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TRADES Application #/O :1 0 Mail In application Harnett County Central Permitting' > ` / / 7 • PO Box 65 Lillington, NC 27546 Telephone Number 910 - 893 -4759 Certification of Work Performed By Owner /Contractor ---r �te Contractor Information 7 1, m l ,uraxJ will complete the NG¢T 4.y9 work on the project (Name) (Trade) or structure herein described. My state license number is /3 €/7 . All work shall comply with the State Building Code and all other applicable State & Local law, ordinances and regulations. ��/ // Company Name: BASS ,4 / depArtoki -l9 e., red e Mailing Address: 3..G/ .(far -fa / ��d tz-, - C9.--? e 6 Business Phone: /- 9/o -q4.2 ti-- 3 S 7p Email Address: Job Infrgation Owner' Name: AI d 7// `5 (Acc7l /fy fir7 C `4.-4 c /,e( Construction or Site Address: a.2,o ,1/4-,7/ 3 e ILA/ 2d �S ecific Directions to Job from Lillington: / �P i 1///,-(5. / zn id,-, .a / 0 74.01 ".A, S 7; /mss a/c"-4 A( /c °Ai/e r x/ /Ns C E tt% if ei ©.t ,e; 5. A 7: Date work is to begin: / 7 4 - ( 0 Description of work to be done: ?C,a�.r 4 7 ct S / //f /JE "4,n/ Job cost of work to be done: fir 4 c 00 - 4. - - - - Per mit Cost - ._ Permit Fee: $ a40- oy (calculated from fee schedule) Mail In Processing Fee: $3.00 per application Total Enclosed: $ ,-,2 e-,3. Make check payable to: Harnett County Central Permitting (HCCP) Mail completed application form to: Harnett County Central Permitting PO Box 65 Lillington, NC 27546 /� Contractor's Signatur 2, Lillington, ( d.,, � 2 Date: 7-/ 9 - JO DO NOT SEND CASH. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. 08/04 GIS_Public: Powered By Freeance 4.3.2 - TDC Group Inc. Page 1 of 1 1`r '' 1 ,° u `,- 1 1H� 4 �6'ng pg .di. Of �`' ii " i1 L l it il n n, ;� . ' r � ,.. �s� . , � f LIIIM177L,aWn m� Ii� a i�' ,4) r 9 hip e Y t - ;i4 air tI 4 1 , f $11�,� 'J7'411' _ g Search � 1, J Tx x t I � - tT'1 tf . + t)" u : I� + .' iowAll Selections ;ii ''.4:::. �.. T t ' Y .. A t' u)i,� : 1 e a � I on s Cle ar' I s 1 1 1 .. e n�u dx, r -':Is Feature '� -1„ '' 4 , V 1 ' , - ' ' - 1R", • I er Inform -lion Alit:'' # �` `� 1 NA " i� >il NEILLS CREEK BAPTIST :1",91 � � 1 ; ��� , � 41114.- I 111000 ` .-1 9+a' ' ,1i " “ . C ! �'! i a�tli'CHURCH ' ,, i jS ! q , tfl _, ,,, - 1, y � ., 3 a r . � ; 4 il, N D' 2i' '' Itl"• A' - w . ` ',Iwo ! f� , ' r _ rt � ' , -'; P - AD' El 200 NEILLS CREEK RD 3 i ta A' ,,, M waw: Is Ix1 . i II N CGIER 1 3 y ' 1 �6.113iII ?O11 10 ,4 - ,e420e I (' �` 1 'P oel Infolaion ,�. i ) �, r - X4 ' /VI "�' ' Y t, P.1 1 011 r a" �f662 -65- 3360.000 �' - G „ " �4 e ! ✓ Ell ` > � ' ` PA CE ID ® 9004 c g , t# i c�a , * y r i �a '1 ( ;&.. R v a ' 1-' 054267 z I � 1' e . , r . r's = i . :' '7 g SI 8 ADDRE . NEILLS CREEK (SR 1513) � , P fly � r 1 = x r rq &> > ,.ft 4kIi o-1f¢IRD 004200X ® , '5 1 * `+ - ` , ,, r.! n. - r � AL11n �w1:, NEILLS CREEK '� y f ' " r' c ��IliuuLC" BAPT / , , ' ' � : i �iI i 0 1 1 '1 a S ° 2 ''is' i 2 r AL'2 UIP HURCH " " r ! ' 5 F .I 3 10AC � t n'i = i alit' ., �. a i1 ! e n j 'T. r r ; n 1 I t td r y 11 1 , a "- .i J h , � p LT + � , I ++ ( :y i i u3 ®' F' X11 i ii "� 1 , r u4' t ) • � 1 ', if "t"'"4 Iltf 7,3 1 -P k ... .. � r t uv1 ,+N H,�� .:,,' , • s. , v 1 tt I `yy y 4 Y�: j • 35. r",ry '� Y ` c. r� , 0 PID PIN PLAT 6�d11L L6oytaPROPADDR88A88E8SACREIDBOOKIDPAOEIDEED __I '1 UA(. NEILLS CREEK 110662 E5- NEILLS f 1 066 7 CHURCH(SR 1513) RD 3.1 01443 320 000100 — 9004 3360.0001 CREEK i I 1 IBAPT x 04200 X Zoom To Result Se( K-7-77---.27-7 ae 7 [ 1 R ret 1 r A!! ` ,, ik 1 p,° - �. � � * G- uLSc.L' H 'a l F; a[IlY i3at http: / /gistools.hamett. org/Freeance /Client/PublicAccess 1 /index.html ?appconfig= public 1 7/21/2010