TRADES
Application
Please note o this application Mail Harnett In application
County Central Permitting
wisith part open pern penmitits. progress PO Box 65 Lillington, NC 27546
Telephone Number 910-893-7525 Fax 910-893-2793 JI~\'-~,
yes _ no www.harnett.org
Certification of Work Performed
By Owner/Contractor
Contractor Information
Kent Johnson will complete the Mechanical-HVAC 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&rM Heating g 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.
Land Owner's Name: CX ::5 VuLs v f,'1rr 1 ob Information Phone: 0\ U~n ~lnt
D '1`t
Tenant/Building Owner(if di Brent : Phone:
Vital
Construction or Site Address: 3~ 1 ~1 ~ . ~ PIN or Parcel # from GIS: .
ecific Directions to Job from Lillin ton: If , r
411 4n qn ALL
Description of work to be done& ( Job Cost: '000 O V
Mechanical: New Unit With DuctworkLIshL New Unit Without Ductwork _ 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: $ ~5. Ca (calculated from fee schedule)
Mail In Processing Fee: $3.00 per application
Total Enclosed: $_L R a do
Make check payable & Mail completed application form to: Harnett County Central Permitting (HCCP)
PO Box 65
Lillington, NC 27546
Contractor's Signature: l~ Date:
DO NOT SEND CA H. INCO PLETE APPLICATIONS WILL NOT BE PROCESSED.
10/06
TOWN OF COATS
(Extra-Territorial Jurisdiction or City)
APPLICATION FOR ZONING PERMIT
To: TOWN PLANNER/TOWN OF COATS Permit No. Ot f5-20/0
P.O. Box 675
Coats, NC 27521 Fees:
Phone: (910) 897-5183
Fax: (910) 897-2662
Date: I Il u 110 Parcel ID•: O 7 0 9 d / (p / g o e O Z!
Area Zoned As:
Applicant: Property Owner
Name (Print) ~V L Name (U
Address Address
City, State City, State G
Zip Code Zip Code
Phone# 910`'9gf1-550[ Phone# _
Location of Property: IN-TOWN IETJ ETJ (contiguous)
Present Use of Property: h q
Proposed Use of Property:
[ ] Single Family Dwelling: # Rooms: # Bedrooms:- Square Feet:
[ ] Multi Family Dwelling: # of Units- #Bedrooms (per unit):_ Square Feet (per unit)
[ ] Mobile Home (single lot): single wide: Double Wide:
[ ] Mobile Home Park: Section 16, Zoning Ordinance must apply
[ ] Business: Total # of employees per day Type of business
[ ] Others (specify):
"N] Existing structure: Renovate: Addition: Demolish:
Water and Sewer Supply: Water Sewer H
Private H VA C,
Public ~ o f
Proposed C9ul~M1L(~0~~
Existing- ~a
NOTE: Attach a site plan that includes property lines (front, side, and rear), location of proposed structures
(including driveways, decks, etc.), and existing structures. This plan should be drawn to scale. Also, in order to
receive a Privilege License from the Town of Coats to open a business, you must have a valid Zoning Permit,
along with all applicable inspections from Harnett County.
Applicant: I certify that all of the information presented in this application is true, complete, and accurate to
the best of my knowledge. False information is grounds for rejection of the application.
Signature: Date: 1 l IV kO
ZONING ADMINISTRATOR USE ONLY
Notes:
Zoning Adminis ator: Date: [ - 145-A o ( ~l
Approved: Denied:
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