DOCUMENTS Initial Application Date: S 1 1 r Application# I SL 43c 3
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 RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER:H&H Constructors of Fayetteville, LLC. Mailing Address:2919 Breezewood Ave.Ste.400
City: Fayetteville State:NC Zip:28303 Contact No: 910-486-4864 Email: LeannaHair@Hhhomes.com
APPLICANT*:Same As Owner Mailing Address:2919 Breezewood Ave. Ste.400
City: Fayetteville State:NC Zip:28303 Contact No: 910-486-4864 Email: BethBirch@Hhhomes.com
*Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE:Leanna Hair/Beth Birch Phone#910-486-4864
PROPERTY LOCATION:Subdivision: Highgrove @ ACC Lot#: 3-V3 Lot Size: 0
State Road# State Road Name: Map Book&Page:a01
Parcel: C.)►OSO0 to S 1 PIN: VSOLI - tom - Hyl ( . Ocoo
Zoning: lood Zone: YY,t7 Watershed: 11W Deed Book&Page:343-1 /039�.Power Company*:
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
(j t Z Mono gc
SFD:(Size 4Z x`41- )#Bedrooms:.3 #Baths?'SBasement(w/wo bath): ✓ GaragelC"Deck:ha Crawl Space:_Slab:_Slab:
(Is the bonus room finished?(_)yes ()()no w/a closet?U 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 (i 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 x )Use: Closets in addition?( )yes ( )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(500')of tract listed above?U yes U no
Does the property contain any easements whether underground or overhead(__-)yes (X)no
Structures(existing or proposed):Single family dwellings: Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 25' Actual al ,
Rear 25' Vq,0,
Closest Side 10 1k0
Sidestreet/corner lot 20 —'
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: Hwy 210 North ,turn on Ray Road. Turn left into Subdivision on Highgrov
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.
Signature f Owner or Owner's Agent ate
***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
/, MICHAEL P. GRIFFIN , certify that under my direction and
supervision this mop was drown from on actual field survey, that the error of
closure of the survey as calculated by coordinates is 1: 10000+ ; that the
area shown hereon wos calculated by coordinates.
Witness my hand and seal this day of MONTH 2018. ,1` .dV
00 o2
19,
HIGHGROVE AT ANDERSON CREEK
PHASE 5
PB 2010 PG 692
N 37°54'30"E 127.26'
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17,862 SQ.fT. -o
0.4f AC. (1'
rn
2121
PAT10 1
30.00 (21 41
PR0P05ED
FREELANCE A
12.0 (A)
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42.3' 4.83' 4.83* 24.34'
L ------ `r sr PROP J
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DRIVE
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5 35°4047"W — 70.6? —
NEW CASTLE LANE
GO' R/W
SITE PLAN APPROVAL
DISTRICT USE S SETBACK S
#BEDROOMS FRONT 25'
REAR 25'
SIDE /O'
•` CORNER SIDE 20'
REVISION: RIGHT HAND 2/12/18 Deb ;
C/ R=470.00'L=56.46'N39°07'22"E 5G.45' I do
LEGEND
09/09/11 Application#
Harnett County Central Permitting
PO Box 65 Edlington NC 27546
Each section below to be filled out 910 893 7525 Fax 910 893 2793 www harnett org/permits
by whomever performing work
Must be owner or licensed
contractor Address company Application for Residential Building and Trades Permit
name&phone must match
Owners Name H&H Constructors of Fayetteville, LLC. Date � t cb
Site Address 1--Nkeb I\JLAA) Cs- Phone
Directions toob site from Lillington Hwy 210 North and turn left on Ray Road. Turn left into subdivision
on Highgrove Drive.
Subdivision Highgrove @ Anderson Creek Lot a-t
Description of Proposed Work New Single Family Dwelling #of Bedrooms 3
Heated SF I iRa-1 Unheated SF LA Finished Bonus Roomy Yvo Crawl Space Slab X.
General Contractor Information
H&H Constructors of Fayetteville, LLC. 910486-4864
Building Contractors Company Name Telephone
2919 Breezewood Ave. Ste.400 Fayetteville,NC 28303 LeannaHair@hhhomes.com
Address Email Address
74158
License#
Electrical Contractor Information
Description of Work Service Size 200 Amps T-Pole XYes_No
JM Pope Electric,Inc. 919-776-5144
EI ctric I Cpntrac or s C mpny 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. 910-891-1239
Mechanical Contractors Company Name Telephone
703 N. Clinton Ave. Dunn, NC 28334 CarolinaComfortAir@yahoo.com
Address Email Address
29077 H-3-1
License#
Plumbing Contractor Information
Description of Work #Baths
Vance Johnson Plumbing, Inc. 910-424-6712
Plumbing Contractors Company Name Telephone
3242 Mid Pine Road Fayetteville,NC 28306 VanJohnson@vjplumbing.com
Address Email Address
07756-P-1
License#
Insulation Contractor Information
Tricity Insulation Inc. 418 Person St. Fay. NC 28301 910-486-8855
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 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
Signature oflOwner/Contractor/Officer(s)of Corporation Date
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
X General Contractor Owner X_ 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
X 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.
Sign w/Title ,�, ,, c Permitting Coordinator Date c3 \ '
LIEN AGENT INFORMATION
Effective April 1,2013
In accordance with North Carolina General Assembly Session Law 2012-158,
Inspection Departments are not allowed to issue any permit where the project cost
is $30,000 or more unless the application is for improvements to an existing
dwelling that the applicant uses as a residence OR the property owner has
designated a lien agent and provided the inspections office with the information
below: •
Name of Lien Agent First American Title Insurance Company
Mailing address of Agent 19 W Hargett Street Ste. 507
Raleigh,NC 27601
Physical address of Agent Same As Mailing
•
Telephone 1-888-690-7384 Fax 919-489-5231
•
Email www.liensnc.com
The information will be attached to the permit record and a copy provided to the
applicant. The applicant is required to post a copy on the construction site.
Excerpt from North Carolina G.S. 160A-417:
"(Effective April 1,2013)No permit shall be issued pursuant to subdivision(1)of subsection(a) of
this section where the cost of the work is thirty thousand dollars($30,000)or more, other than for
improvements to an existing single-family residential dwelling unit as defined in G.S. 87-15.5(7)that
the applicant uses as a residence,unless the name,physical and mailing address; telephone number,
facsimile number,and electronic mail address of the lien agent designated by the owner pursuant to
G.S. 44A-11.1(a)is conspicuously set forth in the permit or in an attachment thereto. The building
permit may contain the lien agent's electronic mail address. The lien agent information for each
permit issued pursuant to this subsection shall be maintained by the inspection department in the
same manner and in the same location in which it maintains its record of building permits issued."
www.liensnc.com
Appointment of Lien Agent: Details - LiensNC Lien Service Page 1 of 1
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 04/30/2018
Entry #: 843120
Initially filed by: meaganbradshaw
Designated Lien Agent Project Property Print & Post
First American Title Insurance Company HGR000213 Lot 213 Highgrove @ Anderson ❑e *• •❑n
Creek �r•�'
Online:www licnsnc corn.,,,..._.i.m�..,� 468 NEW CASTLE LANE
Address:19\V.Hargett St.,Suite 507/Raleigh,NC Spring Lake,NC 28390
27601 Harnett County
Contractors:
Phone:888-690-7384 Please post this notice on the Job Site.
Fax:913-489-5231
EmaO: lienenc rnm .,- .• Property Type Suppliers and Subcontractors:
ww ori'd Scan this image with your smart phone to
view this filing.You can then file a Notice
to Lien Agent for this project.
1-2 Family Dwelling
Owner Information
Date of First Furnishing
H&H Constructors of Fayetteville,LLC.
2919 Breezewood Avenue Ste.400
Fayetteville,NC 28303
01/30/2018
Email:leannahair@hhhomes.com
Phone:910-486-4864
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Technical Support Hotline:(888)690-7384
https://apps.liensnc.com/scr/appointment/details.html?entryNumber=843120&printable= 4/30/2018