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SET UP Application # v 7 9 24 Harnett County Central Permitting PO Box 65 Lillington, NC 27546 Telephone Number: 910 - 893 -7525 Fax 910 - 893 -2793 www.harnett.org /permits Application for Manufactured Home Set -Up Permit (Please fill out each part completely) Part I —Owner Information: Home Ow -r Information (T. r : c. ple ed by owner of the manu t u/�1d� home) L Name: 1U _ t. _ , - Address: :5 /0,g i}f�mW < V City: 4)4 . r1 4 notate: 1 v Zip: S J2 a ( Phone: q /� �Si Y�7^ • s Landowner Information (To be completed by landowner, if different than above) Name: Address: City: State: Zip: Daytime Phone: ( ) Part II — Contractor Information (To be completed by Contractors or Homeowner, if applicable. Name, address, ( phone must maid). information on license) A. Set -Up Contractor Company Name: S/a-/e Moe 11 Le- /%on.e- Mews -J a Phone: 9/ 9-L/22 - tc. 23 Address: /6 es 4 /giwrl /e. Ram-d Cit u,J : NC • Zip: / 2750 Setup Signature: ♦ State Lic# 28 s B. Electrical Contractor Co pany Name: ,o Nrr'S t � , KRpJ 13e*s Le al/ Phone: RIP -R�i`V-6205I Address: MI 'Fred M Leodl a i L Ala City: roH-fa State: NC. Zip: 2752 1 Electrician's Signature: „ads _ State Lic# 26 311 C. Mechanical Contractor Company Name: ' �k S OC4e / 9 Phone: 9/9. 6211'2/ 7 y Address: Syy QC :1 -i D/L • City: Wil lou certr .fit State: WC • Zip: 15 - HVAC Signature: s.� State Lic# / 2 736 #3 eimrs D. Plumbing Contractor Company Name: Pric or( (:)( "- r Phone: -C all -'7260 Address: Q•G -'ox 2-St City: tl(uv/ S /6r' State: ►JC . Zip: 2754 2 Plumber's Signature: r.c $ # 4 J State Lic# Part III — Manufactured Home Information !!!!////0000 Model Year: n20 / 0 Size:LX 57—) Complete & follow zoning criteria sheet Park Name: Lot Number: I hereby certify that I have the authority to apply for this permit, that the application is correct including the contractor information and signatures, and that the construction or installation will conform to the applicable manufactured home set -up requirements, and the Harnett County Zoning Ordinance. I understand that if any item is incorrect or false information has been provided that this permit could be revoked. e " P ) (Q_I7 —/O ature of Home Owner or Agent Date 'Effective July 1, 2004, a County Tax Department Movino Permit must be provided before a Set Up Permit will be issued. It is purchased from the tax office of the county that the home is moved from. ll the home is from a dealer, we need proof of year on the Form 500 and if available, the serial number. List of inspections and Egress requirements available upon request. Progress Energy customers must provide Premise Number. SETUP 4/08 - SALES AGREEMENT CMH Homes, Inc.. PO Box 9790 CUSTOMER No.: Maryville, TN 37802 1 7 1 /M DATE: /D BUYER(S): -1 / . 2-)/ s /» L LL`}kc/ - SSN: SSN: Q /(� -/ y /� ::. ADDRESS: 300 4. st• F & !/t / )Vf3 /Yc. ,ezc& �'r DELIVERY ADDRESS: r D . TELEPHONE: /I 9' SS 7 7373 HOME CONSULTANT: C— A ' //ly GO ry 1 . � 3 sq • BASE PRICE: $ SS p /7 ' 29' Make: COW W Model: SUBTOTAL: $ Year: / Length:.) - Width: 2 8 Stock #: : SALES TAX: $ COO. 515 Serial #: Re.5 ❑ New ❑ Used © 6 P. S $ �• /..2,51. u e Trade: Make: Model: $ Year: Length: Width: Stock #: $ Qp• 'f =o Serial #: 1. CASH PRICE: $ 7O, &6 / • Amount owed will be paid by: ❑ Buyer ❑ Seller Trade Allowance: $ Owed to: Less Amount Owed $ 1 OPTIONS:et .C 72 A/ /3 sn kr. t eavo a secs. c.Jo 4 Trade Equity. $ si Aro f 4etn . Nevis, Wi ma 4y0aw4 -t. - Soo Cash Down Payment: $ S • Ce /'1e Am-44- up 4 /da /Sewed•- 4e4.1o; /3/Lr/cS)&oc,' Other Payments: $ I riltlFit_4 fec 41,16 ,%0 /X1aWlg, /00 /� '° r a 2. LESS ALL CREDITS' $ SoG•• SELLER RESPONSIBILITIES: DeVenee' A / . f �/ .S Gr- -CeD 3. REMAINING BALANCE' $ i - /. a- ' er . t4Asti. Lc3ts&- • ✓ j, ESTIMATED MORTGAGE. Buyer is voluntarily purchasing any insurance products listed below. All numbers are estimated. // Tr A. Other Charges' $ BUYER RESPONSIBILITIES: 1 ,/ 5 i Property Insurance. $ Q / __// . &osfN eos7 1 added C� Credit Life Insurance' $ OA./41_ t� M K-G Sii 5/ / HBPP' $ Title Fees. $ May not meet local codes and standards. New homes meet • Federal Manufactured Home standards. License Fees. $ $ Buyer(s) agree: (1) that the terms and conditions on page two are part of this agreement; (2) to purchase the above home $ including the options; (3) they received and acknowledge $ receiving a completed copy of this agreement; (4) that all promises and representations made are listed on this TOTAL: $ agreement; and (5) there are no other agreements, written or B. Unpaid Bal. /Amt. Financed (3 +A): $ verbal, unless evidenced in writing and signed by the parties. C. Interest Rate: "/o D. Finance Charge• $ '/LL.L �� ... / X /k : i � I L I E. Total of Payments (B +D)• $ '° " " ^) F. Total Sales Price (1 +A +D)' $ X G. Number of Payments. # X H. Payment Amount. $ (signature) This is not a loan commitment. X (signature) Rev. 10/08 Multi State Sales Agreement (excluding NC & VA) CMH 1179 Sales Agreement (gener1c) -Multi /476