TRADE 4
Application #
19 2,2 24 X1
Harnett County Central Permitting ''
PO Box 65 Lillington, NC 27546 t
910- 893 -7525 Fax 910 -893 -2793 "
www.hamett.org/permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
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Owner (s) of Structure: \& (M \\\ �l .) \ 6 `D,W Phone: c'
Owner (s) Mailing Address: \° ?‘•(14 C \ & c CV
�-Ac\ oc �z � ' . 3:33' s
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Land Owner Name (s): Phone:
Construction or Site Address: T c \ (VQ \C\ Ct 9 CO -c R c)Cc k) C mk
PIN or Parcel # from GIS: )3 9 <J 9Z J ✓07 _ ' 2 94i — Z4— PV„ n : t
Job Cost: Description of Work to be done %7A/5 r `
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
S ecif•c Directions to J fr Lillin
,cogrias4,, t, C cc (A\ ci■ L ON.12 (o c -O s('
_ D a . / _•. •' • • • / • /
Subdivision: wit. La— y Lot #: '( A
1 _ 4 S Pzi/I fv/" will provide the / 441 - labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is 4 ,&aincr , 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, ordinances and regulations.
A
Structure owner(s) signature: Date: 1
OM 01 - • - • = : Phone:
Address: c
County: ontractor's i = • -
Contractor's Si! . - . Date:
'C.. • .„ ny name, address, & phone must match Information on license. '
TRADE 2 7 � 7/ U/ 4/08 i
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ICI.Ilh jfilf111111111 1
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FOR RrR Y r re irq Or Ofry
i NE 0 NW TAX lC 401p T1 4o: PA
JG .. P's BK:2747176:668.678 FEE:$72.08
CV. A I
, - Prepare• c : _ • 1 , • Attorney Steve Bunce File #30368 -10
Revenue St. mp . • • i 1 ! 0
Tax Pin Numb: 13-* . -0059
NORTH CAROLIN •
GENERAL WARRANTY DEED
HARNETTCOUNTY
THIS DEED made a • • : : : - this 26 day of May, 2010, by and between J &S
Development Company, II • corporation, hereinafter called "Grantor," whose
mailing address is 1172 Vic : h R• • rd, 27332 and Joshua L, Shaw and wife
Kaltlin O. Shaw, whose maili . Cr :: - 1! - - ridge Cove Sanford, NC 27332, hereinafter
called "Grantee ".
The designation Grantor an. e : as used h: rein shall Include said parties, their
heirs, successors, and assigns, and : : include th:: i ular, plural, masculine, feminine, or
neuter as required by context.
WITH:
The Grantor, for a valuable conside :•ion • - id b • , Grantee, the receipt of which is
hereby acknowledged, has and by these pr-.. : nts '. t, bargain, sell and convey unto
the Grantee in fee simple (with the exceptions : rel, •: if any), all the certain tract or
parcel of land situated in the City of in Barbecue T •'^" : melt County, North Carolina,
and more particularly described as follows: --
Being all of Lot 69, Block L, In a Subdivisi • • 0..- rolina Lakes,
Section Five, according to a plat of same bean, • • • ed In Plat
$
Cabinet C, Slide 174, Harnett County, and • , . the 4 • property
conveyed to J &S Development Company by d, • • • o • • • Book 2719,
Page 136,.
This property does not Include the primary residen ntor(s).
1 I I I I OP,