DOCUMENTS Initial Application Date: SII SI
I g Application# t SSV C 't'. O.; LI
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street,Ellington,NC 27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.hamett.orglpermits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER:Curr-Well Developments, LLC Mailing Address:21 Little Farm Circle
City: Angier State:NC Zip:27501 Contact No: 9196327255 Email: cunie@adamshowell.com
APPLICANT:WJH,LLC Mailing Address:3300 Battleground Ave.Ste 101
City: Greensboro State:NC Zip:27410 Contact No: 919-995-5654 Email: Trabitz@wadejumeyhomes.cor
'Please fill out applicant information If different than landowner
CONTACT NAME APPLYING IN OFFICE:Tara Rabitz Phone#919-995-5654
PROPERTY LOCAI@IDN:Subdivision: Quail Hollow Lot#: I t.o Lot
Size:iz✓;ORI
State Road It I tin1..n State Road Name: Deanne Ln. /l// ' I Map Book&Page:r err�r/MT)
Parcel: (T tit( 006V3S PIN: I(,// �7y /3-(.
Zomig:,,,,11"Flood Zone: A) Watershed: A/ Deed Book&Rage:151U /OCE6 Power Company': Duke
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROP SED USE:
2 Monolidtic
SFD:(Sizea x93 )#Bedrooms:3 It Baths: Basement(w/wo bath): Garage: ✓ Deck:_Crawl Space:_Slab:_Slab: x7
(Is the bonus room finished?(_)yes ( )no w/a closet?(_)yes (_)no(If yes add in with#bedrooms)
❑ Mad:(Size_x )#Bedrooms_#Baths_Basement(wtwo bath) Garage: Site Built Deck: On Frame_Off Frame_
(Is the second floor finished?( )yes (_)no Any other site built additions?(_)yes Lino
❑ 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/Accesssory/Other:(Size_x )Use: Closets in addition?( )yes (_)no
Water Supply: V County Existing Well New Well(*of dwellings using well )"Must have operable water before final
Sewage Supply: I 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 (✓)no
Does the property contain any easements whether underground or overhead(_)yes (L)no
Structures(existing or proposed):Single family dwellings:Proposed
Manufactured Homes: Other(specify):
fy):
Required Residential Property Line Setbacks: Comments:
Front Minimum Actual
Rear l/01(')..CI
Closest Side
Sidestreeticomer lot
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: Head west on E Front St toward S 1st St
Continue on S Main St.Take US-421 S and NC-27 E to Ebenezer Church Rd in Coats
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.
tua.abl 51 2..1�Ci
Signature of Owner or Owner's Agent Date [DJ
"'h 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 issuer
Residential Land Use Application Page 2 of 2 03/11
NAME: LA)adP,. Y)fYIIU fUOmL' J APPLICATION#:
*This application to be filled out when applying for a septic system inspection.*
County Health Department Application for Improvement Permit and/or Authorization to Construct
IF THE INFORMATION IN THIS APPLICATION IS FALSIFIED,CHANGED,OR THE SITE IS ALTERED,THEN THE IMPROVEMENT
PERMIT OR AUTHORIZATION TO CONSTRUCT SHALL BECOME INVALID. The permit is valid for either 60 months or without expiration
depending upon documentation submitted. (complete site plan=60 months;complete plat=without expiration)
910-893-7525 option I CONFIRMATION#
Environmental Health New Septic System Code 8 00
• All property irons must be made v isible.Place"pink p roperty fags" o n each corner iron of lot. All property
lines must be clearly flagged approximately every 50 feet between corners.
• Place"orange house corner flags"at each corner of the proposed structure. Also flag driveways, garages, decks,
out buildings, swimming pools, etc. Place flags per site plan developed at/for Central Permitting.
• Place orange Environmental Health card in location that is easily viewed from road to assist in locating property.
• If property is thickly wooded, Environmental Health requires that you clean out the undergrowth to allow the soil
evaluation to be performed. Inspectors should be able to walk freely around site. Do not grade property.
• All lots to be addressed within 10 business days after confirmation.$25.00 return trip fee may be incurred
for failure to uncover outlet lid,mark house corners and property lines, etc.once lot confirmed ready.
• After preparing proposed site call the voice permitting system at 910493-7525 option 1 to schedule and use code
800 (after selecting notification permit if multiple permits exist)for En vironmental Health inspection. Please note
confirmation number given at end of recording for proof of request.
• Use Click2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
❑ Environmental Health Existing Tank Inspections Cod e 800
• Follow above instructions for placing flags and card on property.
• Prepare for inspection by removing soil over over outlet end as diagram indicates, and lift lid straight up(if
possible)and then close back down. (Unless inspection is for a septic tank in a mobile home park)
• After uncovering outlet end call the voice permitting system at 910-893-7525 option 1 &select notification permit if
multiple permits, then u se code 800 for Environmental Health ins pection. Please note confirmation number
given at end of recording for proof of request.
• Use Click2Gov or IVR to hear results. Once approved, proceed to Central Permitting for remaining permits.
SEPTIC
If applying for authorization to construct please indicate desired system type(s): can be ranked in order of preference,must choose one.
{__} Accepted {_} Innovative {Si Conventional (_} Any
{ } Alternative {_} Other
The applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in
question. If the answer is"yes",applicant must attach supporting documentation.
{ }YES {x}NO Does the site contain any Jurisdictional Wetlands?
{}YES (,) NO Do you plan to have an irr'eaCnn system now or in the figure?
{ }YES {x}NO Does or will the building contain any drains?Please explain.
{ )vES 90 NO Are there any existing wells,springs,waterlines or Wastewater Systems on this property?
{ }YES (X) NO Is any wastewater going to be generated on the site other than domestic sewage?
{_}YES {o5,}NO Is the site subject to approval by any other Public Agency?
{_}YES {X}NO Are there any Easements or Right of Ways on this property?
{'YES (_}NO Does the site contain any existing water,cable,phone or underground electric lines?
If yes please call No Cuts at 800-632-4949 to locate the lines. This is a free service.
I Have Read This Application And Certify That The Information Provided Herein Is True,Complete And Correct. Authorized County And
State Officials Are Granted Right Of Entry To Conduct Necessary Inspections To Determine Compliance With Applicable Laws And Rules.
I Understand That I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site Accessible So That A Complete Site Evaluation Can Be Performed.
PROPERTY OWN OR OWNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DA E
E-Health Checklist I of 3 12/10
MD
AU- DIAMENSONS. LOCATIMS AND FEATURES MOWN ON
THIS PLOT PLAN ARE APPROXIMATE AND ARE ONLY AN
ARTISTS RENDITION, EXACT LOCATIM OF ALL FEATURES
ARE SVB.ECT TO CHANGE AND MAY NOT BE INSTALLED
o $ EXACTLY AS SHOWN ON PLANS NID/OR IN MCOELS.
d� —N— PLACEMENT OF HMC. DRIVEWAY, 9DEWALKS AND
• EXTERIOR FEATURES ME SUBJECT TO MCOIFDATIM AS
.,'% C0.. o
i -o L9 DEEMED NECESSARY BY FIELD PERSONNEL
1/4 NUNu 40
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SHE -0 CUSTOMER DATE
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b CUSTOMER DATE
I' EBEN o- . . ROAD p
WADE JANEY REPRESENTATIVE DATE
Si
-M_ APPROVAL FOR .SrAKINGF
IS
THIS
MIDAS PREPARED
APPROVED FOR STAfNG ON THE
VICINITY MAP DATE SHORN BELOW.
Not To Scale
WADE JURNEY HOMES REPRESENTATIVE DATE
SFTRA— IMPERVIOUS SURFACE AREA
FRONT - 35' DESCRIPTION AREA
REAR - 25'
SIDE - 10' HOUSE w/ PORCH 1,247 S.F.
SITE PLAN APPROVAL DECK/PATIO/HVAC 9 S.F.
C (� DRIVEWAY & WALKS 364 S.F.
DISTRICT_/___�,/_3YZ SF, -0 TOTAL (PROPOSED)= 1,620 S.F.
#BEDROOMS 2-, LOT AREA = 17,417 S.F.
` �� '� R IMPERVIOUS AREA =9.3R
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468'28'01"W
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HARNETT COUNTY CASH RECEIPTS
aaw CUSTOMER RECEIPT raa
Oper: TBROCK Tyne: CP Drawer: 1
Date: 5/15/18 52 Receipt no: 357074
Year Number Amount
2018 50044024
91749 TECH 2
LILLINGTOH, NC 27 ENV HEALTH FEES
46
B4 $750.08
NEW TANK
*MLLE
Tender detail_
CK CHECK PAYMEN 15563 $750.80
Total tendered $758.08
Total payment
Trans date: 5/15/16 Time: L1:00:22
x* THANK YOU FOR (BUR PAYMENT **
44
*Each section below to be filled out Harnett
# III5nnY OZ
Hdfne
by whomever performing work.
PO
Central Permitting
Must be owner or licensed PO Box 65 Lillington,NC 27546
contractor. Address,company 910-893-7525 Fax 910-893-2793 www.harnetLarg/permits
name 8 phone must match
Application for Residential Building and Trades Permit
Owner's Name: Cuff-Well Development,LLC Date:
Site Address:147 Deanne Lane Phone: 919-623-7255
Directions to job site from Lillington: Head West on E Front St.towards S 1st St.Continue on S.Main St.Take
US-421 S and NC-27 to Ebenezer Church Rd. in Coats.
Subdivision: Quail Hallow Lot: 16
Description of Proposed Work: Single Family New Residential #of Bedrooms: 3
Healed SF:1000 Unheated SF:216 Finished Bonus Room?No Crawl Space:_Slab:
General Contractor Information
WJH,LLC 919-995-5654
Building Contractor's Company Name Telephone
3300 Battleground Ave.Ste.101 Trabitz@wadejurneyhomes.com
Address Email Address
49262
License#
Electrical Contractor Information
Description of Work Electrical Install Service Size: 200 Amps T-Pole: ✓ Yes_No
W-3 919-550-7341
Electrical Contractor's Company Name Telephone
308 W.Main St. Clayton,NC,27528 Ewiggly@w3electric.com
Address Email Address
11452U
License it
Mechanical/HVAC Contractor Information
Description of Work Heating and Air
Comfort Air 336-794-9730
Mechanical Contractor's Company Name Telephone
PO Box 527 Clemmons NC 27012 kayaustin@outlook.com
Address Email Address
4218
License#
Plumbing Contractor Information
Description of Work Plumbing Install #Baths 2
Thomton's Plumbing 919-550-4833
Plumbing Contractor's Company Name Telephone
3160 A Vinson Rd.Clayton NC 27520 Thomtonsplumbing@embargmail.cr
Address Email Address
4218
License#
Insulation Contractor Information
Builders Insulation 919-788-9806
Insulation Contractor's Company Name&Address Telephone
'NOTE:General Contractor must fill out and sign the second page of this application.
RESIDENTIAL BJir DING APP'.ICA-HON 1a2 C4.n
Homeowners Applying to Build Their Own Home
Please answer the following questions then see a Permit Technician to determine if you qualify for permit under Owners Exemption.
Questionnaire per G.S.87-14 Regulations as to Issue of Building Permits (Memo available upon request)
1. Do you own the land on which this building will be constructed? Yes d No
2. Have you hired or intend to hire an individual to superintend and
manage construction of the project? / Yes No
3. Do you intend to directly control & supervise construction activities? ! Yes No
4. Do you intend to schedule, contract, or directly pay for all phases of
construction work to be done? d Yes No
5. Do you intend to personally occupy the building for at least 12 consecutive
months following completion of construction and do you understand that if
you do not do so, it creates the presumption under law that you fraudulently
secured the permit? Yes d No
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 I affirm that I have obtained all listed contractors
permission to obtain these permits and if a�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.
7r,z41
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:
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:
1 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:
WJH,LLC
Sign w/Title: rs Date:
RESIOFN NAI RU'' DING tPPLICAI ION 20'2 04,11
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 05/08/2018
Entry #: 846639 Initially filed by: w)h2013
Designated Lien Agent Protect Property Print & Post
Investors Title Insurance Company QLH 16
147 Deanne Lane
onaoe.www.liensnccom_. ......_... Coats,NC 27521 x 's
Address:19 W Hargan Sr.Suite 5011 Raleigh:N< Harnett County El_W
27601
Contractors:
Phone:888-690.7384 Please post this notice on the lob Site.
Pei:911489-5231 Property Type Suppliers and Subcontractors:
Email:map3aasn om;,... , Scan this image with yourman phone to
view this filing.You can then file a Notice
1-2 Family Dwelling to Lien Agent for this project.
Owner Information
WJH,LLC
3300 Battleground Ave Suite 101
Greensboro, NC 27410
United States
Email: abit i wadejumeyhomes com
Phone 336-282-3606
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Technical Support Hotline:(SS8)690-7384