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DOCUMENTS Application It 3 (4 q y 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 Owner Information (To e completed by owner of the manufacture) Name: t�+'r"" Address:,,/7 r City: ' 44AllWd1,1 State: 7 . Zip: ,-83,24 Daytime Phone: (7/9 y ?$"-3 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,addresA& hone mus atch information on license) A. Set-Up Contractor Company Name: Phone:?I9 ?5-Z,,71 Address:;_ City: tate: n Zip: 213 T45 Setup B. Electrical CRt ntractor C any Name: .V . / , State Lic# Y cA l^i )e, Phone: 7/4' Addres 4�1 City: n�ctlttf State: C Zip: S3Z6 Electrician's Sianature:19,turit State Lic#,-Cp"S p AS7.12' C. Mechanical Contractor Company N e: Phone: Address: City: State: Zip: HVAC Signature: State Lic# D. Plumbing Co tractor Company Name:Aotctsi Phone: - ... Address: /'s L City: a... . „ State: 14C Tip: ,, 733 D Plumber's Signature: _ . State Lic#�� Part Ill—Manufactured Home Information Model Year:f Q 4 .' Size: /I x 7 t9 Complete& follow zoning criteria sheet Park Name: ,E, .4/ AVAIL Lot Number: /5' 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. lyG --1� Signature of Home Owner or Agent Date 'Effective July t,2004,a County Tax Department Moving 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. If 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 �'',. v • '. ` r�,.,.i 'f.: � '• ,, 4,, APL 4,./"�ss�,'I u�4, . i^ d:4,,0 ry . .,-,clha '4� +: -.4?4,`;9,- �.! '' 1 STATE OF NORTH CAROLINA eA r � 'i�, e , ., €� _ l� r`, '1`` ' , �/ y ao oa vo 00 6 is J�r�:a£" d/�� i ��-�� • �-:��1d dam- �`f-:fib • �.�_!���-�� ��- Y f l - _ 'h ..y L :—fs n� -�`j�v� 4 ` MVR 191 (Rev 1/13) � CERTIFICATE OF TITLE l''' t41 r E VEHICLE:-IDENTIFICATION.NUMBER YEAR MODEL MAKE BODY STYLE s ` " g NCFLR41.A40886"CII 1995 FLEE MH ` TITLE NUMBER TITLE ISSUE DATE PREVIOUS TITLE NUMBER . - f'' 7778981,42194+412 10/22/2014 ©0000143.4012310 m '1I ODOMETER READING j u� :. . =i JANE COSBY THORNTON z` s -0, E ; 217 BRITTON LOOP gf ODOMETER STATUS . ;d CAMERON NC 28326-6475 i kTITLE BRANDS ,';• 1 °VI OWNER(S)NAME AND ADDRESS 44. ei '°F-1 JANE COSBY THORNTON ��' Itl217 BRI'TTON LOOP "�0y��� CAMERON NC 28326-6475 I°''Jf` 1 PI �a 11 I1 IIIIIII111111111111111111111111111111111111111111111 1111111111II 1111111111III111111 R1' tI 4h The Commissioner of Motor Vehicles of the State of North Carolina hereby certifies that an application for a certificate of title for the herein described vehicle I a-'k "#� N has been filed pursuant to the.General Statutes of North Carolina and based on that application,the Division of Motor'Vehicles is satisfied that the applicant 1R41,r v �t is the lawful Owner.Official records of the Division of Motor Vehicles reflect vehicle is subject to the liens,if any herein enumerated at the date of issuance . E: of this certificate. . i� fi As WITNF S,his hand and seal of this Division of the day and year appearing in this certificate as the title issue date. i`il0 .'' COMMISSIONER OF MOTOR VEHICLES a '1 r -r1 Q FIRST I.IE:NHOLDER: DATE OF LIEN A,�i'I LIEN RELEASED BY: ' _ !I SIGNATURE.. M '$�* a.,yE� TITLE— -- -- DATE_— � I `�`', SECOND LIENHOLDER: DATE OF LIEN V' S LIEN RELEASED BY .4', SIGNATURE --— — Y to,., ' I pA TITLE_----, — DATE. — F ,,,vo 1 THIRD LIENHOLDER: DATE OF LIEN. SIGNATURE A a .'4. t'O ,e' LIEN RELEASED BY a TITLE. —_DATE---' ` o 4 FOURTH.. IENHQLDER: DATE OF LIEN r iJ ill° IJEN RELEASED BY: °+@° a((i. . SIGNATURE.— __ ' ;%t".•41','!'= TITLE—_. — _DATE_ 1;I a ,�f ADDITIONAL LIENS: ,a". 93645607 is,,:,-.., 112 1 Mann ; 'I'`! - ".- .:..x�. typsL' .,uwwaMxK�iiJura'i k, .: s` ,41' a, {j �4�,.� ANY ALTERATIONS OR ERASURES VOID TITLE ` � �Y� I , ffi 0,4 HARNETT COUNTY CENTRAL PERMITTING P .O. BOX 65 LILLINGTON, NC 27546 For Inspections Call : (910) 893-7525 Fax: (910) 893-2793 Bldg Insp scheduled before 2pm available next business day. Application Number 14-50034794 Date 11/06/14 Property Address 390 BRITTON LOOP PARCEL NUMBER 09-9564- - -0049- -03- Application type description CP MOBILE HOME PARK Subdivision Name Property Zoning PENDING Owner Contractor THORNTON JANE RODNEY BROWN 3212 TAYLORSVILLE RD 23 POLLY LANE BARBOURSVILLE VA 22923 SANFORD NC 27330 (919) 775-8871 Applicant THORNTON JANE #15 -- - Structure Information 000 000 14X80 2BDR SWMH IN PARK Other struct info # BEDROOMS 2 . 00 MOBILE HOME YEAR 1994000 . 00 PROPOSED USE SWMH SEPTIC - EXISTING? EXIST Permit MANFACTURED HOME PERMIT Additional desc . Phone Access Code 1060508 Issue Date . . . 11/06/14 Valuation . . . . 40000 Expiration Date . 11/06/15 Special Notes and Comments T/S : 10/21/2014 10 : 04 AM VBROWN ---- 390 BRITTON LOOP CAMERON 28326 . SAND ROCK MHP #15 27W, 24W, HILLMON GROVE RD, LEFT ON---- BRITTON LOOP HARNETT COUNTY CENTRAL PERMITTING P.O. BOX 65 LILLINGTON, NC 27546 For Inspections Call : (910) 893-7525 Fax: (910) 893-2793 Bldg Insp scheduled before 2pm available next business day. Page 2 Application Number . . . . . 14-50034794 Date 11/06/14 Property Address 390 BRITTON LOOP PARCEL NUMBER 09-9564- - -0049- -03- Application description . . CP MOBILE HOME PARK Subdivision Name Property Zoning PENDING Permit MANFACTURED HOME PERMIT Additional desc . Phone Access Code 1060508 Required Inspections Phone Insp Seq Insp# Code Description Initials Date 10 501 T501 R*MOBILE HOME FOUND. / M. WALL / / 10 307 P307 R*PLUMB WATER CONNECTION 20 818 Z818 PZ*ZONING INSPECTION _/_/_ 20 814 A814 ADDRESS CONFIRMATION / / 30 507 T507 R*MANUFACTURED HOME FINAL / /_ 999 H824 ENVIR. OPERATIONS PERMIT / / 999 H828 ENVIRO. WELL PERMIT / /