TRADE Application # /®500 zit - 7yZ
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910- 893 -7525 Fax 910 - 893 -2793
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www.harnett.org /permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (s) of Structure: A oA) -l- r./rfil -:.Q4 !EGG Phone: CO - q,;2 - q 3
Owner (s) Mailing Address: l (ILO CAR.O L Wa 1 >Z-
A.lr,stii AiC al CO/
Land Owner Name (s): Phone:
Construction or Site Address:
. PIN or Parcel # from GIS: '1O(o 7 ra j . ; i
()(10(0 / 5
Job Cost: gv V °-"- Description of Work to be done 6 r LJa T 7P_ tPf
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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 V Number of Baths _ Water Heater
Specific Directions to Job from Lillington:
Mk) li J 10 -To LA alit; AL* 5 P. - AT NAt4417 CErrz,1c ad , Ltf p,J
10 ft rrH^yl'S WI, cc Pew!: Rd . L£! ,.j CAna,..A Aft.. /-1,2, \:,7, eft.: LT.
Subdivision: Cm-440.A ESTKT!s / � / Lot #: 1 5
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1 //L r r7ccii? c °"wul pfovide the /9 t-'* -^-A -y labor on this structure.
(Contractors Name) f - (trade)
I am the building owner or my NC state license number is 292A J , 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 and local laws, ordina j. s and regulations.
Structure owner(s) signature: ' / /, i Date: JA( ,)" C Zo /a
Company Name: S" //2.42 --r )
// 2er?4ty c ' c Phone: 9t unty: cif c f92
Address: 2e-) /9-0. --r r' fa %w, .c L/� 'ie,O c % o /,CS(�i•ie7�
Contractor's License #:, fJ Address: r rf
� rc'7, *'V. ('or. --
Contractors Signature: e, Date: ��� Zoio
*Company name, address, & phone must match information on license.
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Individual Trade Application 1 of 1 06/10
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29933 11: 9:11 IN
- . > - 9K,193316:113 -13 31359.99
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DEED OF TRUST .. ID 4: 0033833906
WPHN than 0: 0225703313
Room t 1 - • Home Mortgage Inc
11301 ,,,.-.o BLVD. 309, CHARLOTTE, ITC 28226, 704 -529 -7383
Prepared y: . h
11301 - w ' ► -• • •: :1. *
VD 309, CHARLOrrH, NC 28226, 704 -529 -7383
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DEFINITIONS
Words used In multiple , f .i- — enters defied below and other words are dented in
Sections3, 11, 13, 18, 20' d2 r - in In - rdingthe usageof words used in this doe®entare
also p im Seetlen.1 . ,.
(A) Tam* lortImeeN!' m T1 ' , t, - b dated September 17th, 3003
together with all Eiden tot . '.. 1t' t< ,
(B) "Bmrowal" is JASON L • . , • lobe- • and wife and t'f1 LY I.RDO
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Borrower is the Inane under this Security •
((.) j' is WELLS FARGO HONE MORTGAGE II
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Lender is a CORPORATION
organized and existing ender the Ins ofTbe Sta e of • • ia" •
NORTH CAROLIW14Ypb PmnlyFwmb MrMaedh Mao UNIFORM
Ferro 3031 1101
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