DOCUMENTS Initial Application Date 1 Y Application* \'' H&(4(a"
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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.harnettorg/Permits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER
Comfort Homes, Inc. Mailing Address:P O Box 369
City: Clayton state:NC Zip:27528 Contact No: 9185533242 Email: comfrthomes@aol.com
APPLICANT':
Comfort Homes, Inc. MailingAddress:P O Box 369
City: Clayton State.NC Zip;27528 Contact No: 919 553 3242 Email: comfrlhomes@aol.com
*Please fit out applicant imormaton if different than landowner
CONTACT NAME APPLYING IN OFFICE:
Julian Stewart Phone*919 422 1481
PROPERTY LOCATION:Subdivision: Oxford Woods Lot#:28 Lot Size:.741 acre
State Road#1006 State Road Name: Old Stage Road N Map Book 8 Pag -a`''� l I Ill I
040692 0017 47FIN06882-99-2369.000
.
Parcel: e`
RA-30 IV3S 5j 1l`1
Power Company: Duke Progress Energy
Zoning: Flood Zone:"C Deed Book&Page
29516739 from Progress Energy.structures with Progress Energy as service provider need to supply premise number 9
PROPOSED USE: Monolithic
fitf 5567' 54.67'
SR/(Size_z )#Bedrooms:3 #Baths: Basemen[(wMro bath):_Garage: 1 Deck:_Crawl Space:_Slab:_Slab:
(Is the bonus room finished?( lyes (✓)no w/a closet?( )yes (✓)no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms #Baths_Basement(wNro bath)_Garage:_Site Built Deck:_ On Frame_Off Frame_
(Is the second floor finished?( 1 yes ( )no Any other site built additions?(__J yes U no
❑ Manufactured Home: SW DW TW(Size x )it Bedrooms:_Garage: (site built? )Deck: (site built? )
❑ Duplex:(Size x 1 No.Buildings. No.Bedrooms Per Unit:
❑ Home Occupation:#Rooms: Use: Hours of Operation: #Employees:
❑ Addition/Accessory/Other.(Size x_)Use: Closets in addition?( )yes ( 1 no
Water Supply. ✓ County Existing Well New Well(#of dwellings using well )•Must have operable water before final
Sewage Supply. 1 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?U yes (✓)no
Does the property contain any easements whether underground or overhead(I)yes ( )no
Structures(existing or proposetl)'.Single family tlwellings.
proposed Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 38 Actual 40
Rear 25' 150'
Closest Side 10 13
SidestreeUcorner lot nla
Nearest Building n/a
on same lot 0S/1 t
Residential Land Use Application Page 1 of 2
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: NC 210 N; right on Benson Road; right on Old Stage; subdivision on right
If permits are nted 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 th st t ents are a rid co e to the best of my knowledge. Permit subject to revocation if false information is provided.
� (� � 2128/18
^ re I Date
Si bre of Owner Owner's Agent
"'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 H permits have not been issued'
Residential Land Use Application Page 2 ol 2 03111
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NAME:, QS\\*"c aS.N.Qe \ic\ APPLICATION#:
*This application to be fiLei 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 I\IPROVEMEYF
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 pian=60 months:Complete plat=without expiration)
910-893-7525 option I CONFIRMATION#
Environmental Health New Septic Systen,Code 800
• All properly irons must be made visible. Place "pink properly flags" on each corner iron of lot. All property
•
lines must be clearly flagged approzima rely 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 undergrowth to allow the soil
evaluation to be performed. Inspectors should be able to walk freely around site. Do not grade property.
• All 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 recorjino for proof of request.
• Use Click2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
1 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 TANX
• 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 'or Environmental Health inspection. Please note confirmation number
(liven at end of recording for proof of realest.
• 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\stern r;pet sl: can be ranked in order of preference.must choose one.
I-1 Accepted I—I Innovative 1_`Y{ Com entional
IJ Any
I_I Alternative IJ 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. If the answer is"yes". applicant MUST ATTACH SUPPORTING DOCC\IEN'TATION:
LI YES 1_/( NO Does the site contain any Jwisdictional Wetlands? W\\C.-CI� —.C\
1__1YES IL) NO Do you plan to have an irtip;p ion system now or in [he future?
i j_l YES (%) NO Does or will the building contain any drains?Please explain.
Il TES Ix/I NO Are there any existing sal Is.springs. waterlines or Wasteuater Systems on this property?
I—I YES 1`1Y NO Is any wastewater going to b.: generated on the site other than domestic sewage?
Il_IVES 1a1 NO Is the site subject to approval by anyother Public Agency?
l YES 1_1 NO Are there any Easements or Right of Ways on this property?
I—I YES 11' NO Does the site contain any existing water.cable.phone or underground electric lines?'oh-\xsA \Vte1 w.%�
If yes please call No Cuts at t 00-6324949 to locate the lines. This is a free service. ..A4
I Rase Read This Application And Certify That The Information Provided Herein Is True.Complete And Correct. Authorized Co rnty And
State Officials Are Granted Right Of Entry To Conduct Necessary Inspections To Deterndne Compliance With Applicable Laws Add Rules.
I Understand That I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And 6 aldng
essibl Tha�C.{ple Site E aluation Can Be Performed.
PROPERTY OWNE OWE`\BSA LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) �DA TE `�
l0/10
0910911
Application#
Harnett County Central Permitting
E.drwWn D.bwbbe filled outPD Bon 55 Winton NC 27548
by etanarer psrtonnrg 910 607 1525 Fix 010 607 2793 mom Arnett ag�pmnip
Must be owner or Yenned
1onbecor i1ddiess 4O11piny Application for Residential Building and Trades Permit
name 5 phone must matin
Ovmers Name .AS \ \.\ s _ \ Date
Site Address _► ..,,t. \\ c\ t_\�y{,�a&a'7SO\ Phoneek\S-WS-7a'1�
Directions to lob site from Lilhnglon V r r2 W' \� ' ' cS. cac ` ,-ass A•
Subdivision VycJ<bt,s\S \<i ��(( (+ Lott .act
Description of Proposed Work�t\S�eyS�' . t7� 5. ��{iflJ o/Bedrooms 3
Heated SF\LOt\oUnheated SF %$'y Finished Bonus Room' C\i Crawl SpaceU "Slab
Genejl Contractor Information
CS:1&1/4N-Q- N � .c Q\q-StS-'Ca
Building Contractors Companx Naine -.��y Telephone
B • N s .\ Q 2 sod Comgt.<
Address �Otl.Xl� Q Clo\.coCr
Email Address
S3\%y
License#
Electrrp9l Contractor Information
Description of Work " v, '.n a cC-4c\ tttri.alv. Service Size t300 Mips T-Pole Yes_No
S��SC...%C \a. � � _ g\A-Qns- CSg9
Electrical Contractors Company Name Telephone
c)OS PSN\-SC -s•A 4\10\�:c( - S4
Address Email Address
License##
MechamcalpHYAC Contractor Information
Description of Work�-SttwiLy.;v t*c'-i� \ EK
Mechanics Contractor s Company Name Telephone
31/4-\3 Sti*•.q\�aS.� Va«ems arsaq
Address Email Address es2
License#
Plumbing Contractor Information
Description of WorkCt $.ate \ a< m w,, s #Baths
C\‘ ' CEA-CEA-el- ne 3�t \319
PlumbingContractor ontrectw Co s Company me (�� Telephone
l
ISS ZO Q 0.c G2•bi
Address ' a-jc0Emad Address
ao%ar2)
License#
Insulatitn Contractorp� Information �l \ n
Insulation Contractor s Company Name &Address\tac.Pt Telephone
9--)Sa4
'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 Budding Electrical Plumbing and i
Mechanical codes and the Harnett County Zoning Ordinance I state the information on the above
contractors is correct as known to me and :hat b st nm below I have obtained all subcontractors
ennission to obtain these errnits and if DE 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
_'
41
Signature of Owner/ContrraOFbcer(s of Corporation te <
Date
Affidavit for Worker's Compensation N C G S
The undersigned apphcanl being the 87.74
General Contractor Owner
Officer/Agent of the Contractor or Owner
Do hereby confirm under penalties of perjhry'Yhal the person(s)rfvm(s)or corporation(s)
set forth in the permit
performing the work'.
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
-XL 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 an no subcontractors
While working on the project for which this perm'is sought it is understood that the Central Permitting
Department issuing the permit may require certr'mates of coverage of workers compensation insurance
to issuance of the permit and at any time durin the er
carrying out the work g P matted work from any poor 'I
person firm or corporation
Company or Name Ne
Sign w/T - ..
Date� K`\y
• O
Appointment of Lien Agent: Details-LiensNC Lien Service https://apps.liensne.com/scr/appointment/details.html?entryNumber=...
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed 0 2114/2 018
Entry #: 799908 Initially filed by: ComfortHomes
Designated Lien Agent Project Property Print & Post
WPC National title Insurance Company Oxford Woods lot 28 l7
".e. D
76 CLARENDON COURT
Online:swot,Humes eomnr.....u..�...i AN41tR,NC 27501 irtItelnYX:t.1
Address:le w.Hargett sr,Suite 507/Raleigh.NC Hamen County El
na' Co ntractors:
Phone:858-690-1354 Please post this notice on the lob Site.
enauaen_svl Property Type Supplien and Subcontractors:
End:vnpnunshcrianC :a.eww,.. Scan this image with your smart phone to
view this filing.You can then file a Notice
1-2 Family Dwelling toLien Agent for this project.
Owner Information
Comfort Homes,Inc.
P 0 Box 369
Clayton, NC 27528
United States
Email:comfnhomesa aol.com
Phone 919-553-3242
View Comments(0)
Technical Support Hotline:(888)690-7384
I of I 2/14/2018,2:05 PM
HARHETT COUNTY CASH RECEIPTS
**a CUSTOMER RECEIPT aw*
Oper: 7BROCK Type: CP Drawer: 1
Date: 3/86/18 52 Receipt no: 277277
Year Number Amount
2818 58843468
76 CLARENDON CT
ANGIER, NC 27511
B4 BP - ENV HEALTH FEES
f75B.8B
NEW TANK
COMFORT HOME INC
Tender detail
CK CHECK HYMEN 38811 $750.00
Total tendered
Total payment $750.08
Trans date: 3/06/18 Time: 13:16:18
** THANK YOU FOR YOUR PAYMENT **