HomeMy WebLinkAboutDOCUMENTS Initial Application Date: 1-11111 )S-- Application# I O SOoy N.)Co
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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.orglpermits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER:BARBARA TESTON Mailing Address:818 RAINEY DRIVE
City: SPRING LAKE State:NC Zip,28390 Contact No'. 704-288-0128 Email: KBIRMINGHAM@POWERHON
APPLICANT':POWER HOME SOALR Mailing Address:818 RAINEY DRIVE
City: SPRING LAKE State:NC Zip:28390
Contact No: 704-288-0128 Email'.
'Please fill cut applicant information fi different than landaunwr
CONTACT NAME APPLYING IN OFFICE:KIMBERLY BIRMINGHAM Phone#
PROPERTY LOCATION:Subdivision: Lot Lc Lot Size: •Vf y
State Road##818 State Road Name:VRAINEY DRIVE MapapBook&Page: 1 I\ / I J D
Parcel:
AA b 11 b$1(4`/b'a0 b yy PIN: os I�t--S i - • � I • U Vv
Zoningl*A?OiAood Zone: 6 Watershed:$. Deed Book&Pagel ea3 A D Y Power Company':
'New structures with Progress Energy as service provider need to supply premise number_ _from Progress Energy.
PROPOSED USE:
Monolithic
❑
SED:(Size x )#Bedrooms:_#Baths:_Basement(wlwo bath):_Garage:_Deck:_Crawl Space:_Slab:_Slab:_
(Is the bonus room finished?( )yes (_)no wl a closet?( 1 yes (_)no(if yes add in with#bedrooms)
❑ Mod:(Sae x )#Bedrooms_#Baths_Basement(wlwo bath)_Garage: Site Built Deck:_ On Frame OR Frame_
(Is the second floor finished?(_)yes (—)no Any other site built additions?(__ )yes LJ no
❑ Manufactured Home:_SW_DW TW(Sire x )#Bedrooms: Garage:_(site built?_)Deck: (site built?_)
❑ Duplex:(Size x )No.Buildings: No.Bedrooms Per Unit:
U Home Occupation:#Rooms: Use: Hours of Operation: #Employees:_
bf Addition/Accessory/Other:(Size x )Use:SOLAR 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(rad listed above?( )yes (_)no
Does the property contain any easements whether underground or overhead(__)yes ( 1 no
Structures(existing or proposed):Single family dwellings: Manufactured_ Homes:yOther
(specify):
Required Residential Pro erty Line Set cks: Comments: VCA In
'°u� •�L11E-Lr- 17 .
Front Minimum Actual
Rear
Closest Side
SidestreeUcorner lot
Nearest Building
on same lot
Residential Land Use A (cation Page 1 of 2 03/11
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
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.
4/10
Signature of Owner or Owner's Agent Date
"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 S months from the initial date if permits have not been issued"
Residential Land Use Application Page 2 of 2 03/11
Application#
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546 - Ph:910-893-7525 - Fx:910-893-2793 - www.hamettorg/permits
Certification of Work Performed By Owner/Contractor
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(Individual rTryI/�e�`A',�1plication) `� 1� yn�
Owner(s)of Structure: �In It b frA —L>•/" 'b 1 , Phone: 10' \ '?j�v 0 O
Owner(s) Mailing Address: EI . I a1, ' .a
f'
Land Owner Name(s): tA /A/, A _MI 1 Phon :a58.01258
Construction or Site Address: ip Fame-4
PIN# QL\ Parcel# of�,��/�y,����y'y,r� `(\y/{1'�/n,
Job CoSt: B cription of Work to be done 33 go IJ r 1 r atir I1V� vV laq
G( .emiKW
Mechanical: New Unit With Ductwork_ New Unit Without Ductwork_ Gas Piping Other
Electrical*: 200 Amp_<200 Amp_Service Change_ Service Reconnect Other
*For Progress Energy customers we need the premise number
Plumbing: Water/Sewer Tap Number of Baths_ Water Heater_
Specific Directions to Job from Lillinnton:
Subdivi
sion:
/'A�t rr/ ye' Lot#:
I ( tic will provide the Vl�\� labor on this structure.
ontractors Name) ) I '
I am the building owner or my NC state license number is
y( —V which entitles me to
perform such work on the above structure legally. All work shall comply with the State Building Code and all
other applicable�!'yState and local laws, ordinances and regulations.
Cbnttrrac Co any-Horne (: \a^� 1OR 19 0 025
con
ot 14 pip plame� ^ /+� TelephoneKr ant +^
Ad Email
N VII I U Email AddresslK,/rll �r 00•
License#� 314-0 �rt41 791
etr----
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Structure Owner/Contractor Signature: Date: y 1
By signing this application you affirm that you have obtained permission from the above listed I cense holder to
purchase permits on their behalf. If doing the work as owner you understand that you cannot rent, lease or sell
the listed property for 12 months after completion of the listed work.
*Company name, address, & phone must match information on license