TRADE
~~D~Y~i ( C4 0
Application #
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
Telephone Number 910-893-4759
www.harnett.org
Certification of Work Performed
/ By Owner/Contractor
ll~J JI rood- l" U.j
r Owner (s) of Structure: r
Owner (s) Telephone: 9 10 -293 -447 ci J ,mi/ r
l
Owner (s) Mailing Address: P 0. ~Qx 2" -
Construction or Site Address: m-
Yjob Cost:
✓Description`of Work to be done
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork _ Gas Piping _
I
Electrical: 200 Amp _ <200 Amp _ Service Change _ Service Reconnect _ Other
Plumbing: Water/Sewer Tap _ Number of Baths _ Water Heater
S ecific Directions to Job from illin tan:
Subdivision: Lot
1 f ✓j / IlM G-~S have provided or will provide the \C labor
(Name) \e i (Trad )
on this structure. I am the owner or hold a NC state license number
(Trade)
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 State and Local laws,
ordinances and regulations. r
Owner (s) signature: Date:
a
Contractor's Name: II t.✓4f'5 1,,4 Date: y
&-/J•P ~i v ~/VC 6z-s
Address: /I/
County: k S t,15, C,/
Contractor's License: O S
Contractor's Signature:
10/05
I
ZONING VERIFICA71ON
Town of L Illington MAY 24 2006
P O Box 296
lob West Front Street
Llllington, North Carolina 27546 TO N OF LILLINGTON
Phone: 910/893-2654 'Fax: 910/8933693
NOTE: This application must be accompanied by a $35.00 fee and plat plan drawn to scale showing property
lines and all buildings andlorsigns located on property. A Water/Sewer Application MosT accompany all
Zoning Verification applications for proposed land. use that will require connection to the'Lilfington
waterlsewer system.
(Street AddresslLocation of Property: 5U
loU
Zoning Property: L.I RA-A L] R Lj C-1 C-2 L] C-3 L] f L] OS
, Book, Page Map Book, Page
Property Identification Numbeeer~(Deed
Proposed Use of Property: ';6d j
Nature of Project (Check all that apply):
L]. Residential- F1 New L_( Alteration L] Demolition f.1 Grading
r I Non-Residential r ] .Addition L] Move Lj Filling ( ) Dredging
Water Systenn. [_j" Publiic Lj 'Private Property Located Within Town Limits?. L]. Yes r I No
Sewer SystenrLj Public L] Private Property Located Within Flood Plain Area? U Yes L1 No
Measure merits from Property Lines and Other Structures:
Front Property Line: Feet Left Side Property Line: Feet-
Rear Property Feet Right Side Property Line: Feet
From Other Structures'.' Feet From Comer Line (if applicable) Feet
1. APPLICANT (Owner, er ntafive, Architect or Engineer):
Name:
Address: Phone: O
Conrad Person:
. OWNER(S) OF PROPERTY Of Different from Applicant):
Name:
Address:
Contact Person: Phone:
3. PROJECT DEVE L PER (If Di ferepr from Owner):
Name: d S
Address t 3 Phone. 9 ! 0 389 SQ17
ContactPerson: ~ A/'- .,s
I , hereby certry that an of the information furnished in this applnaf , nd f included materials, are true to the best of myr/o~w~IJmowledge.
Date: 6
owner/Agent Signatu
- Office Use Only -
PPR9l{ED--t;OMMEN--"-------- -
L] DENIED
Fl ood Map PaneiNumber. Elevation of Lowest Floor Above MSL-
F
-
Zoning Administrator. At.
i
2006006300
HARNETT COUNTY TAX ID# FOR RffMj;eitE" RUISao aN OF DEEDS
slut' si PM
KW PG:222-226 FEE:93.0
Recording c Boo an Page
Parcel ID No. 65 Verified by County on the _ day of , 20_
i Br
Mail/Box to: st Broad Street. Dunn-NC 28334
Phis imtrutnew ass prepare j h a Attorney w
Brief description for the index:
NC N WARRANTY DEED
This deed m . M ay of Marc 005 by and between:
GRANTOR: G TE ;
GARY COUn LARD and wife, IN Y FOOD HART, LLC
ASHIMA COUILLARD
1922 Sugarstone Drive 11 421 stir
Lawrenceville GA 30043 Luling N 2 6
The designation Grantor and Grantee as uscd herein shall inc s arts s r hens, successors, and
assigns, and shall include singular, plural, masculine, feminine or re d y context,
I
WnNESSETH: that the Grantor, for a valuable consideration paid by tee, of which is -Yll
hereby acknowledged, has and by these presents doth grant, bargain, sell o ey unto Grantee in
fee simple, all that certain lot or parcel of land situated new the City of Lhv~inQin
Lillineton Township, Hametl County, North Carolina, and more partic 1 de d a follows:
SEE ATTACHED EXHTHIT "All
INCORPORATED HEREIN BY REFERENCE AND MADE
A PART OF THIS INSTRIIMFNT,