TRADES
G
Please note o this application Mail Harnett In County Central. application Application #%G DD
Permitting
with is part of perrmits. progress PO Box 65 Lillington; NC'27546
open peit
Telephone Number 910-893-7525 Fax 910-893-2793 ck r~
yes no www.harnett.org d p
Certification of Work Performed ~I
By Owner/Contractor
Contractor Information
Kent Johnson will com lete the Mechanical-HVAC
p work on the project or
(Name) (Trade)
structure herein described. My state license number is 17164 . All work shall comply with the
State Building Code and all other applicable State,& Local law, ordinances and regulations.
Company Name: J$M.Heating $ Air, Inc.
Mailing Address: 724 Turlington Road Dunn, NC 28334
Street Address: Same
Business Phone: 910-897.5501 Email Address: -
'Company name, address, & phone must match information on license.
n Jot l formation
Land Owner's Name: `C-~1 ~t~LbIA1 Phone:
Tenant/Building Owner(if different): Phone:
Construction or Site Address: 9~
PIN or Parcel # from GIS:
Specific Directions to Job fro Lillin to rlP-~~~
A 1" 'T`{l f~t,~,f ICJ
Cu L
Description of work to be done: UW-4w. MW Job Cost: 6~^
vv + W
Mechanical: New Unit With Ductwo New Unit i hout Du twork Gas Piping _
Electrical: 200 Amp _ <200 Amp _ Service Change _ Service Reconnect _ Other _
Plumbing: Water/Sewer Tap _ Number of Baths _ Water Heater _
Permit Cost
Permit Fee: $ (6S. 66 (calculated from fee schedule)
Mail In Processing Fee: $3.00 per application
Total Enclosed: $ (gq ~ ~)c)
Make check payable & Mail completed application form to: Hamett County Central Permitting (HCCP)
PO Box 65
Lillington, NC 27546
Contractor's Signature: Date:
DO NOT SEND CASH. INCOM ETE A PLICATIONS WILL NOT BE PROCESSED.
10106
From:TOWINI OF COATS. N.C. 910 897 2662 01/20/2005 17:19 #037 P.002/002
TOWN OF COATS
(Extra-Territorial Jurisdiction or City)
APPLICATION FOR ZONE PERMIT
To: TOWN PLANNER/TOWN OF COATS Permit No. O1 /5-Z 'o /O
P.O. Box 675
Coats, NC 27521 Fees: 2$• ~
Phone: (910) 897-5183
Fax: (910)) t i897-2662
Date: 1 1 10 Parcel ID": i7 7 to (i3 6 ~l
Area zoned as:
O-
Nance (Print) Name
Applicant: Propeft-a
Address t L 1 Address
City, State City, State
Zip Code ;-0 ~3t1 Zip Code Phone# ~10-Ygt1-Ci5QII I Phone#
Location of Property: h(n
Present Use of Property:
Proposed Use of Property:
[ j Single Family Dwelling: # Rooms:- # Bedrooms:- Square Feet:
[ ] Multi Family Dwelling: It of Units: #Bedrooms (per unit):- Square Feet (per unit)
] Mobile Home (single lot): single wide: double wide:
f ] Mobile Home Park: Section 16, Zoning Ordinance must apply
f) Business: Total t'I of employees per day Type of business
[ ] Others (specify):
Existing structure: Renovate: Addition: Demolish:
Water and Sewer Supply: Private Water Sewer
C 1lf C~
T[
Public
Proposed
Existing 6300 o~t~
NO'T'E: Attach a site plan that includes property lines (front, side, and rear), location of proposed structures (inclu ing
driveways, decks, etc.), and existing structures. This plan should be drawn to scale. Also, in order to receive a
Privilege License from the Town to open a business, you must have a valid Zoning Permit, along with all applicable
inspections from Harnett County.
Applicant: 1 certify that all of the information presented in this application is true, complete, and accurate to the best
of my knowledl. ..False ' ffUrnaatioonn is grounds for rejection of the application.
Signature: Date: I 1 O
ZONING ADMINISTRATOR USE ONLY
Notes:
Zoning Administr r _ Date: 1
Approved: _ Denied:
'This number can be obtained through die Harnett County GIS office along with a map of the site (www.harnettore).
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