DOCUMENTS Initial Application Date: I' `� I I O Application k
DRIB ft ' U UL-14 03 r7
CU#
COMMERCIAL
COUNTY OF HARNETT LAND USE APPLICATION
Central Permltrg (Physical)los E.11FrontSheat,btington,NC 27546 (Mailing)PO Box 65 Ulington NC 27546 Phone:e{ )9910)59939525 opt re 2 Fax':(910)393.27R3 xxwdamef.org/permitt
LANDOWNER: 64- 1 ,e,I, VvtiveOc 'ly Mailing Address: I N2, xvluM J . t
City: RI^e5Creek State:NCZip: a 4contactit coo-S 3- I61O Email. 'Olinbnr6.7eliell.edtl
APPLICANT: 5 Fc, Lam- Mailing Address: Po a Li k'
City: 6✓t CS (reel-L- State: l& Zip:)7506 Contact it glri-B o5-6661-f Email: bb S 60 $2-ne'Cohn
'Please fill out applicant information if different than landowner SIndownerr /
CONTACT NAME APPLYING IN OFFICE: 47 neT JltucEctGnc+ Phone it RI9- So5-666�4-/'
PROPERTY LOCAffTlION:Subdivision: c- Lot#: '� Lot
,,Sii`ze: �A •Sn']
State Road# VI4 State Road NNam'e`':\ TWrt^o. K-L'• {--� Map Bookok&PaggeeQ-x+LIC 75
Er-
Parcel! I b1f lO `tb(V PIN: 0.i0rjD - / -�X� /0 • &s
Zoning' L 1 V -Aloud Zone: K Watershetlf' *Deetl BookBPage: / Power Company':
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
PROPOSED USE:
❑ Multi-Family Dwelling No.Units: No.Bedrooms/Unit:
❑ Business Sq.Ft.Retail Space: Type: #Employees: Hours of Operation:
❑ Daycare #Preschoolers: If Afterschoolers: #Employees: Hours of Operation:
❑ Industry Sq.Ft: Type: if Employees: Hours of Operation:
❑ Church Seating Capacity: #Bathrooms:
n Kitchen:
1 ' Accessory/Addition/Other(Size x )Use: I&r� r R�ticere.d-'on
Water Supply: J County Existing Well New Well(#el dwellings using well ) *MUST have operable water before final
Sewage Supply: New Septic Tank(Complete Checklist Existing Septic Tank(Complete Checklist County Sewer
Comments:
(li— fit- a ct - i Cc 5
\ .a. ..t_ S `)yen r✓'
If permits are granted I agree tod
pconform 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 are accurate and rrect to the best of my knowledge. Permit subject to revocation if false information is provided.
/1?. S- is- IC
Signature of Owner or Owner's Agent Date
"This application expires 6 months from the initial date If permits have not been issued"
A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATOR
Harnett
(--; COUNTY
NORTH iAROt{NA f �� � ww.lwmrl.ap
Application for Plan Review
I / ,Application# \ p -5(j:114 (33'7
Date Received:_ 51 ILO I I ReceivedIBy:
Name of Project: / Cu J`vrfenT" LcEc Reno/h
Physical Address of Project: 1-14. [lzrn^ott Ra
, NC D-7596
Plans Submitted By: $ vth[C51cnt `o.,5ry'✓c eon of t3L e5 ((re k-i Ur—
Project Phone: (0( 919 )- to5- Ora6H
Contact Person/Address: Brelt S't(c(4^c
d-a S ,/{-2Ai1 er {- f?l _
, N c .a833ci
Contact Email: bn-++5 ez se - n C- LoM
Contact Phone: ( eit )- O5- o4G4 ( )- -
Contractor's Namellnfo: 5ovaq(tint (o15{+ on o-E I3c'cs Gee )C1 LLC-
,a A4t10,4 04
R Y C aCC33`)
Contractor's Phone: ( 919 )- 450S- 6664-1
• Plans that are submitted will be reviewed as quickly as possible with an average time of review
between 7-10 working days.
• Status checks may be conducted on plan reviews by visiting the website
http:llhteweb.harnett.orq/Click2GovBPllndex.isp or by calling the Harnett County Central Permitting
Office (910-893-7525,Option#2),or the Harnett County Fire Marshal's Office (910-893-7580).
• Approved plans must be picked up from the Central Permitting Office and all fees paid before any
required inspections can be conducted.
*Each section below must be filled out by Application#
Harnett County Central Permitting
whoever is performing the work. Must be
owner or licensed contractor. Address, PO Box 65 Lillington,NC 27546
company name & phone must match 910-893-7525 Fax 910-893-2793 www.hamett.org/permits
information on state license. COMMERCIAL
Application for Building and Trades Permit
Owner's Name: Cc.rj1AeO Q
VerS�� Date: s-is- I$
Site Address: 94 7. &PADA 1d- (-%((tny-(wr 1JC Phone: cab-St 3-11 ID
Directions to job site from Lillington:
Subdivision: �tII Lot:
Description of Proposed Work: cn�<nor ac0/44a-Al
Heated SF Unheated SF
General Contractor Information: Building Cost$ 000.0O
EC, &Lc yio-513- S'ifl
Building Contractor's Company Name Telephone
pO (0.00 ncc C'rec(cfive- ?7506 bre{'}$ & 5 •-nGCory
Address Email Address
f dos Kk
Signa ure of Owner/Contract r Rcer(s)of Corporation License#
Electrical Contractor Information: Electrical Cost$ 3 5-eta:).sty
Description of Work Service Size: Amps #T-Poles
Ytx.nps Fleck/c- trr R14-634'-a47
Electricaltontractor's Company Name Telephone
ho Bo - 3. 4s 7471FC1 , uC_ ,�-lso( 6uvc_lNyfm,-5(=Wake.Om
Address Email AddreAs
O. , .V 457)41 -u
Signature df Qytrin r/Contractor/Officer(s)of Corporation Licengsc
Mechanical Contractor Information: Mechanical Cost$ 'o0°.Oe
Description of Work #Units
Jcac oi, ± Sons 1!4-658-5454
Mechanical Contractor's Company Name Telephone
.3304-1-natc . n` cc Qo;ci Rd ley t'Dc-at333 CkAny .5CJ c(c5a 4Aifcn5. ton
Address Email Address
iiid � toss-7
Signa re of ner %ntractor/Officer(s)of Corporation ��---. License#
Plumbing Contractor Information: Plumbing Cost$
Description of Work #Baths
Plumbing Contractor's Company Name Telephone
Address Email Address
Signature of Owner/Contractor/Officer(s)of Corporation License#
Insulation Contractor Information
Insulation Contractor's Company Name&Address Telephone
`NOTE: General Contractor must fill out and sign the second page of this application
Sprinkler Contractor Information
Sprinkler Contractors Company Name Telephone
Address Email Address
Signature of Officer(s)of Corporation License#
Fire Alarm Contractor Information
YOk.r5 Uledrit tele Rlq-63,- 2af-1
Fire Alarfn Contractor's Company Name Telephone
(lbDOC34s Att er , NC aa7sot tefltl `/Ami sa'lecfnt../OM
Address Email Address
Signature bf ffic r(s)of Corporation License#
Driveway Access- NC Department of Transportation Driveway Access/Permit? Yes 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 ifray 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 Hamett 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 charged at full price per current fee-chedule.
; _ '%j S• is-l8
Signature of Owner/Contrac or/Officer(s)of Corporation Dale
Affidavit for Worker's Compensation N.C.G.S. 87-14
The undersigned applicant being the:
J. 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.
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:p�/5��1I Lc-C.-
/�
Sign w/pitle: ;��".`- Y,p`- VP Date: 5-t5- 18
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 05/16/2018
Entry #: 852731 Initially filed hy: Betrlck89
Designated Lien Agent Project Property Print & Post
Chicago Title Company,LLC 44 Harmon Rd lK .1D
Lillington,NC 27546 �? f
online:ww'^'-lienmccm._ ,__ NORTH CAROLINA County
Address:19 W Hargett St.,Suite 507 I Raleigh,NC i] � t
27601 Contractors:
Phone:Sgt-690-7394 Property Type Please post this notice on the Job Site.
Fax:913489-5Th Suppliers and Subcontractors:
Fm.p:suppu=la]Iicwu coal Scan this image with your smart phone to
Other view this filing.You can then file a Notice
to Lien Agent for this project.
Owner Information Date of First Furnishing
Campbell University
05I62018
143 Main Street
Rules Creek, NC 27506
United States
Email:brett( si-nc.com
Phone:919-805-0664
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Technical Support Hotline:(888)690-7384