TRADES RUG - 10 -. 6M0 U :9y FROM: UALTON'5 LP GR5 S1082210 IU:893219.3 P.2'2
9108032793 Hann Coady Plannlnq HAM/ti t CO. PLANNING SERVICES 10.13 20 a m 03 -0%-nt 0 1 It
lo
Appurrett011 s /OJ-60 ? /'/
Please note if this application Hamel County Centre Permitting
is pan of a job in progress PO Box 85 LWatgtcn. NC
with opal ponces, 910893 -7525 Fax 916.899 -2793
T ye no www.trelrM[argrpemfl7s ,
CMfcation of Work Performed by OwnerlCord ad or
(Individual Trade Application)
Contrserer sdvn atlo s
1,1l t. nLO Al f Yr Op n P, will complete the Cy el e) i i lined work on the project or
(Name)
My �a 1 a (,o crrade>
*What herein deaCr9led. state arznse number is . M wart mad comply with the State Building
Code and ea ether applmble State & Local mw, ordinances and regulations.
Company Name: 14 I Arm-VAX 03 1 .T e pal)",
Malang Addresr f . - Pe n y a9_,,3 no r i fiC
Street Address: 1 • • 440 s •_ Q CC � _ _ A . A .. r •. C. 3&3
Q"
Business Phone: 9 la - 7 75-5 td 5 1 Erna0 Address;
tommuty name, addren &phone /can match Information on Damn.
Land Owner's Name: G G,hc'1 2.1 ,. tri loh.,, i asq -P9 -30,3
Tenant/BuIldjng Owner Of different): Phone:
Construction or site Address: 1 7 1p A b rn rn C)- . p. , roe t L + .
PIN or Pane/ W from GIS: C7
1 4
Description of we* tobedone: nu *1 ina lbr 519rE rob dos: S[Q,Da
Madm+icel: New Urdt W Ih Ductwork _ New Unit W thggt Ouc tk Gag . OW3X
Elecfdcat 200 Amp Amp ^ Service Change Service Reconnect _ Omer —
Plumbing: Water/Sewer Tap Number of Baths — Water Heeler
%� 00 Permit Cos(
Permit Few: $ \ J rr��0. 00 (Calculated from tae schedule)
Mall In Processing Fee: $3.00 trey lob Few Electrical Permits wbh Progress Energy we
O � need the premise n umber provided.
Tdfal lamed: $ 5 5.
Make dm& payable & Mao completed application form to: Harnett County Central Pannone (HCCP)
1 PO Box 65
Lillington, NC 27546 7-
Connate Sig 14 4 a _ 1•• ■d _ .. - Vi 73/4 J
*"DO NOT S - D C - H. IN • g APPLICATIONS WILL NOT AE PROCESSED"*
IndMdaai Trade Mall In Arelleation 1 er1 04n0
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