DOCUMENTS Initial Application Dater) ) O Application# t' bC) ly
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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 PURR�CHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING,A LAND USE APPLICATION"
LANDOWNER:If17, 14I`�r( +5J Iz*H/I1 .Mailing Address: 4-)9/61 /�(.'� fi ii(A�,,f/Cy�II�'(7P� J� l�
city:Etngc(k.UI Ile- State:/Lc Zip: ad lD 3 Contact No: 9/O*&'-WIY Email:'1C1J1rlL1.I,fLlr EikiniarneS'eM
APPLICANT*: 5 A4u. f AS (4k)O(CLJA)E 2 Mailing Address:
City: State:_Zip: Contact No: Email:
'Please flll out applicant Information if efferent than landowner
r� (�^ (� r G
CONTACT NAME APPLYING INOFFICE://F,^, i Iy',n1 ei I� as i cu q / / //I(-yI-/lYyf -v Ly ^h
PROPERTY LOCATION:Subdivision: ///-t Itaaria/Z 6) (ext7)Ojf4Q /"/04//(Jfl0 Lot#:W • a Lot Size'rI 0 •cleS
State Road# Sta- Road Name: ap :ook&Page:!i /& ,
Parcel: �j(1"1 • / • • ►NM PIN: • ' like I
^ AA
Zoning:Y i-ZGR Flood Zone: A Watershed: Deed Book&Peg- e a tai / Power Company /1: l of%'�G/ifr r
'New structures with Progress Energy as service provider need to supply premise number "' from Progress Energy.
PROPOSED USE f D J / ?
t l q7 boliV,ic
� SFD:(Size Y x I)#Bedrooms:� #Baths._Basement(w/wa bath):/Uo Garage: Deck:� Q{f0 Crawl Space:_Slab: Slab:_
(Is the bonus room finished?( )yes ( )no w/a closet?( )yes ( I no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms_#Baths_Basement(w/wo bath) Garage: Site Built Deck: On Frame Off Fame_
(Is the second floor finished?( )yes U no Any other site buitt additions?( )yes (_)no
❑ Manufactured Home:_SW_DW_N/(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 x )Use: Closets in addition?( )yes ( )no
Water Supply: eZ County _Existing Well New Well(#of dwellings using well )'Must have operable water before final
Sewage Supply: New Septic Tank(Complete Checldist) Existing Septic Tank(Complete Checklist _County Sewer /
Does owner of this tract of land,own land that contains a manufactured home withiy(fIve hundred feet(500')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: V Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
I
Front Minimum 35Actual
'
Rear r)C I,1c:
Closest Side yl ID I • /
SidestreeVcorner lot rA/
Nearest Building —
on same lot '
Residential Land Use Application Page 1 of 2 D3/1I
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
lli C 2/0 .ioctxi'<d/ -9/7.,/, (OA e,t jU/-if 1/ o.n
e • l • f✓cP. n ea✓ los c. Over-di((
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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 tements are accurate and correct o t e besj of my knowledge. Permit subjrev V false information is provided.
Signature of OwnerWor OOwne 3IDate�\< �Q(
"'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
4 MICHAEL P. GRIFFIN . certify that under my direction and
sup.Hnm this mop ars atom Fan an actual rare neve, that the.,u-of
Sown of the sew as cm[Wated by Md0#orn 1e t.' 10.000*; that the
area sham hereat was calculated by rordlarp
Mite=my nand and sew tors cloy of MOWN lata ie y
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30'SEIMEKUTILITY
---I— EASEMENTEASEMENT
IO UNDERGROUND 4
UTILITY EASEMENT
I 11.60'
����� CI 39°59'12"E —_—_—_—_
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PITTFIELD RUN
50 PUBuuuTIury war SETBACKS
FRONT 35'
REAR 25'
SIDE(ONE SIDE) 5'
512E(ONE 510E) I O'
CORNER SIDE 20'
CI R=325.00'L=61.53'N34°3153!f GI.79'
I FC. F M n
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/pensits
by whomever performing work.
Must be owner or licensed
contractor. Address,company Application for Residential Building and Trades Permit
name&phone must matchI
Owner's Name: H&H Con _ for a��11-tte ille _C.
/-Data '�/6/_
Site Address: ., S t at \C. W U n Phoned/O` 86 -yo W
Directions to job site from Lillington: NC Hwy 210 to Spring Lake. Turn Rt. On Overhills turn left to stay on
Overhills. Continue straight onto Nursery. Turn Rt. On 24/87. Turn Rt on Sawyer. Keep Straight.
,^ I '
Subdivision: The Manor(dr Lexington Plantation Lot: Q7
Description l!oa�f Proposed Work: New Sin�gst7e Family Dwelling #of Bedrooms:
Heated SFLY'Unheated SF: Finished Bonus Room? Crawl Space: Slab: V
General Contractor Information
H&H Constructors of Fayetteville, LLC. 910-486-4864
Building Contractor's Company Name Telephone
2919 Breezewood Ave. Ste,400 Fay., NC 28303 Leannahairahhhomes.com
Address Email Address
74158
License#
Electrical Contractor Information
Description of Work Service Size: 200 Amps T-Pole: X Yes No
JM Pope Electric, Inc. 919-776-5144
Electrical Contractor's Company Name Telephone
409 Chatham Street Sanford, NC 27330 electricpope( windstream.net
Address Email Address
21326
License#
Mechanical/HVAC Contractor Information
Description of Work
Carolina Comfort Air, Inc. 919-934-1060
Mechanical Contractor's Company Name Telephone
5212 US Hwy 70 Business, Clayton, NC 27520 carolinacomfortair@yahoo.com
Address Email Address
29077 H-3-I
License#
Plumbing Contractor Information (� GG
Description of Work #Baths(�( .5
Dell Haire Plumbing 910-429-9939
Plumbing Contractor's Company Name Telephone
PO Box 65048,620 Gillespie St. Fay, NC 28306 dellhaireplumbinq((?hotmail.com
Address Email Address
32886P-1
License#
Insulation Contractor Information
Tricky Insulation, Inc. 418 Person St. Fay., NC 28301 910-486-8855
Insulation Contractors Company Name&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.
Or is 3laa1
� -
Signature of Owner/Contras fficer(s) of Corporation Date
Affidavit for Worker's Compensation N.C.G.S. 87-14
The undersigned applicant being the:
X 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:
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.
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: H&H Constructors of Fayetteville, LLC. /I��//
Sign w/Titl �� /Permitting Coordinator Date3I CJR'� I D
Appointment of Lien Agent: Details- LiensNC Lien Service Page 1 of 1
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 03/20/2018
Entry g: 819925 Initially filed by: meaganbradshaw
Designated Lien Agent Project Property Print 8 Post
First American Tale Insurance Company MLP900642 lot 642 Manor®Lexington I 1 rO
Plantation
254['infield Run
nddreu:IOW.Huget Sr,Suii 507/Wkigh NC Cameron,NC 28326 Qi
27601Hames County
Contractors:
P6cn..858.90a384 Please post this notice on the lob Site
Fut
EmaIL eseasnl property Type Suppliers and Subcontractors:
Scan this image with your smart phone to
w this("dung You can then file a Nonce
in Lien Agent for this project
1-2 Family Dwelling
Owner Information
118E1 Constructors of Fayetteville,LLC. Date of First Furnishing
2919 Breezewood Avenue Ste 400
Fayetteville, NC 28303
Untied States 03/0/2018
Email leannahair@hhhomes win
Phone 910-986-4864
View Comments(0)
Technical Support Hotline:(888)690.2984
https://apps.liensnc.com/scr/appointment/details.html?entryNumber=819925&printable= 3/20/2018
Date 1IoCWJ r
Plan Box # P q Job Name
Plan Name LrifsQ,
313y 0236eApp Valuation Aw SQ Feet
Garage 461
= a?oI
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 v Envir. Health_ Other
Additions/ Other
Footing
Foundation
Slab_
Mono_
Open Floor_
Rough In
Insulation_
Final