DOCUMENTS R - PLAN CHANGE Initial Application Date: FI r� (� Application# I (cj43F0
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION 1
Central Permitting 108 E.Front Street,Ellington,NC 27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.harnett.org/permits
"A RECORDED SURVEY MAP.RECORDED DEED(OR OFFER TO PURCHASE)&SEW 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:Same
City: Same State:_Zip: Contact No: Same Email: Same
`Please fill out applicant infcomalon If different than landowner
CONTACT NAME APPLYING IN OFFICE: Leanne Hair Phone it 1 919-0866-48664
PROPERTY LOCATION:Subdivision: Anderson Creek Club Lott C1639:1 Lot Size: (.0(0 .1Q t
State Road#1117 State Road Name: Nursery Road Map Book&Page: 0 14 1 .414-E
Parcel: lei y'OS3S '13 al co l2 PIN: EDCr>C-919% - 1 Stob . 00n
�r South River
Zoning:9-1Q 2oILF:cod Zone: Yu Irv,Watershed: .o Deed BookPageaS 11 root Power Company`:
New structures with Progress Enemy as service provider need to supply premise number from Progress Energy.
PROPOSED USE: Pr.
r 1 ,. �1 / Monolithic
IS SAD:(Size x 1.69)#Bedrooms:#Baths:.r.Basement(w/wo bath):,r a Garage:�l�''yDI'eck:_Crawl Space:_Slab:vSlab:_
(Is the bonus room finished?( )yes (Si no w/a closet?(J yes T no(if yes add in with#bedrooms)
❑ Mod:(Size_x )#Bedrooms_#Baths_Basement(wAvo bath)_Garage:_Site Built Deck:_ On Frame_OH Frame_
(Is the second floor finished?L__)yes ( )no Any other site built additions?( yes (J no
❑ Manufactured Home:_SW_DW_TW(Size x )#Bedrooms:_Garage: (site built? )Deck:_(site built? )
❑ Duplex:(Size )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 trap listed above?U yes (.71 no
Does the property contain any easements whether underground or overhead(4)yes ( )no
Structures(existing or proposed):Single family dwellings: I Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 30 Actual 05p
1
Rear 25 -bat
10 nI I
Closest Side
SidestreeVcamer lot 2 13, I
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.27 to Nursery Road,turn left and follow Ray Road.Turn left and
follow to Anderson Creek Drive.
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. Permittsuubjj_etttolrevvoo�tion if false information Is provided.
Signature of or Agent r Da
"it is the ownerlapplicants 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 oft 03/11
/. MICHAEL P. GRIFFIN , crary that"neer my...aka and
supentqcn Ma map was drawn
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SITE PLAN APPROVAL t r� ke
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DISTRICT USE FI2 /
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it ° PROPOSED -71
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GLEN BEND COURT
SCR RAM
REVISION-NEW PIANS 4/24/18
CI R=275.00'L=56.02'565°31'50"E 55.92'
C2 R=25.00'L=51.53'N49°3437"E 42.55'
LEGEND I 1 I%
Application#
Harnett County Central Permitting
PO Box 85 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&phone must match
Owners Name: H&H Constructors of Fayetteville,
1�LLC. Date:_,S__12111.„
Site Address: MD J rs 1 r Phone: 910-486-4864
Directions to job site from Lillington: Hwy 27 to Nursery Road.Turn left,follow to Ray Road,turn left and
follow to Anderson Creek Drive.
Subdivision: Anderson Creek Crossing Lot: gab
Description of Proposed Work: SFD #of Bedrooms: S
Heated SF: 1 r1ic Unheated SF:til‘0 Finished Bonus Room? at Crawl Space: Slab:
General Contractor Information Stun"-,
H&H Constructors of Fayetteville. LLC. 910-486-4864
Building Contractors Company Name Telephone
2919 Breezewood Avenue Ste.400.Fav, NC 28303 Leannahair(plhhhomes.com
Address Email Address
74158
License#
Electrical Contractor Information
Description of Work Service Size: 200 Amps T-Pole: X Yes No
JM Pope Electric LLC. 919-776-5144
Electrical Contractors Company Name Telephone
409 Chatham Street Sanford, NC 27330 electricpopeCWwindstream.net.com
Address Email Address
21326
License#
Mechanical/HVAC Contractor Information
Description of Work
Carolina Comfort Air,Inc. 919-934-1060
Mechanical Contractors Company Name Telephone
5212 US Hwy 70 Business, Clayton,NC 27520 carolinacomfortair(a�yahoo.com
Address Email Address
29077 H-3-I
License#
Plumbing Contractor Information
Description of Work #Baths
Vance Johnson Plumbing Co.. Inc. 910-424-6712
Plumbing Contractors Company Name Telephone
3242 Mid Pine Dr. Fayetteville. NC 28306 etoepferc viplumbinq.com
Address Email Address
07756-P-I
License#
Insulation Contractor Information
Tri-City Insulation 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 lw 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 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 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 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/ritle: /Permitting Coordinator Date: •