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DOCUMENTS Initial Application Date.t Q Il\ \ 8 Application S' .tn 44-a as CU# COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION Central Permitting 108 E.Front Street,Lillington,NC 27546 Phone:(910)893-7525 exL2 Fax:(910)893-2793 wnw.hametl.org/permits ^A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION" LANDOWNER:Cummings Brothers Enterprises Mailing Address:P.O. Box 591 City: Manvers State:NC Zip:27522 Contact No: Email'. APPLICANT':Tara Rabitz Mailing Address:3300 Battle ground ave Ste. 101 City: Greensboro State:NC Zip:27410 Contact No: 919-995-5654 Email: Trabitz@wadejurneyhomes.cor *Please Ml out applicant information if different than landowner CONTACT NAME APPLYING IN OFFICE:Tara Rabitz Phone#919-995-5654 PROPERTY LOCATION:Subdivision: Summerhill Lot#:19 Lot�Size:�,.--r10.73 State Road#137 State Road Name: Maple Leaf Ct. Map Book&Page: L(57 / CLI33 parcel: 130539 0200 26 PIN: 0539-98-5670.000 Zoning'.RA-30 Flood Zone:N Watershed:N Deed Book 8 Page:25 JltO / 5/0 Power Company': 'New structures with Progress Energy as service provider need to supply premise number from Progress Energy. PROPOSED USE: 99��I Monoli c SFO:(Size 37 x28 )#Bedrooms.3 ftBaths:y Basement(w/wo bath):_Garage:I Deck:_Crawl Space:_Slab:_Slab:_ (Is the bonus room finished?(_)yes (_)no w/a closet?(_)yes ( )no(if yes add in with if bedrooms) D Mod:(Size x )#Bedrooms_if Baths_Basement(wlwo bath)_Garage:_Site Built Deck._ On Frame_Off Frame_ (Is the second floor finished?(_)yes ( )no My other site built additions?(_J 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: U Addition/Accessory/Other:(Size__)Use: Closets in addition?(_)yes ( )no Water Supply: 1 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 (✓)no Does the property contain any easements whether underground or overhead(___)yes (✓)no Structures(existing or proposed):Single family dwellings:SFD Manufactured Homes: Other(specify): Required Residential Property line Setbacks: Comments: Front Minimum Actuall3 t7 Rear r1 '—x-7^ Closest Side rti'' J SidestreeUcomer lot Nearest Building on same lot Residential Land Use Application Page I 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 Turn left onto Old US Hwy 421 Slight left onto McDougald Rd Turn right onto Oak Leaf Dr Turn right onto Maple Leaf Ct 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 statem are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided. ICCu4 ' Signature of Owner or •Atio 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$months from the Initial date if permits have not been issued' Residential Land Use Application Page 2 ii 2 03111 IMPERVIOUS SURFACE AREA ``„Aqua np DESCRIPTION AREA „ ' ,`44 9--(N C'4R04 ',, HOUSE w/ PORCH 1,093 S.F. Z.ZO.Q-�FESSj ' DECK/PATIO/HVAC 16 S.F. Q `- DRIVEWAY & WALKS 634 S.F. L: ...E SE TOTAL (PROPOSED)= 1,745 S.F. /%� L— 7 9 O , LOT AREA = 31,817 S.F. € ".e,,SUR`„.,.'+.' O $ % IMPERVIOUS AREA 5.5% '¢ .,,,,,.2/4, ........ I .,, NI,M.IIR,H OPp`� FLATWORK WTH R/W = 240 S.F. ob I¶ PO 45\-436 1- i_ ?B 2007• \ VICINITY MAP Not To Scale SFTRACKS; FRONT — 35' SIDE — 10' REAR — 25' — CORNER SIDE — 20' _ N` ' T —1I� L 1,0 scp it Aa 4 L 19 31,817 S.F. 1 0.73 AC I 01 71.5IR w e a) P NO m 20 s 18 w g I. Im A E iEN h r 4 N 1 I!M-A SLAB F M2-CAR I W`I o PER PVH oG 10 48.5 485 CC ce _. 37.0 —k— 20' SLOPE. A . h UPEASEMENT ASEMENSEIAENT — S 6.3 3"W — MAPLE LEAF COURT 50' PUBLIC R/W NAME: tJaAP, 61/1/1.3 140{ t6 APPLICATION ft: *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 1 CONFIRMATION# Environmental Health New Septic System Code 8 00 • All property irons must be made visible. Place"pink p roperty flags'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 qrade 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 910-893-7525 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 8 select notification permit if multiple permits, then use 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 [f applying for authorization to construct please indicate desired system type(s): can be ranked in order of preference,must choose one. (_} Accepted (_} Innovative {c}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 {A}NO Does the site contain any Jurisdictional Wetlands? {_}YES (X) NO Do you plan to have an jmigationsysjrla now or in the future? {_}YES {x}NO Does or will the building contain any dfajns?Please explain. { }YES (X)NO Are there any existing wells,springs,waterlines or Wastewater Systems on this property? {_}YES (1}NO Is any wastewater going to be generated on the site other than domestic sewage? {_}YES {A} 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? OYES (_)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[Am Solely Responsible For The Proper[dentificaton And Labeling Of All Property Lines And Corners And Making The (/SSiite AAcccenssssi�blleea,SSo That A Complete Site Evaluation Can Be Performed. PROPERTY OWNIOR OWNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE E-Healm Checklist 1 of 3 13/10 DocuSign Envelope ID:5C4A7244-A88D-4401-8000-609C7389E449 AGREEMENT TO PURCHASE AND SELL LOT(S)OR VACANT LAND THIS AGREEMENT TO PURCHASE AND SELL LOT(S) OR VACANT LAND (the "Agreement") is made and entered into as of the latest date on which it is signed by either party (the "Effective Date"), by and between WJH LLC, a Delaware limited liability company (hereinafter, "WJH"),and Cummings Brothers Enterprises(hereinafter,the"Seller"). WITNESSETH: WHEREAS, Seller is the owner of certain real property commonly known as SUMMERHILL, and more particularly described on Exhibit "A", which is attached hereto and incorporated by reference (the"Property",or each individual lot being referred to as a"Lot"); WHEREAS, WJH is engaged in the business of building and selling residential real properties in the southeastern United States,among other places,and acquires vacant lots or land from time to time in furtherance of that business;and WHEREAS, WJH desires to purchase the Property from Seller, and Seller desires to sell the Property to WJH. NOW THEREFORE, in and for good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged,the parties hereby acknowledge,agree and covenant as follows: I. DEFINITIONS. The following defined terms shall have the meanings set forth below: a. "Seller": Cummings Brothers Enterprises b. "Purchaser"or"WIN": WJH LLC,a Delaware limited liability company, and/or any of its successors or assigns; c. "Purchase Price": Thirteen Thousand Dollars($13,000.00)per lot with a Total Purchase Price of Fifty-Two Thousand Dollars ($52,000.00). d, "Earnest Money": One Thousand Dollars ($1,000.00), to be deposited in accordance Section 4,below. e. "Escrow Agent": Black,Slaughter,& Black,PA 3623 N.Elm Street,Suite 200 Greensboro,NC 27455 f. "Effective Date": The date on which this Agreement is executed by the latter to sign of Purchaser or Seller,as indicated on the signature page of this Agreement. roe Seller 141 DooiSlgn Envelope ID:5C4A7244-A88D-4401-8000-609C7389E449 EXHIBIT"A" SUMMERHILL,LILLINGTON,HARNETT COUNTY,NORTH CAROLINA (4 LOTS) Lot# Legal Description Address City,State 19 SUMMERHILL S/D 0.73AC 137 MAPLE LEAF CT LILLINGTON,NC 27546 MAP#2007-433 20 SUMMERHILL S/D 0.59 165 MAPLE LEAF CT LILLINGTON,NC 27546 MAP#2007-433 21 SUMMERHILL S/D 0.58AC 195 MAPLE LEAF CT LILLINGTON,NC 27546 MAP#2007-435 22 SUMMERHILL S/D 0.67AC 205 MAPLE LEAF CT LILLINGTON, NC 27546 MAP#2007-435 Seller J'to-s WJH( r D oeuSl9n Envelope ID:6C4A7244-A660.4401.89C D.669C7389 E446 ADDENDUM TO PURCHASE AND SELL LOT(S)OR VACANT LAND By this Addendum to Agreement to Purchase and Sell Lot(s) or Vacant Land (Ow "Addendum"), Seller represents, in good fault, It Is the record owner of the Properly described in the Agreement to Purchase and Sell Lots) or Vacant Land. In the event it is later discovered, whether by htadvertetce or other mistake of fact,that Seller is not the record owner of the Property, the Agreement to Purchase and Sell Lots)or Vacant Land is voidable at the sole and exclusive discretion of Will LLC. If the Agreement to Purchase and Sell Lolls)or Vacant Land is voided by WJH LLC pursuant to the provisions of this Addendum, WJFI LLC shall be refunded any earnest deposit money mud any extension monies,within five(5)days from such demand,even if such demand is made atter the expiration of the Due Diligence Period. WJH shall also be entitled to recover the actual,out-of-pocket fees,costs and expenses incurred by WJH as a result of Sellers failure to be able to convey good and marketable title to the Property.Upon being refunded, WIN LLC and Seller shall have no further obligations or liability to one another. Any capitalized terms used in this Addendum shall have the same meaning as used in the Agreement, Unless otherwise modified by this Addendum,all other terms,conditions and covenants contained in the Purchase Agreement shall remain unchanged. Will LLC oeeus,enm by: Le. i404 744$ (SEAL) erJfaichaudD.Taylor Director of Lot Acquisition Date:2/28/2018 •^-� 1.,, (SEAL) Sp I : L^nmmb gs ZiaLerprlses Ay: J.a(f-1 0.,.mm :v qS Title: Po,px_ 'l Date; 3- 1Li--1 $ (SEAL) Seller: Title: Date: Ds Sellel�le?E'' WJH[Rr Application# 'Each section below to be filled out Harnett County Central Permitting by whomever performing work. PO Box 65 Lillington,NC 27546 Must be owner or licens910-893-7525 Fax 910-893-2793 www.harnett.org/permits contractor. Address,company name&phone must match Application for Residential Building and Trades Permit ((�� Owner's Name: Cummings Brothers Enterprises Date: ()_ Site Address:137 Maple Leaf Ct. Phone: 919-995-5654 Directions to job site from Lillington: Head west on E Front St toward S 1st St Turn left onto Old US Hwy 421 Slight left onto McDougald Rd Turn right onto Oak Leaf Dr Turn right onto Maple Leaf Ct Subdivision: Summerhill Lot: 19 Description of Proposed Work: SFR #of Bedrooms: 3 Heated SF:1606 Unheated SF:401 Finished Bonus Room? No Crawl Space:_Slab: I General Contractor Information Wade Jurney Homes 336-282-3606 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,27520 Ewigly@w3electric.com Address Email Address 11452U License It Mechanical/HVAC Contractor Information Description of Work Heating&Air Comfort Air 336-794-9730 Mechanical Contractor's Company Name Telephone PO Box 527 Commons,NC,27012 Kayaustin@outlook.com Address Email Address 4218 License# Plumbing Contractor Information Description o1 Work Plumbing Install #Baths 2.5 Thornton Plumbing 919-550-4833 Plumbing Contractor's Company Name Telephone 3160 A Vinson Rd.Clayton, NC,27520 Thorntonsplumbing@embargmail.a Address Email Address 22152 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. Homeowners Applying to Build Their Own Home Please answer the following questions then see a Permit Technician to determine if you quality 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? I Yes No 4. Do you intend to schedule, contract, or directly pay for all phases of construction work to be done? 1 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 ay 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/ppr current tee schedule. SSiiga ure of Owner/Cont46 r r Officer(s)of Corporation Date to bile 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:Wade Jurney Homes.LLC Sign Writ! . Date: DO NOT REMOVE! Details: Appointment of Lien Agent Filed on: 05/31/2018 Entry #: 861030 Initially filed by: wJh2013 Designated Llen Agent Project Property Print & Post Investors Title Insurance Company SUM 19 Err'El 137 Maple Leaf Ct C 51.14 Onuoe:www.11ensoctom.a,......,.- Lillingion,NC 27521 K o Address:19 Hargnl Si.,Suite 500/Raleigh,NC Haynes CountyO 27601 Contractors: Phone:g8s-6904384 Please post this notice on the lob Site. Far:913-489-5131 Property Type Suppliers and Subeou mart em.a:ggppol�renme aom�_,__ Scan this image with yourlir smart phone to view this filing.You can then file a Notice 1-2 Family Dwelling to Lien Agent for this project. Owner Information WIH,LLC 3300 Battleground Ave Ste.101 Greensboro, NC 27410 United States Email:trabitzQwadejumeyhomes.com Phone.336-282-3606 View Comments(0) Technical Support Hotlne:1888)690-7384 HARNETT COUNTY CA5F RECEIATS *** CUSTOMER RECEIPT *** her: BBROCK Type: CA Drawer: Date: 6/11/18 52 Receipt no: 365628 Year Number Amount 2018 58844225 91749 TECH 2 LILLINGTON, NC 27546 B4 FG - EMV HEALTH FEES x758.88 NEW TANK WJH LLC Tender detail CK CHECK PAYMEN 17166 4758.08 Total tendered 1758.86 Total payment 4758.88 Trans date: 6111/19 Time: 11:35:55 ** THANK YOU FOR YOUR PAYMENT **