DOCUMENTS Initial Application Date: St 631j 4 Application# 12S I ` 1413q' /(.4
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street,Lillington,NC 27546 Phone:(910)893-7525 ext2 Fax:(910)893-2793 www.harnett.org/permits
"A RECORDED
/SURVEY
.rMAP,RECORDED DEED(OR OFFEROETO PURCHASE)Rj &SITE PIAN ARE REQUIREDWHEN SUBMITTING� ,An LANDUSE APPLICATION"
LANDOWNER:j1g I-I enn51 rixk lAAc 1 a-w f l it..Mailing Address: 0 / (61 &e e z eiitJ--`__W� /Ave;/1 /�fee1�Vei)
City:(il(C(4(.0 II( State:JOL Zip: )1)83 Contact No: 910'yt('/li- MY Email:'L cI1r4Lhclr E12kka 6.63n
APPLICANTS SAIL& AS (l4 k ODLOi a 2 Mailing Address:
City: State: Zip: Contact No: Email:
'Please fill out applicant information if different tha/n landowner/� y� (�/� 1 /. (� ` 77 I� (p t�L `/G
CONTACT NAME APPLYING IN OFFICE:/{,^, II una lflQ nS.VI ryJ/ v CA-111C IY'Lrl, 9/0 Zd(J-We'V
PROPERTY LOCATION:Subdivision: ///R Ilianu>Z (e,, 7Cy/01 //0/J lU/Jbn Lot ft: tF'sr Lot Size: '0•a-`o at.
State
(-
State Road# State Road Name: Map Book&Page: Jc% 1 / 9 c,
Parcel: L0 clf}j LSlr1 0 3—Ma 3� PiN: 11
k. . coo /�
Zoning:/a4-7DX Flood Zone: �i Watershed: . Deed Book&Page:3593 /0d-37 Power Company: (lee,/
tai/erg(
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
t 1 a j CMonolr,
(EY---SED:(Size \OxS�l )#Bedrooms: #Baths._Basement(/w/wo bath):NU Garage: Deck:W Crawlrawl Space:_Slab:_Slab:
(Is the bonus room finished?( )yes ( F.)no w/a closet?U yes (1,..)
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: 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?( )yes 1/)no
Does the property contain any easements whether underground or overhead(/‘)yes ( )no ...L.T.tailh
Structures(existing or proposed):Single family dwellings: t Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual 35
Rear ()S aS. �l
Closest Side SI IC a4-41 '
Sidestreet/corner lot JU ct.kC
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:
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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 statements are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
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 2 03/11
O MICHAEL P. GRIFFIN , celly that undo my daemva and
superulthat
closure of the*nayhis map w calculated by mattes I: ro, 0 ♦elle that the aN d'4 ✓�
oro ao.a hereon was calculated by caa'duatm. �y5g6 p7 p2 .
Mtaece my haw end nes this day of MOWN mon O9 d t
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IUNDERGROUND 1
UTILITY EASEMENT PRO?
CONC
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-------------- . (:
--_5 ,j2a7"W—78.38' 1
— L
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PITTFIELD RUN
50' PUBLIC/UTILITY RAN
SETBACKS
FRONT 35'
REAR 25'
SIDE(ONE 5192) 5'
SIDE(ONE SIDE) 10'
CI R=5000'L=6.22'N61°31'24"2 6.21' CORNER SIDE 20'
C2 R=25.00'L=22.12'553°1551"W 21.41'
C3 R=25.00'L=39.27 N26°2O03"W 35.36'
LEGEND
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/permits
by whomever performing work.
Must be owner or licensed
contractor. Address,company Application for Residential Building and Trades Permit
name 8 phone must match
Owner's Name: H&H Constructors of Fayetteville. LLC. Date: K h 116
Site Address: i1? p(a-: ` A, . Phone:
Directions to job site from Lillington:yv�, p1 v
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.
Subdivision: The Manor(rD Lexington Plantation Lot: Lilo
Description of Proposed Work: New Single Family Dwellina #of Bedrooms: L V
Heated SF:a4S_Unheated SF: to 11 Finished Bonus Room? ho Crawl Space: Slab: X
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 Leannahair(rihhhomes.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 electricpopeto7windstream.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 carolinacomfortairo)yahoo.com
Address Email Address
290771-1-3-1
License#
Plumbing Contractor Information
Description of Work #Baths
Dell Haire Plumbing 910-429-9939
Plumbing Contractor's Company Name Telephone
PO Box 65048.620 Gillespie St. Fay, NC 28306 dellhaireplumbincahotmail.com
Address Email Address
32886P-1
License#
Insulation Contractor Information
Tricity Insulation, Inc.418 Person St. Fay., NC 28301 910-486-8855
Insulation Contractor's 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 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.
a../+-. (an � ti s \ , \ 1
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:
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 worker's 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 /" b CAnn(L„� Date: c I I I
Appointment of Lien Agent: Details - LiensNC Lien Service Page 1 of 1
DO NOT REMOVEI
Details: Appointment of Lien Agent Filed on: 05/88/2010
Entry M: 847897 Initially filed by: meaganbradshaw
Designated Lien Agent Project Property Print & Post
Firs'Amencm title Insurance Company MLP000662 Lot 662 Manor @ Lexington El 9tr, l7
Plantation PIN 959541-]]I 6.000 iii -rt
Online:n rcmm
v. ..@swyKetteringOD PittIeld Run(Corner of Kering and �j
Atltlrm.tow.Wgenh,Sui¢50]Imarch,NC Ciern Q "]= t
camamama NC 2e326
27601 Hamel County Con
Phone.86N690-7384 Please post this notice on the Job Sire
Fu 913489-5331
Supplier,and Subcontractors:
Property Type Scan this image vAh your smart Phone
New this filing You can then file a Notice
to Lien Agent for this project
Owner Information 1-2 Family Dwelling
H&H Constructors of Fayetteville,LLC. Date of First Furnishing
2919 Breezewood Avenue Ste 400
Fayetteville NC 28103
United States
Ennuileannehart®hhhomes cons 04424/20/8
Phone',910486-4864
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Technical Support Hotline:(888)6909184
https://apps.liensnc.com/scr/appointment/details.html?entryNumber=847897&printable= 5/8/2018