DOCUMENTS Initial Application Date: I)/ R/ 017 Application / 1 St,
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**
L ANDOWNER:Wynn Construction, Inc. Mailing/A�d`dress:2550 Capitol Dr.Ste 105 /1��
City: Creedmoor State: Zip:27522
Contact Nc. LQ -CW-0Y30 Erna.ttiCT'i'f-7S&Nit/ Aho✓/1.Q$,Ca,.
APPLICANT.Ttrr 1 T7�'e YtTZJ Mailing Address:2550 Capitol Dr.Stet105 � �/y
City: Creedmoor State: Zip:27522 Contact No: Qi COST-Dt8)Email:-ffre '+,CA'ia1L� ✓n'�erD
*Pleasefirl out applicant information if dierentHan landowneran ' r- (, , ,/ I / T
CONTACT NAME APPLYING IN OFFICE: -i)t-1 TPI ci c-S Phone it j1`(7J-�(/7S3 - Orr`L/36
PROPERTY LOCATION:Subdivision: Anderson Creek Academy Loti lox / Lot Size: •eA) A`
Sntad# d State Road Name: )GU.f. &A T7) ✓L alit — Map Book 8Pager9rfl((013x7
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C)K,„pp'K— n
$ '1 - G '3742 oC) 01056 C 91
Zoning IvAvgwrgrlood Zone:X Watershed:4,14 Deed Book&Pagf (0 WI 1.065 Power Company: South River
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED 1USE: N �� ry Babath):
( 5+�" r utac
SFD:(Slza./A r(}"F 91#Bedrooms?#Bathsy sement(w/wo bath): . Garage: ✓ Deck: Crawl Space:_Slab: Slab:
(Is the bonus room finished?( )yes Lino w/a closet?( )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?U yes ( )no Any other site built additions?Li yes Li 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: ✓ 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) County Sever
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 property contain any easements whether underground or overhead(i yes U no
Structures(existing or proposed):Single family dwellings: 1Manufactured Homes: Other(speciy):
Required Residential Property Line Setbacks: Co mments:
Front Minimum 35 Actual Ii I
25
Rear /��
Closest side 10 x= ,3
Sldestreet/colner lot 20
Nearest Building
on same lot
Residential Land Use Application Page 1 of 2 03/11
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 27 W.to Nursery Rd. left on Nursery then left on Ray rd then left into
Anderson Creek
If permits are gra • -e to confo , . dins ces and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state at foregoing s •,- s are acc ra and correct to the best of my knowledge. Permit subject to revocation if false Information is provided.
gnature of • nor or s Ag 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 6 months from the initial date If permits have not been Issued"
Residential Land Use Application Page 2 of 2 03111
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"PRESENTS A SURVEY N EE MY THIS COMM T10 NM ISS MT • I �/f Z//
INTOIKS RR ISSORBATION,CONEYMW,IA SMD
Charlie T. Carpenter, P.L.S. PRELIMINARY S E PLAN FOR
C 1 / Professional Land Surveyor WYNN CONSTRUCTION
1940 Juniper Church Rood
—Ii— Four Ooke, NC 27524 PIN 0505-87-6376.000
PARCEL ID 01053525 0100 27
(919) 320-5281 LOT 1084 ANDERSON CREEK CLUB S/0
/ I PB 2017 PG 327 38 EDUCATION DRIVE
PISchuck300yuhoc.corn 12/12/17 SPRING LAKE. IC 28390
1'=30'
09109/11 Application#
Harnett County Central Permitting
Eacheawm below to M Med out PO Box 65 ltllepbn NC 275/8
IN whomever performing work 810 683 7626 Fox 010 883 2789 www Mmatl mg/permits
Mut be owner or Iwensed
contractor Addresscompeny Application for Residential Budding and Trades Permit
name a phone must match
Owners Name h n>n T11AO iintt), YW .- Date
Site Address N g i) t• -bv2i✓2- Phone g l q- a cg-a 30
Directions to job aitsfrom Edlington 7 l.J -Ir, a(Strl� d ., I,�f+ za u.rserci,
2-P+ Oral KRy , LQ)} onitt rJneau h so, —t-ek-
SubdivisionlanlW,Zson"l� Cg.njc. A(\Ab-eft1 Lot 108`f
iY
Description of Proposed Work -21n) UOricTrµthcrs) - #of Bedrooms -!
Heated SF3y 14d-unheated SF 4S-C" Finished Bonus Room/ Crawl Space _Slab ✓
General CoMrector Information
kit., It) 0,0n1 On) , fry . 919- asg-a430
Building Contractors Company Name Telephone
550 °Apt flit 5+e- loC,Cread✓i-tio, t/G27Saa ttref'J'+rsBLaynnklomPS 0,r4
Address Email Address
AiL9a4S
License#
^/ n tectrical Contractor Information
Description of Work 1 Y Oa ut,_fi o n) Service Size dO0 Amps T-Pole Lyes_No
R .& LS-FM soli CLF-CM:L- q14-'73D - /SSI
Electrical Contractor a Co any me Telephone
�iaa I leLgt . tea. rbc g7Cbq
Address Email Address
r91 /-1Lf
License#
.. ff hamcallHVAC Contractor Information
Description of Work N.fG.t) n1 3ri,.r 7i on)
OPrT- ;ed, Nee+ A#a Aile_. Ola -$Sts- oo00
Mechanical Contractor s Company Name Telephone
X 79 <,trt&t+ Lf4ke P. butli"u a?r;d4e MG
Address 383SJ Email Address
NC.;Gaal I&S.
License#
/' plumbma Contractor Information
Descnption of Wor D1,t) a.oi1 ( it
ufon..) #Baths 3. g
111.-camr.s Lu nn6; ni `W9- 5-56- y833
Plumbing Contractors Com Nam Telephone
&o e
31 -A br d. .0.14 T) i Nc a7sa 7
Address Email Address
(Pir-
License#
—{— Insulation Contractor Intonation
/ Ai- n/1 ZNWTont 410- L21o1- 0997
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 pv arantna below I have obtained all subcoMrectora
permission to obtain these permute 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-S Months to 2 years permit re-issue fee is$150 00 After 2 years re-issue fee
is -. -nt fee _ - le
Signature of OwnerlContr--ctor/ to, .`:.rporation 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 hereby confirm under penalties of perjury that the person(s) firm(s)or corporation(s)performing the work
set forth 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
Hae 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 dunng the permitted work from any person firm or corporation
carrying out the work
Company or N-ee A r —t//ld'" I11 # 1../ e—
Sign w �.� �� n ,Th7 . Date /I 9 /
DO NOT REMOVE!
Details: Appointment of Lien Agent
Filed on: 11/08/2017
Entry Y'. 751808 Initially filed by: wynnhomes
Designated Lion Agent '. Project Property pant 8 Post
Investors Tide Insurance Company Anderson creek subdivision lot 1089 El El
38 eduction dr_ P 0-4
spring lake,NC 28390
Address:19W Nugen St.Sole 507r Raieseh.NC Int Co:mly p.tS43°
17601
Phone:B88-690-7384 .Contractors
it
Please post ria notice on the lob Sim. 1
Pm 91348F5231 Property Type
emvJ:•^-^mac — m _...._.*_
Suppliers and Subcontractors:Suncan i this image with your smart phone w
view ibis filing You can then file a Notice
1-2 Family Dwelling to Lien Agent for this Project
Owner Information
wymthomes
2550 capitol dr
creedmoos NC 27522
limbed Stated
nency@nyiu1homes.mm I
?bone 919-528-1393
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