TRADES
tJ*l iu In aoolicatioct Apmicat10/1 # ~DD
,mltx41c now irdmis 41pplirau~»
i.+ pun 01-41 jab in progn m Harnett County Central Pemmin
with open pmmk& PO Box 65 Ullington, NC 27548
Telephone Number 9104M7525 Fax 6iQtSg3-2793
..._yes ~n0 www.hamett.org
C*dMcetion of Work Performed.:
By OwnedCordractor
ee,,,t 1 r- Cd CDDr Information
t. J~~G^~ fYlrx rl 1 V -r r LL -will complete the _ work an the
(Name) e projed or
(Trad
sbuctwe herein described. My state license number is 12911&-, qg work shall comply wgh the
State Building Code and all other applicable State & Local law, ordinances and regulations.
Company Name: t
Mailing Address: V94
~,~p jY} (Yl t
SlreatAddress: 11r ll;G ~giy
Business Phone: mail Address:r)1jrjpj(, nr~E 11 C . -r Cr+,~
'ComPartynwrre, address B prrone must Match /nk mation on IGaense.
rmati
Land OwWs Name,-Er Job Info
• tie: q~m - oZo$
TonantlBuikling Owner(If ditrgm per.
Construction or Site Address :l911'M 1 ~$h l}~~1~ R~ lalli %krl. Nr- Z115 ll)v
PIN or Parcel # from GIS.
SRwAC Directions to Job g•orrl Ugk gtorr
Description of work to be done: Chgn% Out- he+ InaIry {eAkl%b Cost:
Mechanical: New Unit With Ductwork New Und Without Ductwork Cas PipkuJ
EleddW. 2W Amp <200 Amp- Sendoe Change Sarvtce Reconnect Other
Plumbing: WatedSewer Tap _ Number or 9aths Water Heater -Z--1
ca Permit Cost
Penns Fee. S 4D (ca,culeted from fee schedule)
Mail In Processing Fee: $3.00 oaraoppgtion
Total Erldo,,ed_ $
Make Check Payable & Mall aMVteted applir don far to: County Central PerniOrg (HGCP)
PO Box wWgton, NC 27546
Contractor's 871 Me: Date: g 09
DO NOT SEND CASJt4 ~N~QMAf E7EAPPLICA77ONS KILL NOT ARN PROCessea.
IOU
ZIZ 9002-8 L-LO tiL CZ sL 9331AU3S 9NINNYId'00113NbVH DUP Md RHnoo yOWnH 091ZCAMLK
0 C,
Application E
is pw b u or pc in PO Box 65 NC 27546
Telephone Number 910-850 Fax 916493-2793
-Yes _uo www.hameftorg
Cer ffmftn of Wort Perfonrred
By OwrienC`,orrbaeter
i
I, !a!.I.:: Gr(~f1 ~5"~ ;r ws se fer4-p-e c1_.. work c n the project or
(Nome) (Trade) f
sl UCWM herein CIMUdred, My slats froerrse number is _D95,I1 L; AN work shad comply wim the
State BtAftW Code and ad other gViiCable SUM 8 Local low, aces and rel;uloor~%
company Nance l~ i~.hb 15 -Vu►'Y1 fbi
~`~i n
Y-Ld
MaltingAMtesw ~`oL1Cl L{, i M
Street AddrOW
9usu,ess Phata 9j()- a St
-41 o u 2 Erroll A ddreas: to -
r nww, a&Wft &Phormmuaf inat0lr and mration an #owns
l
Land Owners Name J o i i _ 02.08
Trxrer V&dd ng Ownet((f ddferan0
C.onsttuclionorSbAddrm C1qi ~tiL~lill5 'SZc~ i_L 1l NC Z'15 1~_.
PIN or Parcel 9 from 615
S xwft_ Qbgl= to .lob from Lffmcb :
De$aiptiar of work to be dotre: ~
Medranical: New Unit With D 'k uckyoF _ New Unit Vildhortt Ductwork- Gas
EMMICel: 200 Amp _ Q00 Amp T Service Charge _ Service PAcan rect purer
PhonbkV VVdw SMw Tap _ Ntanber of Balks _ Wafer Heater _
Permit Celt
Permit Fee $ Cn. (calculafed from fee sd+emm)
Mad In Proceairg Few an eef anpo s tim
i
Total Er4WOO& S,
Make dhecit pgyable & Mail complel®d ePplxaaon form to Named COW* Cenh-A Pam OMM
I* Om 65
U1r% % NC 27'546
Corrbac.~ors sigrrabjre:PYJ,rr'~ad' ~9 Dais
DOMMsewvCAM. APPLrArmmmymrBEpnOCES4;m
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Is Feature
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GUTZWILLER ERWIN C & ` -
L!f „j ~IFE
UTZWILLER PEGGY L
o SKUT &
rdd'dn kry r ,*1, ADb 1944 KEITH HILLS RD
` ~`~r ; i ~ LILLINGTON
e
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i3g60000
€
Lion i
" - , 4 - 0579-17-0265.000 i
110579 0021
1 0009374
S KEITH HILLS RD 000978 X
LOTi48 KEITH HILLS SEC 1
110X207
0.56439323
2569
® ite Information
nt,
d PID PIN LEGALtLEGA PROPA ASSESSA IDPAG SALEEASSESSVA
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1105790579-17-KEITH 'KEITH HILLS
10021 0265.000HILLS 110X207 RD 000978 X-1 02569 0196 0 201620 El
SEC 1 N
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http://gistools.hamett.org/Freeance/Client/PublicAccess 1/index.html?appconfig=public 1 9/1/2009