DOCUMENTS Initial Application Date: I Ila'\ \1 ( Application#j- 1 1 `r/Q6v- .3
CU*
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street,Lillington,NC 27546 Phone:(910)893-7525 exb2 Fax:(910)693-2793 www.hamatt.org/permits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFERED PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER H&H Constructors of Fayetteville,LLC. Mailing Address:2919 Breezewood Ave.,Ste.400
City: Fayetteville Sate:NC ZID:28303 Contact No: 910-486-4864 Email: Leannahair@hhhomes.com
APPLICANT':Same As Owner Mailing Address Same
City: Same State: Zip: Contact Na: Same Email: Same
'PleaseSI out applicant Information 1different than landowner
CONTACT NAME APPLYING IN OFFICE: Leanne Hair Phone#910486-4864
Anderson Creek Club I45 p�pc,I-eS
PROPERTY LOCATION:Subdivision: Lot#: Lot Sire: 1
Sate Road#1/^1�17�� ^^��State Road Name:eNursery'fRoad �/�� �( Map Book&Pages/IJ/1YS Tr 1
P arcel: (I/V��J`1VaYq OIOI) / p PIN:o5o5-/tra�:�i{s/f- L7 IUl
Zoning::QOtbPyood Zone: P, Watershed: A)A- Deed Book&Pageq A ? !"+W Power Company': South River
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED UPyt� t t D 11 # J
VI SFD:(Size,',lilt #Bedrooms:. Baths' Basement(wAvo bath):_Garage:V Deck_Crawl Space:_Slab:V Slab:b..a
Size
(Is the bonus room finished?(i yes I 1 no vu a closet?( 1 yes ( I no(If yes add In with#bedrooms)
❑ Mod:(Size x 1#Bed rooms_#Baths_Basement(w/wo bath)_Garage:_Site Built Deck:_ On Frame_Off Frame
(Is the second floor finished?((J yes ( I no My other site built additions?( )yes (_..)no
U Manufactured Home: SW_OW_TW(Size x 1#Bedrooms: Garage: (site built? )Deck: (site built? 1
❑ 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
Wafer 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?( lyes (✓)no
Does the property contain any easements whether undergrounddor overhead( yes ( )no
Structures(existing propose .Single family dwellings: ` Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
1
Front Minimum 30 Actuai3-1
25 I4 ltg,r
Rear y
Closest Side 5 11
Sldestreelcorner lot 20
Nearest Building 10 ---
on same lot
Residential Land Use Application Page 1 of 2 03/11
APPLICATION CONTINUES ON SACK
•
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: Hwy.27 to Nursery Road,turn left and follow Ray Road.Turn left and
follow to Anderson Creek Drive.
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 fore g statements are occur to nd correct to the best of my knowledge. Permit suble to rev° ation I false Information Is proNded.
i I j
Signature of or Owners Agent ate
"'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.TM
"This application expires 6 months from the Initial date if permits have not been Issued"
Residential Land Use Application Page 2 oft 03111
p MICHAEL P. GRIFFIN certify that under my enevo, and
apeMSM Ws map woe been Fon on actual field sumr that the wrap of
Bovie of the survey as calculated by cwv>Fotes is I: 10.0:0+ : that the
In
veno Moen hereon was calculated by coal:%10es N
Witness my halo and»a' this day of MOWN 20r2 v'
If)
UNITED STARS OF AMERICA N
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y—s_ N 65°40'26"E — 60.00'+
FALLS CREEK DRIVE
SETBACKS
50' PRIVATE RN✓
FRONT 30'
REAR 25
ONE SIDE 10'
CORNER SIDE 20'
REVISION. ADD WRAP IOh9/I7
I LEGEND / '" "'
Application#
Harnett County Central Permitting
PO Box 65 Lillington,NC 27546
•Each section below to be filled out 910-893-7525 Fax 910-893-2793 www.harnett.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
Own Add eName:100Constructorsrat 1^ o�Fieet Or 11v.. Phone: 910-48 �I '
Site Address: h 1� 1
Directions to job site from Lillington: Hwy 27 to Nursery Road, Turn left, follow to Ray Road, turn left and
follow to Anderson Creek Drive.
Subdivision: Anderson Creek Crossing Lot: 114
Descriptionof Proposed Work: SFD #of Bedrooms:
Heated SFQroaUnheated SF: IDID 11--1 Finished Bonus Room? Crawl Space: Slab:C.
General Contractor Information
H&H Constructors of Fayetteville, LLC. 910-486-4864
Building Contractor's Company Name Telephone
2919 Breezewood Avenue Ste.400.Fay, NC 28303 Leannahair(a3hhhomes.com
Address Email Address
74158
License#
Electrical Contractor Information
Description of Work Service Size: 200 Amps T-Pole: X Yes_No
JM Pope Electric LLC. 919-776-5144
Electrical Contractor's Company Name Telephone
409 Chatham Street Sanford, NC 27330 electricpope( windstream.net.com
Address Email Address
21326
License#
Mechanical/HVAC Contractor Information
Description of Work
Carolina Comfort Air.lnc. 919-934-1060
Mechanical Contractor's Company Name Telephone
5212 US Hwy 70 Business, Clayton.NC 27520 carolinacomfortair@yahoo.com
Address Email Address
29077 I-1-3-I
License#
Plumbing Contractor Information /�
Description of Work #Baths a•5
Vance Johnson Plumbing Co., Inc. 910-424-6712
Plumbing Contractor's Company Name Telephone
3242 Mid Pine Dr. Fayetteville, NC 28306 etoepferCWviplumbinq.com
Address Email Address
07756-P-I
License#
Insulation Contractor Information
Tri-City Insulation 418 Person St. Fay. NC 28301 910-486-8855
Insulation Contractor's Company Name&Address Telephone
*NOTE: General Contractor I owner 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 signing 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 current fee schedule.
Signature of Owner/Contra actor7HffiCer(s)of Corporation Date
Affidavit for Worker's Compensation N.C.G.S. 87-14
The undersigned applicant being the:
X General Contractor Owner X 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:
X 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.
X 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 worker's 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: H&H Constructors of Fayetteville, LLC. ^ �''t
Sign w/Title(��u.- Hai or-/ Permitting Coordinator Date: , l I l
Appointment of Lien Agent: Details - LiensNC Lien Service Page 1 of 1
DO NOT REMOVE]
Details: Appointment of Lien Agent
Filed 11/3]/301]
Entry if: 760335 Initially filed by: meaganbradshaw
Designated Lien Agent Project Property Print & Post
Firs:Amercan Title Insurance Company ACx000I45 Lot 145 Ame:on Creek CHI: Ort -O
Crowns e^
„t
Onl.ne.xx li.n.ne mm v. 160PoIIs Creek Drive ]k i'
AddteSI 19W Haan SL Sui¢507:Raleigh.NC Sprins Lake.NC 28390 OP S
ayW Hama:County
Contractors:
Phone 8811-640 7384 Please post Ibis notice on the lob Sac
FIE 917.489-5211
Cmnl _... Property Type Supplier,and Submntrenom
Ylpme a lrtnmr COM _.. Scan:his Image with your phone to
view this filing vol can then file a Notice
m Lien Agent for this project
u Family Dwelling
Owner Information
Det, of First Furnishing
H&H Constructors of Fayettevii le,L LC.
79195 reerewend Avenue Ste 400
Iavowsille, NC 28101
I oim.2nt7
r mad ma tiltmtacr@lthltotnes com
Phone:610486-4464
View Comments lot
Technical Support Hotline:(888]690-71P4
https://apps.liensnc.com/ser/appointment/details.html?entryNumber-760325&printable— 11/27/2017