DOCUMENTS Initial Application Date: /V/Pe/ 7 Application# 1 1 11 91g
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street,Lillington,NC 27548 Phone(910)893-7525 ext2 Fax:(910)893-2793 www.hamettorglpermits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER:Wynn Construction, Inc. Mailing AA �r2550 Capitol Dr. Ste 105
City: Creedmoor State:NC Zip:27522 Contact Nc)qdd�//e��ss:"Y S'-dy3O Ema
-r-P-1-7 —LtrePP-7s to Linn ho mks.0 ani
APPLICANT'Tee, ff e.7rtZS Mailing Address:2550 Capitol Dr.Ste 105
City:
Creedmoor State:NC Zip:27522 contact No: QI C SIE-Dy Email:= fr ci-i c P G.)c' if)
•Please fill out applicant information if different than landowners 1
CONTACT NAME APPLYING IN OFFICE:I-4 i '1 'QT'T Lt 'shone#9lq -2sg -aV 3o
PROPERTY LOCATION:II-Subdivision'. Anderson Creek}AAcadde�m�yn y, _ Lot#: ( CS SLot Size': •.ZS A�
State Road#_ 6 W State Road Name: GCutt 1 l Il L](c t Map Book&Page:.1(# / 3a"7
Parcel 0 ) DS°)S S DI 00 c98 PIN (D
✓y6si 0OD
South
outh RiverZoningCtlootl Zone: Watershed: / f1m need BookBPageDt(Q/V/LACPower Company:
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
�/6N Sl abaieme
SFO:(Size cl x/ 14#Betlrooms#Baths:3 Basement(wlwa bath): Garage: ✓ Deck: Crawl Space: Blab: ' Slat_
(Is the bonus room finished?( )yes L.)no wl a closet?( )yes ( )no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms_#Baths_Basement(w/wo bath) Garage: Slte Built Deck:_ On Frame_Off Frame
(Is the second floor finished?U yes ( )no My other site built additions?( )yes U no
❑ Manufactured Home: SW_OW_TW(Size x )#Bedrooms: Garage:_(site built? )Deck:_(site built? I
❑ Duplex:(Size x )No. Buildings: No.Bedrooms Per Unit:
❑ Home Occupation:#Rooms: Use: Hours of Operation: #Employees:
LI Addition/Accessory/Other:(Size x )Use: Closets in addition?U yes U 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 Sewer
Does owner of this tract of land,own land that contains a manufactured home within five hundred feet(500')of tract listed above?( 1 yes ( 1/ no
Does the properly contain any easements whether underground or overhead( )yes Lai('
Structures(existing or proposed):Single family dwellings: ` fdanufactured Homes: Other(specify):
PfpfYy'.t'[i_pl_
Required Residential Property Line Setbacks:h Comments:
Front Minimum 35 Actual,?I.G py
Rear 25 / /
Closest Side 10 r . W 9
Sidestreeticorner 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 granted I a•ree to cont••i• o all ordinances d laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state the • swain! s ents m c rate and •rrect to the best of my knowledge. Permit subject to revocation if false information is provided.
,. r`1 1 ��/"//�/ ,
Signature of Ow 9•rJm' •gent Deedlleee
••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 fi months from the initial date if permits have not been issued
Residential Land Use Application Page 2 of 2 03111
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Charlie T. Carpenter, P.L.S. PRELIMINARY SITE PLAN FOR:
C I / Professional Land Surveyor WYNN C❑NSTRUCTI❑N
1940 Juniper Church Road
PIN 0505-87-6320.000
-~T~- Four Oaks, NC 27524 PARCEL ID 01053525 0100 28
C (919) 320-5281 LOT 1085 ANDERSON CREEK CLUB S/0
/ PB 2017 PG 327 56 EDUCATION DRIVE
plechuck300yahoo.COm 12/12/17
'=30' SPRING LAKE, NC 28390
09109111 Application#
Harnett County Central Permitting
Emil whoa bScw to b.9ed out PFax 9x 65 893 2793miton .wwNC ba n8
by whomever perlmcg 010 693 7626 Fax D10 893 47D3 www Mmett orprpermds
Must be owner or Icenved
aoneectcr Pedrosa company Application for Residential Buildino and Trades Penni
runs&phone must match /
Owners Name q/ 1/1 tot�tto tJ l(Nr1�. ie-4AAll MR)) =rid Date 1/4V/
Site Address sj la F- daMUA-1 i D I V mit ✓e_- Phone q ICI- a 1-a 3o
Directions topb',inkhorn Longtonii IA) -Its l\ L
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I.e-P+ onl Kay , LQJ} DrJto Arihe2soru e. -elr I
Subdivision Rol NeES O1' CPve tie-- A( Aa-e rr1 L-r Lot / n
Description of P—ivied Work IVB CI ar1sTYtiet btu - #of Bedrooms. S-k '1'1
Heated iF, 1-_ Unheated SF/ -ti Finished Bonus Room9 Crawl Space __Slab
General Contractor Information
in t4 rt1 ao sr(tat orJ , l an- . QI4- ase-aq
Building Contractors Company Name Telephone
assn CAp;t 1It .9t. 10C.Cretdr3lo C PIC-27saa ttrtf'12+zsswynnkomes@DM
Address Email Address
11 9a4s
License#
l Contractor Information.
Description of Work Wab .J Service Size
d)0 Amps T-Pole i Vas_No
{Z .A. 3aeltsonl Etee ri.: q14-'130 - joE
Electrical Contractors Company-Name Telephone
ia a, Pic a7S)L�
Address Email Address
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License#
� ( hanlcal!HVAC Contractor Information
Description of Work NAS nl—L,r 7 i o rJ
PP(Tit ;eoL HeAl- Mb A1 410 -t c- oo00
Mechanical Contractors Company Name Telephone
'7179 c1✓Iss+Lrtke. Rd'. LurH1er id9P tire-
Address 2f33sJ Email Address
NCaoaa1 H3 L lefts
License#
plumbing Contractor Information
Dretion of Wo . 1 e J IJ ! - #Baths 3 S
Ihdbaan `S W-114.6; e /9-` /9- SSb- 4833
Plumbing Contractors Com Nem Telephone
3/(p0 A CMAE Re _.C,)Ayfda rvc a7sa7
Address Email Address
License##
Insulation Contractor tnfOmlNtlOn,
TA 114 -INgsiA ion) 41q- Coto/ 099 ?
Insulation 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 authonty to make necessary application that the application is correct
and that-the construction will conform to the regulations in the Building Electncal Plumbing and
Mechanical codes and the Hamett County Zoning Ordinance I state the information on the above
contractors is correct as known to me and that by asoma balow jhaasktawsuillsaiminuan
mailman to obtain these oarmtt,and if spy 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-a Months to 2 years permit re-issue fee is$150 00 After 2 years re-issue fee
a -nt fee - -. le
/ i //9/0.1-6/ 7
Signature of Owner/Co -ctor/• •`�• ••ration Date
Affidavit for Worker's Compensation NC GS 87.14
The undersigned applicant being the
General Contractor _Owner 1.---<3 r/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
1-.4---las 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 dunng the permitted work from any person firm or corporation
carrying out the work
Company or N:ii e/ 1 c /c.d ft id 0—, .
Sign w c1i t -tIsIL" Date I1/9/)- 1 7
rI
DO NOT REMOVE!
Details: Appointment of Lien Agent
Filed on: 11/0512017
Entry 8: 751782
Initially filed by wynnhomes
Designated Lien Agent Project Property Print 8 Post
Investon Title Insurance Company Mdarwn creek subdivision lot 1085 El
56 education dove ilv -F
oeuve:ywrr 11.90,wm S,. . spring lake,NC 2939.0
Au ,.:low.n&E9-sr,sen 507 NC m
haea County o-y4
Auer.,.: 1"
27611
CuotncWn:
Phone:58849D-7384
Please poet Nis notice on the Job Site.
Far:913489-5231 Property Type
EmaJ066978510810ro0...0...a
Supplier(tad with your
Scan this()nage wiu yatsmutephoneNotice
12 Family Owellus tvo LinAgemfor prje:mlJenNouw
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Owner Information
wrinhxaes 'I.
2550 cupimi dr.
aeedmoor,NC 27522
United Smu
i Email ramie®wpmhomea corn
Phone 919-528-1347
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