNeciccs
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SITE PLAN APPROVAL S
DISTRICT USE.J�i�s
a IBEDROOMS 4
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\I\ HALLOW OAK STREET
501 PUBLIC RAM SETBACKS
FRONT 35'
REAR 25'
SIDE MIN. 5'
510E AGO. 15'
1 LEGEND Is,T\acw�-‘5"D
09/09/11 Application#
Harnett County Central Permitting
PO Box 85 Lillington NC 27548
Each sedan below to be filled out 910 893 7525 fax 810 893 2783 www hamett org/permits
by whomever performing work
Must be owner or licensed
contractor Address company Application for Residential Building and Trades Permit
name 8 phone must match
Owners Name (Asia ae.Ju rt aj I4aYVttS . Date
Site Address TQM likes \Q1a.�/`''y`; t1L,-cJ"f' Phone _____15.5(.<L.1
Directions to lob site from Lillington ' I air JJ(L L40XU Z 105 �,.41- /444 Cierid
6.rvtutv�F� Tiqz i 4-urn P Ono , f—eht1+6><-.
Subdivision old GQ.rr n VI 11 6.ti. Lot tpi / [
Description of Proposed Work SGS .. 11 #of Bedrooms
Heated SF _ Unheated SF 1113 Finished Bonus Room'' N Crawl Space _Slab
General Contractor Information
�u 11 . 53&a2.- 5t ncg
Building Co tractors Company Name Telephone
3351 tbdiAtBrpu a AU1,5IP724 Opennbkna Trra ni1ZJ(a1rWtlryl.. kame6.
Address U Z,:-/L110 Email Address 1 C-0IY
4141
License #
• Electrical Contractor Inform tion I/
Description of Work CRL4 rtcA.1 'r/464.4.11 Service Size 7411 Amps T-Pole (/ Yes_No
alit/v.4)4 FALL -lye 2j..5W-1•404n
Electrical Contractors Company Name Telephone
Itt1 ne,. L7 OYjrilnt\tayr ,2111S
Address J Email Address
/sett,
License #
Mechanical/HVAC Contractor Information
Description of Work aL(lln3 Gi Air-
einvIcor+Air 33G-1Qu 4130
Mechanical Contractors Company Name Telephone
9 D• Sox 5r7 Clinmavts, 2.1017.
Address Email Address
y7_lS
License it
Plumbing Contractor Information
Description of Work pIQMt02 K9 11V1S+p11 #Baths
ea?l•L.l PluNainq tnc 33G • 5-75•1-4Z)
Plumbing Contractor s CompanyMame Telephone
X15Sic Loans L4atc ED .
Address Email Address
tos c4
License#
Insulation Contractor Information
'621is.u76Ck15a I �Avt 4t SC6'41so4
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 tome and that pv awning 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-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_
(/ ( toIii 1.0t(-411-71.0t(-411-7Signature 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 t/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 Watt/iv rn t-torn6
Date 10141 �
Sign wadi, �.&__,i I A Y�7' 114
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 10/02/3017
Entry #: 731086 Initially filed by: wjh2013
Designated Lien Agent Project Property Print & Post
Investors Title Insurance Company 011V 61 Ela -
TBD Hallow Oak St. CTS+ '
armee.wwwnen:noCOM.. ,. Spring Lake,NC 25390
Address:19 la Hw0+n 9.,Suns 507 Raleigh,NCHarnett County O t a
27601
Contractors:
Phone.s8g690.71a4 Please post his notice on the lob Site
F.a:m]4S -3131 Property Type
Suppliers and Subcontractors:
annul:mmmma lien.ne corn . Scan 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
WIH,LLC
3300 Battleground Ave Suite 230
Greensboro, NC 27410
United States
mail trahiatri.wadejumcyhomcacom
Phone 919-995-5654
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Technical Support Hotline:(SSg)69373g