DOCUMENTS sict
Initial Application Date:, . l W I I ", I n selc �a /
l Application#
CUP
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street Lillington,NC 27546 Phone:(910)893-1525 ext:2 Fax:(910)893-2793 www.harnettorg/permits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)8 SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER:kite e HACTNA 5Tarrogil Mailing Address. 0SSa ,1161E CevE C/Lc:F
City: 3. CI4trwaiciel0 State: VA Zipp. a tNContact No,&O3)a.g-44,.21+ Email: C CRSS e VAft0.COM
APPLICANT': /f +QVEJI
VTF'! Mailing Address: U I( GAY20 N ST
City: au/MI state:/ft Zip:'975% Contact No: glq)ka-4Email:TB
setO PRYF)EA1TY,eateRe4A4ATR
'Please fill out ap#liicant information if different han landowner
CONTACT NAME APPLYING IN OFFICE: Phone#
PROPERTY LOCATION:Subdivision: B, 1111 AA\e Fa)' D CpSF��. Lot It: I Lot Size: I .q
State Road# ,70D3 Stale Road Name: MC�fM9 /4Y Map Book 8 Page.,o2 lb-3810 _
Parcel:
p�J0�.1-fa.�.U La St (X. .z ,�rr�� PIN: 06$D- SP-0145.66
ZdningP'A3 Flood Zone: u. Watershed_ t.. Deed Book 8 Page. 342 6591 Power Company*:
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
Monolithic
Li SFD:(Size, x._)#Bedrooms #Baths'.�Basement(w/Wo bath):_Garage_ Deck._ ' Crawl Space Slab:_Slab:
(Is the bonus room finished?( )Yes ( )no 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?( )yes (_)no Any other site built additions?(_)yes ( )no
❑ Manufactured Home: SW_DW TW(Size )#Bedrooms. Garage:_(site built? )Deck: (site built?
❑ Duplex.(Size x )No. Buildings: No.Bedrooms Per Unit:
❑ Home Occupation:#Rooms'. Use: Hours of Operation: #Employees.
)3 r t4���� p �
Addition/Accessory/Other.(Size 17 x 34- )Use:1'�.VECYB£1]v VNlti L1--.1J Q ( ,12(4-f 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 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 (✓no
Does the property contain any easements whether underground or overhead(_)yes (✓1 no
Structures(existing or proposed):Single family dwellings: ✓ Manufactured Homes:
Other(specify):
Required Residential Property Line Setbacks:
Settbacksj: Comments: .✓
b
Front Minimum Actual 94 12. O 7g,a1Y - a %CQL QTS
Rear as-f
Closest Side 0 t 10 f
Sidestreet/corner lot
Nearest Building
on same lot
Residential Land Use Appl ical ion Page 1 se 2 Dan 1
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTYFROMLILLINGTON: T•Y6 05(-0-1W1 5ouTLan ots AIC&'7E• TkA�
gm/iv4ertil 3 M'/€ tRyvl ob.( i1cCt/t7B Al I-hii5e 15 f/w Ms)a- oN LEFT.
If permits are granted I agree to conform to- nces and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing s _. ents a- -0nd correct to the best of my knowledge. Permit subject to revocation if false information is provided.
• /r'/Ai ///a9/a0i7
Signatu' • • /•or Owner's Agent Date
'"It is the ownerlapplicants 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 01111
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David McRae
From: Rick Stafford <cptrjs@yahoo.com>
Sent: Tuesday, November 07, 2017 11:44 AM
To: Jay Sikes
Subject: RE: RE: Renovation/Addition Planning Approval
Jay,
Since our renovation and addition will not increase the existing setback encroachment, we request to pull our
request for variance for our property located at 1614 McLamb Rd.
Thank you for your detailed review and timely response.
Respectfully, Rick Stafford
Sent from Yahoo Mail on Android
On Tue, Nov 7, 2017 at 11:20, Jay Sikes
cjsikes@harnett.org> wrote:
Good morning Mr Stafford....1 hope all is well. After further review of our County's Ordinance,staff has determined that
a single family structure can be altered as long as the overall nonconformity(in this case the existing setback
encroachment)is not increased. As you stated in an earlier correspondence,"None of our new addition will extend the
front of the house closer to this property line",therefore per Art 11, Sect 4.0,you do not need a variance.
So, if you will,please send me a request to pull your variance request application and we'll start the process to return you
fee.
Also,when ready to begin,Donna Johnson is a good contact within our Permitting office. (diohnsonc hamett.org,910-
893-7525 x2)
Thank you for cooperation,
Jay Sikes,CFM
Manager of Planning Services
Harnett County Development Services
108 E. Front St
t
NAME: Mgr tiffs' APPLICATION#:
*This application to be filled out when applying for a septic system inspection.*
County Health Department Application for Improvement Permit and/or Authorization to Construct
IF THE INFORMATION IN THIS APPLICATION IS FALSIFIED,CHANGED,OR THE SITE IS ALTERED,THEN THE IMPROVEMENT
PERMIT OR AUTHORIZATION TO CONSTRUCT SHALL BECOME INVALID. The permit is valid for either 60 months or without expiration
depending upon documentation submitted. (Complete site plan=60 months;Complete plat=without expiration)
910-893-7525 option I CONFIRMATION#
Environmental Health New Septic SvstemCode 800
• All properly Irons must be made visible. Place "pink property flags' on each corner iron of lot. All property
lines must be clearly flagged approximately every 50 feet between corners.
• Place "orange house corner flags'at each corner of the proposed structure. Also flag driveways, garages, decks,
out buildings, swimming pools, etc. Place flags per site plan developed at/for Central Permitting.
• Place orange Environmental Health card in location that is easily viewed from road to assist in locating property.
• If property is thickly wooded, Environmental Health requires that you clean out the pnderarowth to allow the soil
evaluation to be performed. Inspectors should be able to walk freely around site. Do not grade property.
• AU lots to be addressed within 10 business days after confirmation.$25.00 return trip fee may be incurred
for failure to uncover outlet lid.mark house corners and property lines. etc. once lot confirmed ready.
• After preparing proposed site call the voice permitting system at 910-893-7525 option 1 to schedule and use code
800 (after selecting notification permit if multiple permits exist) for Environmental Health inspection. Please note
confirmation number given at end of recordina for proof of request.
• Use Click2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
Environmental Health Existing Tank Inspections Code 800
• Follow above instructions for placing flags and card on property.
• Prepare for inspection by removing soil over outlet end of tank as diagram indicates, and lift lid straight up (if
possible)and then put lid back In place. (Unless inspection is for a septic tank in a mobile home park)
• DO NOT LEAVE LIDS OFF OF SEPTIC TANK
• After uncovering outlet end call the voice permitting system at 910-893-7525 option 1 & select notification permit
if multiple permits, then use code 800 for Environmental Health inspection. Please note confirmation number
given at end of recordina for proof of request.
• Use Click2Gov or IVR to hear results.Once approved, proceed to Central Permitting for remaining permits.
SEPTIC
If applying for authorization to construct please indicate desired system type(s): can be ranked in order of preference,must choose one.
1I Accepted II Innovative 1 4 Conventional 1_) Any
I—I Alternative I ) Other
The applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in
question. lithe answer is"yes",applicant MUST ATTACH SUPPORTING DOCUMENTATION:
I_)YES 1/-j NO Does the site contain any Jurisdictional Wetlands'!
1_IYES 1/INO Do you plan to have an ity» now or in the future?
I_IYES NO Does or will the building contain any drains?Please explain.
I YES I_I NO Arc there any existing wells,springs, waterlines or Wastewater Systems on this property?
I_IYES 1_4190 Is any wastewater going to be generated on the site other than domestic sewage?
1—IYES I v) NO Is the site subject to approval by any other Public Agency?
1—IYES NO Are there any Easements or Right of Ways on this property?
I_I YES NO Does the site contain any existing water,cable,phone or underground electric lines?
If yes please call No Cuts at 800-632-4949 to locate the lines. This is a free service.
I Have Read This Application And Certify That The Information Provided Herein Is True,Complete And Correct. Authorized County And
State Officials Are Granted Right Of Entry To Conduct Necessary Inspections Tu Determine Compliance With Applicable Laws And Rules.
I Understand That I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site Ac •:ible So ' MA-15o t tete Site Evaluation Can lie Performed.
aer % ///299.247
PROPER O N . "f„ NERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE
10110
09/09/11 Application#
Harnett County Central Permitting
Eachsection belowb ba titled outPO Box 65 LAWigton NC 27546
by whomever performing wrote 910 893 7525 Fax 910 8e3 2793 www hamee orypermite
Must be owner or licensed
contractor Address company Application for Residential Building and Trades Permit
name 6 phone must match
Owners Name Rick_ • MARTHA $IAFFRO Date /f/a94o,7
Site Address IJol4 IMc LAMB gra Phone (103),93a-L/014
Directions torah site from Lillington U54a.15 lb NC 4146 -.Remo/ 3 Mdr-S
PN McLArtg /Qxf/ j-IlJ✓k 114 Milc ON Lear-
Subdivision
eFrSubdivision 'iIR' DAIS RYeo 1'aT Lot I
Description of Proposed Work ROOM Da u Re COVATIo.“ #of Bedrooms 3
Healed SF /154 Unheated SF Hg4 Finished Bonus Room9nli?Crawl Space ✓ Slab
General Contractor Information
&a 80/dcw (HaoLINA Rem ,a i. .G • G,Nsnet.criwi flc (9 IR)(pp')-L}$QO
Budding Contractors Company Name Telephone
Fl 1 GARO&W cM Lill mi&roo NC 215%, TORY geA,r t_eMBnmc9MAiL.(ant
Address Email Address
rl Yr436
License#
lectrical Contractor Information
Description of Work o aJere .Jera A acne Ai Service Size atm Amps T-Pole /Yes No
es
rve,15ont5 EJeeTR+c rrac (q PP)Rol -3341
Electrical Contractor Company�N�ame Telephone
/
100 1n ( 011,4 iRs. ✓ J Mc- alsa(o 772Avise Q4wsoidgern2ic.Coin
Address ✓ J Email Address
41594 s
License#
Mechanical/HVAC Contractor Information
Description of Work Cotplem A.444tl✓{}c
Quell.tre CcwiFoiat . 1/ic€5 (614) 011- 5610
Mechanical Contractors nCompany Name Telephone
"(a5 13ehterlem. <4. , )<mir.j1ALE nlc aas4s 4.seca/ncir(G,F4ersegvia5. (0A1
Address UU Email Address
ac3(o
License a
//+� Plumbma Contractor Inform,tion
Description—scof Work rumple-sit" flew au MAINE #Baths 3
l✓M/My Mei AuMBINFi (co)(a49—sr 17
Plumbing Contractor s Company Name Telephone
7345 5HTto , 31E€l1 L4AI010w5/9ai.yrr Afc ongic) 7;0601.40.4 PiuMi9;16FYn4*AcaN
Address Email Address
33ia8
License a
Insulation Contractor Information
Minos TASulAncn . PtIli ice. MC- .ncaco 1441160211 - 41438'
Insulation Contractors Company Name&Address Telephone
*NOTE General Contractor must fill out and sign the second page of this application
I hereby candy 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 Jr/slanina 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 entfee - ••ule
�
ir/jit 1011g° /7
Si! atu •t•�.•..�.�- ••nbactorlOfficer(s)of Cgrporation Date
Affidavit for Workers Compensation NC G S 87-14
The undersigned applicant being the
✓ General Contractor _Owner 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
1/77 Has one(1)or more subcontractors(s)who hes 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 pnor
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/� ie n :r' Zinn ij "'' e CKsrnod
xucL X
Sign wlrlde /�1�/1, ab-wei2 Date a/a'9/.Or7 J