DOCUMENTS InitialApplication Date:3l6/2018 App 8 50OW- Si 1
lication# `s�� �—r 5
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.harneh.org/permits
-'A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION'-
LANDOWNER:Timothy Britton Mailing Address:3109 NC 210 N
City: Lillington State:NC Zi 27546 Contact No: 919-669-6798 Email: britton.tj@gmail.com
APPLICANT`:Emerald Energy(John Leoanrd) PO Box 99031
Mailing Address:
City: Raleigh State:NC Zip:27624 Contact No: 919-247-3670 Email: tohnleonard@emeraldenergyn<
'Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE:John LeonaarrddL _ /�I,, _ Phone#919-247-3670
PROPERTY LOCATION:Subdivision:s 121 Olki+YIYJ. .3S Lot#: ^ Lot Siey I• 13 RL.
State Road#3155 State Road Name: NC 210 N Map Book&Page: (7T-S
Parcel: 110661 0034 01 0661-04-3928.000
qq /yy � PIN:
Zoningl\ ti's° Flood Zone: WA Watershed:SActuw Deed Book&Page: 3336 / 0871 Power Company': Duke Energy Progress
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
Watershed: Cape Fear River(Lillington)Class-WS-IV,Cape Fear River(Dunn)Class-WS-IV
PROPOSED USE:
Monolithic
❑ SFD:(Size—x-1#Bedrooms'._#Baths:_Basement(w/wo bath):_Garage:_Deck:_Crawl Space:_Slab:_Slab:_
(Is the bonus room finished?(_)yes L)no w/a closet?(_)yes (_)no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms_if Baths_Basement(w/w°bath)—Garage: Site Built Deck:_ On Frame Off Frame_
(Is the second floor finished?(_)yes (_)no Any other site built additions?( )yes (J 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: Use: Hours of Operation: #Employees:_
Addition/Accessory/Other:(Size 31 x 12' Grid Tied,Roof Mounted Solar Array (_J yes (�
a ry 1 Use'. Closets in addition? 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(5001 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: Manufactured Homes: Other(specify):
Roof Mounted, Grid Tied, Solar, - 17 Panels
Required Residential Property Line Setbacks: Comments:
Front Minimum Actual
Rear
Closest Side
Sidestreet/comer lot
Nearest Building
on same lot
Residential Land Use Application Page 1 of 2 03111
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: North on NC 210 N. house on right hand side.
If permits are granted 1 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.
John Leonard 3/6/2018
gr.g.
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 03/11
09/09111 Application#
Harnett County Central Permitting
Each eecbon below to be hXstl outPO Box 85 Langton NC 27546
by whomever Performing work 910 893 7525 Fax 910 893 2793 www hamelt mg/permits
Must be owner or licensed
contractor Address company Application for Residential Building and Trades Permit
name 8 phone must match
Owners Name Timothy Britton Date 3/6/2018
Site Address 3155 NC Hwy 210 N Lillington, NC 27546 phone 919-669-6798
Directions to job site from Lillington Head North on 210, house on right
Subdivision Lot
Description of Proposed Work Grid Tied, Roof Mounted Solar Array #of Bedrooms
Heated SF Unheated SF Finished Bonus Room/ Crawl Space _Slab
General Contractor Information
Emerald Energy 919-247-3670
Building Contractor s Company Name Telephone
PO Box 99031, Raleigh, NC 27624 johnleonard@emeraldenegync.com
Address Email Address
69879
License#
Electrical Contractor Information
Description of Work Solar Tie In Service Size _Amps T-Pole _Yes_No
Wiring Solutions Plus 919-795-8291
Electrical Contractors Company Name Telephone
4509 Meadow Pine Drive, Knightdale, 27545 wiringsolutionsplus@yahoo.com
Address Email Address
25181
License#
Mechanical/HVAC Contractor Information[
Description of Work
Mechanical Contractors Company Name Telephone
Address Email Address
License#
plumbing Contractor Information
Description of Work #Baths
Plumbing Contractors Company Name Telephone
Address Email Address
License#
Insulation Contractor Information
Insulation Contractors Company Name&Address Telephone
*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 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 manna below I have obtained all subcontractors
permission to obtain these permit}and if ate(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-0 Months to 2 years permit re-issue fee is$150 00 After 2 years re-issue fee
is as per current fee schedule
3/6/2018
Leonard "—
Signature of Owner/Contractor/Officer(s)of Corporation Date
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
k 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
k 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 workers 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 Emerald Energy
Sign wdNew LeorQMTer -... Date 3/6/201
Interconnection Request Application Form
for Interconnecting a Certified Inverter-Based
Generating Facility No Larger than 20 kW
This Interconnection Request Application Form is considered complete when it
provides all applicable and correct information required below. Additional
information to evaluate the Interconnection Request may be required.
Processing Fee
A non-refundable processing fee of $100 must accompany this Interconnection
Request Application Form.
If the Interconnection Request is submitted solely due to a transfer of ownership
of the Generating Facility, the fee is $50.
Interconnection Customer
Name: Timothy Britton
Contact Person: Timothy Britton
Email Address: britton.tj@gmail.com
Address: 3109 NC 210 N
City: Lillington
State: NC
Zip: 27546
County: Harnett
Telephone (Day): 9196696798
(Evening):
Fax:
Contact(if different than Interconnection Customer)
Name: John Leonard
Email Address: johnleonard@emeraldenergync.com
Address: 8673 Harps Mill Rd
City: Raleigh
State: NC
Zip: 27615
County: Wake
Telephone (Day): 9192473670
(Evening):
Fax: •
Owner(s) of the Generating Facility:
1
NC 20 kW Inverter
Generating Facility Information
Facility Location (if different from above):
Address: 3155 NC 210 N
City: Lillington
State: NC
Zip: 27546
County: Harnett
Utility Duke Energy Progress
Account Number: 7340215370
For photovoltaic sources only:
Inverter Manufacturer: Inverter: 1 x SolarEdge Technologies 7.6 kW
Model: (Model SE7600H-US (240V))
Total panel capacity: Inverter Rating (ea): 7.616 kW AC Efficiency: 99%
Nameplate Rating (each inverter): PV Module Array: 17 x Silfab 310W(Model
SLA310M)
Module Rating (ea): 310 W DC, 279.8 W PTC
Tilt: 27 Azimuth: 230 Tracking: Fixed
Nameplate Rating: 5.27 kW DC
AC Rating: 4.709 kW CEC-AC
Estimated Annual Production: 6808 kWh
Design Factor: 86.6 %
7.6 kVA(Ac) (each inverter)
240 Volts(Ac) (each inverter)
Phase: Single Phase
System Design Capacity: 5.27kVA(Ac)
Maximum Physical Export kW(Ac)
Capability Requested:
Prime Mover Photovoltaic
ENERGY SOURCE TABLE
Renewable Non-Renewable
H-1. Solar— Photovoltaic
Is the equipment UL 1741 Listed?
2
NC 20 kW Inverter
If Yes, attach manufacturer's cut-sheet showing UL 1741 listing
Estimated Installation Date 3/19/2018
Estimated In-Service Date 4/4/2018
The 20 kW Inverter Process is available only for inverter-based Generating
Facilities no larger than 20 kW that meet the codes, standards, and certification
requirements of Attachments 3 and 4 of the North Carolina Interconnection
Procedures, or the Utility has reviewed the design or tested the proposed
Generating Facility and is satisfied that it is safe to operate.
List components of the Generating Facility equipment package that are currently
certified:
Number Equipment Type Certifying Entity
1.
2.
3.
4.
5.
3
NC 20 kW Inverter
Interconnection Customer Signature
I hereby certify that, to the best of my knowledge, the information provided in this
Interconnection Request Application Form is true. I agree to abide by the Terms
and Conditions for Interconnecting a Certified Inverter-Based Generating Facility
No Larger than 20 kW and return the Certificate of Completion when the
Generating Facility has been installed.
Signed:
Title: Date:
4
NC 20 kW Inverter
Terms and Conditions
for Interconnecting a Certified Inverter-Based
Generating Facility No Larger than 20 kW
1.0 Construction of the Facility
The Interconnection Customer (Customer) may proceed to construct
(including operational testing not to exceed two hours) the Generating
Facility when the Utility approves the Interconnection Request and returns
it to the Customer.
2.0 Interconnection and Operation
The Customer may interconnect the Generating Facility with the Utility's
System and operate in parallel with the Utility's System once all of the
following have occurred:
2.1 Upon completing construction, the Customer will cause the
Generating Facility to be inspected or otherwise certified by the
appropriate local electrical wiring inspector with jurisdiction, and
2.2 The Customer returns the Certificate of Completion to the Utility,
and
2.3 The Utility has either:
2.3.1 Completed its inspection of the Generating Facility to
ensure that all equipment has been appropriately
installed and that all electrical connections have been
made in accordance with applicable codes. All
inspections must be conducted by the Utility, at its own
expense, within ten Business Days after receipt of the
Certificate of Completion and shall take place at a time
agreeable to the Parties. The Utility shall provide a
written statement that the Generating Facility has passed
inspection or shall notify the Customer of what steps it
must take to pass inspection as soon as practicable after
the inspection takes place; or
2.3.2 If the Utility does not schedule an inspection of the
Generating Facility within ten Business Days after
receiving the Certificate of Completion, the witness test is
deemed waived (unless the Parties agree otherwise); or
2.3.3 The Utility waives the right to inspect the Generating
Facility.
5
NC 20 kW Inverter
2.4 The Utility has the right to disconnect the Generating Facility in the
event of improper installation or failure to return the Certificate of
Completion.
2.5 Revenue quality metering equipment must be installed and tested
in accordance with applicable American National Standards
Institute (ANSI) standards and all applicable regulatory
requirements.
3.0 Safe Operations and Maintenance
The Customer shall be fully responsible to operate, maintain, and repair
the Generating Facility as required to ensure that it complies at all times
with the interconnection standards to which it has been certified.
4.0 Access
The Utility shall have access to the disconnect switch (if a disconnect
switch is required) and metering equipment of the Generating Facility at all
times. The Utility shall provide reasonable notice to the Customer, when
possible, prior to using its right of access.
5.0 Disconnection
The Utility may temporarily disconnect the Generating Facility upon the
following conditions:
5.1 For scheduled outages upon reasonable notice.
5.2 For unscheduled outages or emergency conditions.
5.3 If the Generating Facility does not operate in a manner consistent
with these Terms and Conditions.
5.4 The Utility shall inform the Customer in advance of any scheduled
disconnection, or as soon as is reasonable after an unscheduled
disconnection.
6.0 Indemnification
The Parties shall at all times indemnify, defend, and save the other Party
harmless from, any and all damages, losses, claims, including claims and
actions relating to injury to or death of any person or damage to property,
demand, suits, recoveries, costs and expenses, court costs, attorney fees,
and all other obligations by or to third parties, arising out of or resulting
from the other Party's action or inactions of its obligations hereunder on
6
NC 20 kW Inverter
behalf of the indemnifying Party, except in cases of gross negligence or
intentional wrongdoing by the indemnified Party.
7. 0 Insurance
All insurance policies must be maintained with insurers authorized to do
business in North Carolina. The Parties agree to the following insurance
requirements:
7.1 If the Customer is a residential customer of the Utility, the required
coverage shall be a standard homeowner's insurance policy with
liability coverage in the amount of at least $100,000 per
occurrence.
7.2 For an Interconnection Customer that is a non-residential customer
of the Utility proposing to interconnect a Generating Facility no
larger than 250 kW, the required coverage shall be comprehensive
general liability insurance with coverage in the amount of at least
$300,000 per occurrence.
7.3 The Customer may provide this insurance via a self-insurance
program if it has a self-insurance program established in accordance
with commercially acceptable risk management practices.
8.0 Limitation of Liability
Each Party's liability to the other Party for any loss, cost, claim, injury, or
expense, including reasonable attorney's fees, relating to or arising from
any act or omission hereunder, shall be limited to the amount of direct
damage actually incurred. In no event shall either Party be liable to the
other Party for any indirect, special, incidental, consequential, or punitive
damages of any kind.
9.0 Termination
The agreement to interconnect and operate in parallel may be terminated
under the following conditions:
9.1 By the Customer
By providing written notice to the Utility and physically and
permanently disconnecting the Generating Facility.
9.2 By the Utility
If the Generating Facility fails to operate for any consecutive
12-month period or the Customer fails to remedy a violation of
these Terms and Conditions.
7
NC 20 kW Inverter
9.3 Permanent Disconnection
In the event this Agreement is terminated, the Utility shall have the
right to disconnect its facilities or direct the Customer to disconnect
its Generating Facility.
9.4 Survival Rights
This Agreement shall continue in effect after termination to the
extent necessary to allow or require either Party to fulfill rights or
obligations that arose under the Agreement.
10.0 Assignment/Transfer of Ownership of the Facility
10.1 This Agreement shall not survive the transfer of ownership of the
Generating Facility to a new owner.
10.2 The new owner must complete and submit a new Interconnection
Request agreeing to abide by these Terms and Conditions for
interconnection and parallel operations within 20 Business Days of
the transfer of ownership. The Utility shall acknowledge receipt and
return a signed copy of the Interconnection Request Application
Form within ten Business Days.
10.3 The Utility shall not study or inspect the Generating Facility unless the new
owner's Interconnection Request Application Form indicates that a Material
Modfication has occurred or is proposed.
8
NC 20 kW Inverter
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Application Number 18-50043518 Date 3/13/18
Property Address 94447 *UNASSIGNED
PARCEL NUMBER 11-0661- - -0034- -01-
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name C B MATTHEW ESTATE
Property Zoning RES/AGRI DIST - RA-40
Owner Contractor
BRITTON TIMOTHY & CHERYL EMERALD ENERGY
492 HILLIARD RD PO BOX 99031
FUQUAY-VARINA NC 27526 RALEIGH NC 27624
(919) 247-3670
Applicant
EMERALS ENERGY
PO BOX 99031
RALEIGH NC 27624
(919) 247-3670
--- Structure Information 000 000 ROOF MOUNT SOLAR PANELS
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE SOALR PANELS
WATER SUPPLY UNKNOWN
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc . SOLAR PANELS
Phone Access Code 1233220
Issue Date . . . 3/13/18 Valuation . . . . 0
Expiration Date . 3/13/19
Special Notes and Comments
T/S : 03/09/2018 03 : 06 PM JBROCK ----
3155 NC 210 N
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 18-50043518 Date 3/13/18
Property Address 94447 *UNASSIGNED
PARCEL NUMBER 11-0661- - -0034- -01-
Application description . CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name C B MATTHEW ESTATE
Property Zoning RES/AGRI DIST - RA-40
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc . SOLAR PANELS
Phone Access Code 1233220
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 211 E211 R*ELEC ABOVE CEILING / /
999 217 E217 R*ELEC RECONNECT _/_/_
999 205 E205 R*ELEC UNDER SLAB / /_
999 215 E215 R*ELEC. UND. POOL / /_
999 213 E213 R*ELECTRICAL UNDERGROUND _/_/_
999 131 R131 ONE TRADE FINAL /_/_
999 125 R125 ONE TRADE ROUGH IN / /_
HARNETT COUNTY CASE
TS
CUSTOMER RECEIPTC***
***
Date: I
3R13/18 52 RCK eceiptpe: PDrawer:
no: 286697
Year Humber Amount
2818 58043518
94447 *UNASSIGNED
LILLINGTON, NC 27546
I DI BP - PERMIT FEES 308.88
SOLAR PERMIT
JOHN LEONARD
Tender detail 0B.88
CP CREDIT CARD g 3
Total tendered SUM
Total payment
Trans date: 3/13/18 Time: 18:38:25
** THANK YOU FOR YOUR PAYMENT **