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DOCUMENTS ) Initial Application Dater; � 5/ K Application ft I&WI) 433) cr CUP COUNTY OF HARNETT RESIDENTIAL LAND USE APPUCATION Central Permitting 108 E.Front Street,Lillington,NC 27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.hametorg/permits ^A RECORDED SURVEY MAP,RECORDED DEEEED(OR(O- OFFER TOS PURCHASE)UR8 SITE PLAN ARE REQUIRED WHEN SUBMITTINGITA LANDL �7USE APPLICATION" LANDOWNER 13 1 1 u/k^ Vnn5 1 ort irne ik)Mailing Address:G �1l DS I) ell—°w ` d-. I City: 6pri 1C� taK`L state's.zipg�s3 Ol Contact No:`l-//-9N—A73F3 Emaitrerm05 rutltaso`I7 `'&,., APPLICANT': Mailing Address. City: State: Zip: Contact No: Email: Please fill out applicant informatn if different than landowner CONTACT NAME APPLYING IN OFFICE: l 1/t,� p{I Phone# ' 1�J PROPERTY LOCATION:Subdivision: "TA t YVA y` .4`-s(' Lot#: 7 Lot Size' '11 /ice State Road# 2DS I State Road Name: I11/��j,� UYV c� �j Q+' (�'7!M(ap Book�8JPage:a"TU-4 1 O� Parcel: ((tt UI© 12) 111 04 PIN: 0513 D7147.000 (X.47.000 Zoning...l'f ood Zone: X Watershed: /3 0 Deed Book 8 Page: l 21 Power Company': *New structures with Progress Energy as service provider need to supply premise number __from Progress Energy. PROPOSED USE: Monolithic ❑ 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 1#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 x )#Bedrooms:_Garage: (site built?_)Deck: (site built?_) ❑ Duplex:(Size_x_)No.Buildings: No.Bedrooms Per Unit. ❑ Home Occupation:#Rooms: �s`Use: Jt Hours of Operation: #Employees:_ /Addition/Accessory/Other:(Size/� x JT/)Use: 5 h�d Closets in addition?(_)yes (_)no ss/ Water Supply: County _Existing Well New Well(#of dwellings using well )*Must have oo ,able water before final Sewage Supply: New Septic Tank(Complete Checklist) Existing Septic Tank(Complete Checklist) V County Sewer Does owner of this tact of land,own land that contains a manufactured home within five hundred feet(5009 of tract listed above?( )yes (_)no Does the property contain any easements whether underground or overhead(_)yes ( )no Structures(existing or proposed)Single family dwellings: 1 €K \1Manufactured Homes: _Other(specify): Required Res'dential Property Line Setbacks: Comments: ( SI*Front Minimum Actual 'JS Rear aS Closest Side S1 SitlestreeVcorner lot c 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: 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 foregoing statements are accurate and correct to the best of my knowledge. Permit subject to evocation if false information is provided. o2�t 6 Signature of Owner or Owner's Agent 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 03/11 NOT FOR LEGAL USE . 4 IIIIIr :: m o D h 1--‘ Q o' 02 �� . . . • .1,4 ti Q i 51) 11 C p rD le 2ro .. ry► ` O. ' C. -. 7 � CD o n k Q a 7 7 CD fl 7 4inaligji CD 00 m y.. • Oco 1 O r ta. i `4..' • d 7 o. O © 0 L.+ F k T I� 4 :r in (ftN r t E •..sgYq" D Er; • w Fe- Z N. B �. r t m N • O i - (/) • dr m = o � n ,t..'• ' i t n3 P"I . I CD. m - T- 14, coN -, Pn Y s lip ..fib ac`� :..S;;I ilr N '� ' i n t _ 7 c " SITE PLAN APPR(VfN m „ . _ • : . . . DISTRICT SE ..V .. oo BEDROOMS �;�” ' • _ � . rate. N 4 - 2 . a_011_ Application# Harnett County Central Permitting PO Box 65 Lillington,NC 27546 •Each section below to be filled out 910-993-7525 Fax 910-893-2793 www.harnettorg/permits by whomever performing wort Must be owner or licensed contractor. Address,company Application for Residential Building and Trades Permit name 8 phone must match ^y,, �j Owner's Name: U D Spy _I KA. S 11.E Date: a' /�5//g Site Address: log 1\ t°.a--W LA3 5--- 51)(lnc) Lia-k- Phone: 911/400L--923S Directions to job site from Lillington: Subdivision: Lot: Description of Proposed Work: #of Bedrooms: Heated SF: Unheated SF: Finished Bonus Room? Crawl Space:_Slab: General Contractor Information lb w nev Building Contractor's Company Name Telephone Address Email Address License# Electrical Contractor Information Description of Work Service Size: Amps T-Pole: Yes No Electrical Contractor's Company Name Telephone Address Email Address License# Mechanical/HVAC Contractor Information Description of Work Mechanical Contractor's Company Name Telephone Address Email Address License# Plumbing Contractor Information Description of Work #Baths Plumbing Contractor's Company Name Telephone Address Email Address License# Insulation Contractor Information Insulation Contractor's Company Name 8 Address Telephone `NOTE: General Contractor/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. CZII FI(� Signature of owner/Contractor/Officer(s)of Corporation Date Affidavit for Wo er's Compensation N.C.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. 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: ? / 6 w/Title: ��� ?Ogle: 002-A5,9 HARNETT COUNTY CENTRAL PERMITTING P.O. BOX 65 LILLINGTON, NC 27546 For Inspections Call: (910) 893-7525 Fax: (910) 893-2793 Application Number 18-50043319 Date 2/15/18 Intersection Property Address 91749 TECH 2 PARCEL NUMBER - - - - - - - Application type description CP NEW STORAGE BLDG RESIDENTIAL Subdivision Name Property Zoning UNZONED Owner Contractor PUPO RUBENS R RAMOS & OWNER GUADALUPE YAJAIRA PINTO 108 MEADOW ST SPRING LAKE, NC SPRING LAKE NC 28390 (941) 800-8738 Applicant PUPO RUBENS R RAMOS & GUADALUPE YAJAIRA PINTO 108 MEADOW ST SPRING LAKE NC 28390 (941) 800-8738 --- Structure Information 000 000 12X20 SHED / STORAGE Flood Zone FLOOD ZONE X Other struct info PROPOSED USE SHED / STORAGE SEPTIC - EXISTING? SEWER WATER SUPPLY COUNTY Permit RESIDENTIAL BUILDING PERMIT Additional desc . Phone Access Code 1229186 Issue Date . . . 2/15/18 Valuation . . . . 0 Expiration Date . 2/15/19 Permit LAND USE PERMIT Additional desc . Phone Access Code 1229194 Issue Date . . . 2/15/18 Valuation . . 0 Expiration Date . 8/14/18 Special Notes and Comments T/S: 02/15/2018 03 :42 PM JBROCK ---- 108 MEADOW ST HARNETT COUNTY CENTRAL PERMITTING P.O. BOX 65 LILLINGTON, NC 27546 For Inspections Call : (910) 893-7525 Fax: (910) 893-2793 Page 2 Application Number 18-50043319 Date 2/15/18 Property Address 91749 TECH 2 PARCEL NUMBER . - - - - - - - Application description . . CP NEW STORAGE BLDG RESIDENTIAL Subdivision Name Property Zoning UNZONED Required Inspections Phone Insp Seq Insp# Code Description Initials Date Permit type . . . . RESIDENTIAL BUILDING PERMIT 999 101 B101 R*BLDG FOOTING / TEMP SVC POLE 999 425 R425 FOUR TRADE ROUGH IN / / 999 131 R131 ONE TRADE FINAL 999 111 Bill R*BLDG SLAB INSP/TEMP SVC POLE / / 999 103 B103 R*BLDG FOUND & TEMP SVC POLE / / HARNETT COUNTY CASH RECEIPTS *** CUSTOMER RECEIPTPT *** Drainer: 1 Oper: MOCK Type: Date: 2/15/18 52 Receipt no: 254904 Year Number Amount 2018 50043319 91749 TECH 2 LILLINGTON, NC 27546 B1 BP - PERMIT FEES $125.88 SHED RUBENS PUPO Tender detail 1125.A0 CP CREDIT CARD $125.09 Total tendered $125.08 Total payment Trans date: 2/15/18 Time: 15:48:02 ** THANK YOU FOR YOUR PAYMENT aI