DOCUMENTS •
Initial Application Date: 11 I n Application# I< 1-f-)14 ,}4ct_s-
CU#
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.hamett.org/permits
"A RECORDEDTSURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNERt� SetS0n ?or Mailing Address: O I peavey Gree 0rl' r
L
City: V/ATA State:NC zlpiA2?Contact No: 9,17 Mo Eman:;kpelec{ritol tr7 hhoc,;),corn
o
APPLICANT': cOCSO& We< Mailing Ft P,to,vrr Crest Otto f
f
City: 5.)n r. 1 State: NC Zip:7Avt/ Contact No: 19 noo?s7 Email: ',13/0e1 C4(H)1r1O1ltro/I.antPlease fill out applicant infomiaaon it different than landowner t1
CONTACT NAME APPLYING IN OFFICE: On
JCn rpopt Phone# 9/Q $&00837
PROPERTY LOCATION:Subdivision: Rennet Oar C Lot#: 3 / Lot Size: I .77Ac-
State Road# l State Road Name: Q9'1V r r Creek pdatt Map Book&PageaC" / 44174
Parcel: at a. 1 Sa 8 X �
b07 %b PIN: I5a8 - �"R y - 35'15• 0t-
ZoningQ.P30Flood Zone: Watershed: Deed Book&Page:Onnx�LI/ 0 p /Power Company': Dv kG
`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 )#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: ,�// 1Use': �aJJ t-{+ Hours of Operation:
. #Employees:_
❑ Addition/Accessory/Other:(SizeS2.). PaySJ Use: BMA Of?ICe --Finish QN(C <OQ/L Closets in addition?(_)yes ( )no
Water Supply: County F� 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 (V(no
Does the property contain any easements whether underground or overhead(_)yes (a/'no
Structures(existing or proposed).Single family dwellings:✓ Manufactured Homes: Other(specify):
Required Resid tial Property Line Setbacks: Comments:
Front Mini um Actual
Rear
Closest Side
Sidestreeucerner lot
Nearest Building
on same lot
Residential Land se i.plication Page 1 of 2 03/11
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS`� � TO THE PROPERTY FROM LILLINGTON: 41‘9.1IOWNHL"-nn . J.e14 Or. So I
t1 . -a tKlL� 44 n l�eor. Ahth4lorc Art, Ler4 sit gens Por. c
rr1 d titi.� .
e“ nn 4n eiraorr (nee I-os4 ),oucr on Ie FA
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 revocation if false information is provided.
t -7-IS
i ture of Owner 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 employbes 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
OB/09/11 Application#
Harnett County Central Permitting
Each 1000f1 babwbbe Ned outPO Box 65 LiAmgen NC 27516
try whomever performing work B10 BB3 7525 Fax 870 993 2783 www hornetoryhpermM
Must be owner or licensed
000tsctor Add10ss 0p1epany Application for Residential Building and TradesP
name 8.phone most match Penni(
Owners Name to_soti P QL Date '-7-1 rel
Site Address?! Benue Crecy Dr-Arc %m-. A1C 9833 c( _Phone 9/q 2W 0257
Directions to lob site from Lillington H#I Tcr.rart) Ginn . Le-Ff o,. 30 (-12,1 ,pre clienswc 1-ef.J
IrksJUeijSorc Q') LeF+ in{n QeneY• p yy cod al Vision . Left or +r Rpc0 Car
(kw L
(reek Dnn c 1- (inti as I&Al
Subdivision Ren di- Place Lot
Description of Proposed Work Fnfcl.allfc Veer /AIn., £011 a MCC #of Bedrooms 0
Heated SF Unheated SF inished Bonus Room/_Crawl Space _Slab
�f General Contractor Information
�1[3so.. POp f 9/9 Pao 083 7
Building ContrActors Company Name Telephone
f eJecM?S(u)4a1r,c,r),co•-t
Address Emad Address
License#
lect • i r •12r ii • hi i•n gnist-dis
Description of Work i • . ice . L. 1 Service Size y.. Amps T-Pole _Yes
Sq<n. H Pepe PInfh-re Co.,.}rnrlrrc 1-4—C /9 V0 08:17
Electrical!� Contractors Company Name Telephone
WI Uea,rer Creele orioc n,M, .Ne &b31y shy el eefr;cal n")EvrFmpi 1.nM
Address Billed Address
/-27/17 44-U
License#
Mechanical/HVAC Contractor Information
Description of Work ZSotsc.x Port
9X7k 06537
Mechanical Contractors Company Name Telephone
Address Email Address
License it
plumbmg Contractor Information
Description of Work -CQsc Pcp, #Bathe .3 todt,l/2 ex1sf-A.s
9/9 PRD °k3V
Plumbing Contractors Company Name Telephone
Address
Email Address
0 \M rte+ +
License#
Insulation Contractor Information
—Cad a. P . 9/Q Ra0oyn7
Insulation Contractors Company Name&Address Telephone
*NOTE General Contractor must fell out and sign the second pegs 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 pv sronma below I have obtained all subcontractors
permission to obtain these Donnas and if my changes occur including listed contractors site plan
number of bedrooms budding 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 urrent fee sc edule
-- —7'�F
lir lure of ontractorlOhicer(s)of Corporation Date
Affidavit for Worker'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 penury 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 certrficates 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
Coompany or Name
fin Wilde / / 19§te '3]/II S(
e Date 31 ') I 18
Plan Box# L Job Name Po?
Plan Name 1
App # A J4•q5 Valuation o?6 2oB SQ Feet 773
Garage
= P13
Inspections for SFD/SFA
Crawl_ Slab_ Mono_ Basement_
Footing Footing Plum Under Slab Footing
Foundation Foundation Ele. Under Slab Foundation
Address Address Address Waterproofing
Open Floor Slab Mono Slab Plum Under slab
Rough In Rough In Rough In Address
Insulation Insulation Insulation Slab
Final Final Final Open Floor
Rough In
Insulation
Final
Foundation Survey_ Envir. Healthj& - Other
Additions/ Other
Footing_
Foundation_
Slab_
Mono_
Open Floor_
Rough In
Insulation_
Final