TRADE Application # /9 " 74'5? i
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)
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Owner (s) of Structure: D e i (e Pho 7/ ' (� S 8' /4147
Owner (s) Mailing Address: /20 f k-', //, ,r4S ,s'/ 0 4a4 2
Land Owner Name (s): SO/n P Phone:
Construction or Site Address:
PIN or Parcel # from GIS: f2 t — 941- G 741z, cn/ 0'7 0410 076 95 0,
Job Cost: Description of Work to be done (14„ y e /60 /9q// ,tYf f To
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork _ Gas Piping _
Electrical *: 200 Amp _ <200 Amp Service Change _ Service Reconnect Other
For Progress Energy customers we need the premise number
Plumbing: Water /Sewer Tap Number of Baths Water Heater
Specific Directions to Job from Lillington:
CroSJ 6 $ a o w ,�7
50 to lop 4 ,- , 5 (4 7i, /■X/ nn o ronc.n .s 7 — At2 ,i4o <1%1i
•
Subdivision: Lot #:
7r will provide the /_ /p C 7/'/c'a / labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is , 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 ancLJo -I laws, ordi ances -nd regulations.
Structure owner(s) signature: see "_�� Date: 4 — 2 - /D
Company Name: Phone:
Address: County:
Contractor's License #: Email Address:
Contractor's Signature: Date:
*Company name, address, & phone must match information on license.
Individual Trade Application 1 of 1
03/10
FROM Town Of Coats (WED)JUN 2 2010 13: 01/ST.13:01/No. 7515832070 P 1
TOWN OF COATS C----BP"'")
(Extra - Territorial Jerisdictioa or City)
APPLICATION rt
To: TOWN PL.ANNER/I'OWN OF COATS ' f L111U ermitNo.QS °.zA 13 / 13
P.O. Box 675
Coats, NC 27521 (�,r _� ^'
_ Fere: �O. o a
Phone: (910) 897 -51&3 ""�"""'
Fax: (910) 897-2662
Date: ( ¢.' st' I Parcel ID•: G7 7° IP e t o/ G070003 0 /
Area Zoned As: °Pl- &°
Applicant: Property Owner:
Name (Print) �o6ash fi .. ,Sic. Name 5 A rti --
Addres o b W' ar Address
City, State Cott S4 G City, State
Zip Code 2,15P -/ Zip Code
Phone 0 o S v Phone 0
Location of Property: IN -TOWN ETJ ETJ (cantigaous)
Present Use of Property:
Proposed Use of Property:
. Family Dwelling: it Rooms: 0 Bedrooms: Square Feet:
Multi Family Dwelling: #I of UnIIs: #Bedrooms (per unit): Square Feet (per unit)
J Mobile Home (single lot): single wide: Double Wide:
J Mobile Home Park: Section 16, Zoning Ordinance must apply
Lameness: Total 0 of employees per day Type of business
4 Others (wpeeify): Cheery- s e l e c iR.i Cwt Is Bate k.a' - 4 eA
] Existing structure: Renovate: Addition: Demolish:
Water and Sewer Supply: Water Sewer
Mote
Public _ tee ublic
Proposed
Existing
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. Mao, in order to
receive a Privilege License from the Town of Coate to open a business, you mast 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 beet of my knowledge. False Information is grounds for rejection of the application.
Signature: Date: L' A'
ZONING ADMINISTRATOR USE ONLY
Notes: Can r ost )s...r fl— .44.91" p94 °fdd `O"`:1+
Zoning Administrator: ,Zsg / r ( Date: t (a
Approved: ✓ Denied: