HomeMy WebLinkAboutDOCUMENTS Initial Application Date: \\ \ `S I / Application#
I CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street,Lillington, NC 27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.hamett.org/permits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LANDUSEAPPLICATION"
LANDOWNER: �Z CT U.C._ Mailing Address: Ce-S '•�C.J�CrI)
City: ,,__,, `` State: Zip: Contact NNo:: w 22 ww,, ,, Email:
APPLICANT*: !A.LJ I-4-1 LG.G Mailing Address: 33UD �F4 i1L��rYc.AUL 64.4 zzO
��tt -- v •
City: Girl ,y►ybOr-n State: /VesZip:Z?y10 Contact No:
`Please fill out applicant information If different than landowner /� r6•�Wt
!�
CONTACT NAME APPLYING IN OFFICE: 1 (�+r(�.i 6_10 i _ Phone# CtIO-c(Gs-S(.,St
PROPERTY LOCATION:Subdivision: O\ ri_JCn lc
Lot#: 22.• Lot Size: 0.1,(49State Road# 51. State Road Name: �.\\(1(,() .�. k- ' Map Book&Page:.' 2.61113Iri
Parcel: Ot6504 017.6 GS- PIN: 0514-k is SZZI• Du�
Zoning: )(Flood Zone: Ni Watershed: t Deed Book&Page:35LAS /O401 Power Company*:
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
ZZ� ll Zs Monolithic
SFD:(Size J.$ x29,./)#Bedrooms! #Baths:_Basement(w/wo bath):_Garage:11 Deck:AI Crawl Space:_Slab:_ _Slab: X
(Is the bonus room finished?(_)yes (_)no w/a closet?( )yes (J 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: X 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) x 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 L )yes ( )no
Structures(existing o propose :Single family dwellings: anufactured Homes: Other(specify):
9copolf-a
Required Residential PropertyrLine Setbacks: Comments:
Front Minimum 6s Actual 3q
Rear
Closest Side
Sidestreet/corner lot 2.0
Nearest Building
on same lot
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON L A� 14th1 ?!0 J4 -r0 YL,
____LX.cfEDIA40 6. ma 1--Kcan Torn ?. oy\ c. rah-I- 1--
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 s ements aar�re��accurate and correct to the best of my knowledge. Permit subject to/revocation if false information is provided.
Signature of Owner ner'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**
4 MICHAEL P. GRIFFIN , cwttfy that uno.r my dbectcan and
syowwWan this mqr was drown from an actual MWd aumX that the error of
down of the swwy as calculated by coordinate.Ar 1: 14000+; that the
arra shown hw.wn wee calculated by coordinate&
Maness my hand and sed this day of AILW7H 2017.
p yd.44bN
5 21°07'07" E -- 55.00'
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\ PAO I o 15.00' \
1 231 21 .00' Li"' 0 21 1
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PROPOSED o E
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l co f 16.00' 4ry 20.00' � co
7.0
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CONC
Q `^ o ` DRIVE 280—
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mo
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- - IT , o07107" W . 55.0
HALLOW OAK STREET
50'PUBLIC RAN SETBACKS
FRONT 35'
REAR 25'
SIDE MIN. 5'
SIDE AGG. 15'
LEGEND BIT• 000510
PRELIMINARY EIP EXISTING IRON PIPE FES FLARED END SECTION o
IPS IRON PIPE SET WM WATER METER ty� ti
NOT FOR RECORDATION, RNV RIGHT OF WAY Co CLEAN OUT 1
SALES OR CONVEYANCE WF NOW OR FORMERLY FH FIRE HYDRANT
EIS EXISTING IRON STAKE CB CATCH BASIN
CIL,
� GRIFFIN LAND SURVEYING, INC PLOT PLAN
FOR
1 ,,-- FUQUAY — VARINA , NC 27528 WJH, LLC.
may (91 f) — 58 7 1 983
OLDE FARM VILLAGE
DRAWN BY KDF DATE 7/19/17 LOT 22
HALLOW OAK STREET
CHECKED BY MPG SCALE 1" i 20' NORTH CAROLINA
HARNETT COUNTY ANDERSON CREEK TWSP.
09/09/11 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 hamett 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 IAJ Cat JU rh.r.4 &kmh LLC Date &o&gin
Site Address 15?_ a/0,0(1)044-Si- Phone Q tG• SL1
Directions to job site from Lillington61.1 iU(I, 141A.AI Z I0.5r 6
6. to 64-. 4fia -i-urn Q onto g• f-rbrt+4
Subdivision b 61-)Nrl lit 11 Gt(d�L Lot 02-
Description
ZDescription of Proposed Work J' �.�, #of Bedrooms L
Heated SF I s2JJ Unheated SF 34`? Finished Bonus Room/ AJ Crawl Space Slab X
General Contractor Information
ciut - 33(�Z�Z- oc o
Building Colitractors Company Name Telephone
33p) kt-1.1.163rookia A IlL4 f23o Curec146boro TTeilz.ea .1c,,ryu4fhome6.
Address Z74,110 Email Address cony
4-1 42.
License #
Electrical Contractor Information
Description of Work LLLL4 (t(aA-TV►64.64!) Service Size 212 Amps T-Pole J4Yes No
Cherare v LLtC 4x -! 33/1-584•QOQO
Electrical Contractor s Company Name Telephone
I 1140 i TX.54-.GZDO Audi.h51.6 ,z-72.1 5-
Address Email Address
1O51,(4)
License#
Mechanical/HVAC Contractor Information
Description of Work t r-•
011.4cor+Air ?;3Ct- q-730
Mechanical Contractors Company Name Telephone
Ern( 5E7 (i rivtS 2 ?
Address Email Address
License #
Plumbing Contractor Information
Description of Work P1UMIO t n TIi14,-0 ( #Baths
3&,f lL P1uY1►�L i-c� G- 33u • 44`76.042.f
Plumbing Contractor s Company-Name Telephone
1-153g Letut, 1.4,14e. 20 .
Address Email Address
2..U5
License#
Insulation Contractor Information
$u Iid.V62�501 v 4t. •1A-QSat
Insulation Contractor s Company Name &Address Telephone
*NOTE General Contractor 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 sianina 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 cu ent fee sschhe'd^leg<_
Iblq 1)7
Signature of�r/Contractor er s of Corporation Date
9 ( ) P
Affidavit for Worker's Compensation NC G S 87-14
The undersigned applicant being the
General Contractor Owner V Officer/Agent of the Contractor or Owner
Do hereb confirm under penalties of perjury that the person(s) firm(s)or corporation(s)performing the work
set fort n 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 U I&{Liu rn t-l-tol S
Sign w/TitleZeUAlakaS Pi,fNl t-"C,rly /kt . v' Date OM/0
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 10/02/2017
Entry #: 731079
Initially filed by: wjh2013
Designated Lien Agent Project Property Print & Post
Investors Title Insurance Company OFV 22 ❑��.-.
152 Hallow Oak St ...•r
Spring Lake,NC 28390
Online:www.liensnc.com��, ,,, �:�,.,,,,,,,,
ft
Address:19 W.Hargett St.,Suite 507/Raleigh,NC Harnett County
,.:
❑
27601
Contractors:
Phone:888-690-7384 Please post this notice on the Job Site.
Fax:913-489-5231 Property Type Suppliers and Subcontractors:
Email:sunnort(dliensnc.com .,,...,•,-F,.,..,•...... Scan this image with your smart 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 230
Greensboro, NC 27410
United States
Email:trabitz@wadejumeyhomes.com
Phone:919-995-5654
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Technical Support Hotline:(888)690-7384