TRADES Jul Ju uD x.ep
i
Application #
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910-893-7525 Fax 910-893-2793
www.harnelt.org/permits
Certification of Work Performed By Owner/Contractor
(Individual Trade Application)
Ov ner (s) ofi structure: Phone:
Ov ner (s) Md iling Address: -7
La d Owners Jame (s): Phone:
Cc istructioni x Site Address:
PII or Parcel # from GIS:
Jol Cost: Description of Work to be done 1
-OF
,hanical: I New Unit With Ductwork- New Unit Without Ductwork ZGas Piping
BE .trical': 200 Amp _ <200 Amp _ Service Change _ Service Reconnect, Other _
' For Progress Energy customers we need the premise number
Ph. nbing: Water/Sewer Tap _ Number of Baths _ Water Heater
SP cific Dir tions to Job from Lillington: i
Su division: { Lot
I will provide the labor on this structure.
(Contr ;tors Name) (Trade)
I ai i the buil ng owner or my NC state license number is /,?,f 03 which entitles me to
pei orm suchi work on the above structure legally. All work shall comply with the State Building Code
ant all other applicable State and local laws, ordinances and regulations.
I
i
Str cture owl er(s) signature: Date: 2 3v •y
Cc ipany N4 ne: Phone: ek
Addrg;s: 120A ~ i2-2 ! ,~.5L1 f~~ 7~ 3
Count Contractor's License l3 ss~?
Contr; ctor's Signature: Date: ) - R)-c S
`Coma )any name, address, & phone must match information on license.
I
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I ~~~c0a 1-N0~ NAME ROBINSON DORA j
_ D g~ lI
9s~ee3zlasmo - iZ'1
AQDR3 ; P D. BOX 151
CAMERON F
= STATE I NO 156
ZIP 283260000 _
-Parcel.InforDn3tion
I~ J PIN O 9546-62 9734 D00 I
PARCEL ID p~099566 0108
1'fy~ ' 9u&e?•2ranoa 961&e26m4.aoa REID 01 0028519
1*78tE1' SITUS ADDf S~HWY 27 B/S X
19si&~9~rmo LEGALI 20.86 ACRES ATKINS
LEGAL2 WEATHERS
1 D AC E 0.86
C2- 000
CALC ACRES 120.04260075 ~ ~ yt
DEED BOOK 0917
DEED PAGE 10916
DEED DATE 19900827
951&e14a11 D00 Structure Data
YEAR BUILT 11994 1
5MI ( I 851&712B78A90 it fll ~`i N1
5knm
95 1 v ite Information
h t
v9PID PIN LEGALI LEGAL2 PROPADDRSS ASSESSACREI DBOOKI DPAGE)SALE
-
-16-COLONIAL 542 MAP#2004- COLONIAL
1~030507 0226 45 90506 LT#71
9145 HILLS DR 11 02432 0553 23500
.000
HILLS PH2 000339 X j
W LT#24 COLONIAL
2030507022637 0506-25-COLONIAL MAPti2004-HILLS DR 2.68 02432 0569 23500
0475000 s 544.
http://gistools.harnett.org/Freeance/Client/PublicAccess 1/index.html?appconfig=public 1 7/30/2009
Jul au un uz. sup p.c
Application #
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910-893-7525 Fax 910-893-2793
www.harnett.org/permits
Certification of Work Performed By Owner/Contractor
(individual Trade Application)
Ow or (s) of tructure: ~jK/l /gu/J.irSu✓ Phone: .~yS-mil
Ow er (s) M~ ing Address: 1/"S " e ~ a vY 2
Lar i Owner p ame (s): Phone:
Cot >truction r Site Address: j
PIN or Parcel] a from GIS:
i
Job Cost: Description of Work to be done
i
Me( ianical: New Unit With Ductwork _ New Unit Without Ductwork _ Gas Piping _
Ele :rical 200 Amp _ <200 Amp _ Service Change _ Service Reconnect!! Other _
For Progress Energy customers we need the premise number
Plui bing: j Water/Sewer Tap _ Number of Baths _ Water Heater
SoE :ific DireQd tons to Job from tittlil lfi5n: 4!'ec~~
oq/
i«
i f r! c 7-
Sut fivision: Lot
I _ will provide the /z;W labor on this structure.
(Contra tors Name) (Trade)
I an the build) lg owner or my NC state license number is which entitles me to
I
pert trm such vork on the above structure legally. All work shall comply with the State Building Code
and all other :)plicable State and local laws, ordinances and regulations.
i
Stn ;cure own ar(s) signature: Date: 7: of
I
Cor pany Nor te: i ~ J Phone: ~ j
Addre~ s: S7 /7. t l✓JXl /l.v~ _/4g~;' O'7~'~~27
County : Contractor's License -:101i;7k
Contr~ Aor's Signature: Date: 7 _ec, rt:r
'ComIll any name, address, & phone must match Information on license.
TRA lE 4106
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