SET UP •
Aug. 10.2010 09:17 PM PAGE. 2/ 2
Aug. 1'. 2010 3:17PM . /' / No. 2099 O P. 1 •
Application It /G •7 �'" 2-7 75 2
Harnett County Central Permitting
PC) Box 65 Lillington, NC 27546 .
Telephone Number 910.893•7525 Fax 910 - 893 -2793 www.hamett.org/permlts -
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Application for Manulaclurad Home Set -Uo Permit
(Please all out °ash pan completely)
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Part I -Owner information:
Home Owner Information To be com lot d owner of the manufactured home)
• Noma: ( r ,I )o ( 0-Address:
Lily, State Zip: Daytime Phone: ( ) 919- 3 33- 9x 83
Landowner Information (To be completed by landowner, d Meters than above)
Name: Address;_ _ .
City: .._ State: Zip: Daytime Phone: ( )
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Part 11- Contractor Information (To be completed by Corsrannrs or Homeowner, If applicable.
Name, address, 6 non mull reapph (nfor(nation o license) t- vr pin/
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A. Set -Up Contractor Company Name: 1 Lo � 1 c 1 e ( otr.ef s
Phone' �.5 &3O - -G�,/o Address. SO f3 t ,t c (/ ,
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City' krai Jr Si e: Ai C. _Zip: .,2 7S`f►Z
• - Setup Sienature: State L� SSQ,
Lice 3.
B Electrical Contractor Company Name;_ n h tx'.�Cri 1 ! .Silt/; Cc.. /
_i n 1 lac. ,
Phone: 6 114- 4.11.-.2 1— .7 17'( Addre PA. Bs la '75 -
City, _6 a!� n e s . 21p- __ „7 7 So-�
N' ifprs SN azure: `i./. //r � . ! /4 7 i , state lice ,.2 T7 1/..
C. Mechanical Contractor Company Name; cPI nILKrc, i :SR f - al'L • On )y
Phone. ( i/`3 - 4.�/ -- 75/ Address: P. n,' R at /a 7C r T C
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City' _-. a Ste :• hp: 7 9 ._
. HVAC Slonaturej id. - 4- _ . f State Lice /3_73 0
D. Plumbing Contractor Company Name; f' i bt ; 1 tr,wt �r; n q
Phone: 9 - A ( 935Address: C/', 0, n4c r2 (. 't
City: W: fir,,., 4,4- Q State: /V e- Zip: 2 7,s9 0— _
• • plumper's Slggatute, f r, ygss96 _...._State Lice / e 5r1) P -I
Part 111- Manufactured Nome Informetro
Model Year: c 2 No size: tx Sa— Complete & follow zoning criteria sheet
Park Nome; .4)/4 _•__ _ Lot Number;
. 1 hereby certify that I heal me s/honle to apply ON des Pernik :tat the apptcaaart to apnea Inducing sing the wnlraclor •
• Inlamal n aM swpnrurea. snd dal the cmalwaion d lta/Ebl WI co&mm In the
ra>oecablo manul8ttured home
atop regraarntolla, and the Harlot' Corm/ Za ins Ordnalm. 1 unoereard am a any Item s Inwood ca !aloe
rNOr rnaflOn , been provided Mal nl manta mold Fs lesolad.
Signature of Home Owner or Agent Date
'Effetdva July t, 2004. a County Tex fleaerlrnenr Movinn Permif roust be provided hefofe a Set Up Permit will be Issued, 71 Is
purchased from the fee °Mite or the County Mee Me home is moved from. If Mrs home Is from a dueler, we need proof of year on the
Form 500 and M evadable, the serial number.
List of Inspections and Egress requirements available upon request Progress Enarpy customers roue(
provide Premise Number.
SETUP 4/06
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SALES AGREEMENT
• CUSTOMER NO.: DATE: 7' D /— /17
P 1
BLYI_H(s): C hCt ( t-t ts\ W -cr f SSN: ,
ADDRESS: 3'40'7 /.linV e.,"3 l -k'1t,4rch f , A'v iCr Al / ,.x '75 U /
DELIVERY ADDRESS: /J
TELEPHONE: C) (1 ' 333-- — 1 3 SALES PERSON: if I' 1 Si a tAl .
BASF; !'RICE: $ r '/ CO Make: a
Model: rn v P 5' P oe ca x 67
• Dealer Prep $ Year: N/A Len N/A Width: N/A Stock #:
SUIt- TOT,u• $ e i 995D Serial No.: [ _ • ' v'New ❑ Used
Sales Tax $ 4 ab TRADE: Make: Model:
• Title Fees , 1 " // $ Year: Length: Width: Title #:
>cr Addf..,44 4 $ IV / (130 Serial No.:
S Amount owed will be paid by: ❑ Buyer ❑ Seller
c $ it I) 4
1. Ctsjr PR CE $ rY � ),'Y7.)• QO Owed to:
Trade Allowance $ OPTIONS: " - E r • j wr ^ c
Less Amount Owed $ + . - 'Trade Equity $ •
• Cash Down Payment $ SELLERRESPONSIBILITIES:
Other Payments $ etLIl (\C-er5,(7,r: p - rn
r ,is ;S
2. LESS ALL CREDITS $ • a� ^ - • + - , t _ N ` '`',,' �'ig`j 1 = ;
3. REMAINING BALANCE $ a• c t] 1. i r 7 r t-�
L II rr I
acatiun It -Value Thickness Type of Insulation 3 BUYER RESPONsiBILI'1TEs -n Vi (`e i C tr � et- -I )'1 C0k ti i
Ceiling _— �! 4 1 (t vN L c
i ' O t'M
c _ dl.LAie* P(.l C n,' - NI 1
Exterior • a ►4 R + •p i 1` 1.1 +1' •
Roars l r. I t r Orr fe Dar )
This insulation information was fivntshed by the Alarufacturer Alay not meet local codes and standards. New homes meet Federal Alan, factured Houle Standards.
and is disclosed in compliance with the Federal Trade
Couunisston Rule /6CRF Section 460.16 I UNDERSTAND THAT I HAVE THE RIGHT TO CANCEL THIS PURCHASE BEFORE MIDNIGHT OF THE
'•I' Tern. i n R ucr' is voluntarily pureha.sin THIRD BUSINESS DAY AFTER THE DATE THAT I HAVE SIGNED THIS AGREEMENT. I UNDERSTAND
• ,' insurance products listed below. All numbers ar• THAT THIS CANCELLATION MUST BE IN WRITING. IF I CANCEL THE PURCHASE AFTER THE THREE -
enfy ded.
'n DAY PERIOD, I UNDERSTAND THAT THE DEALER MAY NOT HAVE ANY OBLIGATION TO GIVE ME
A. O !, ER CIIARGLS BACK ALL THE MONEY THAT I PAID THE DEALER. I UNDERSTAND ANY CHANGE OF THE TERMS OF
• Proper`, nsurance $ THE PURCHASE AGREEMENT BY THE DEALER WILL CANCEL THIS AGREEMENT.
I Ins fly m c e $ ESTIMATED RATE OF FINANCING: N/A % NUMBER OF YEARS: NULL
License Fee $ • ESTIMATED MONTHLY PAYMENTS $ NIA
" $ Buyer(s) agree: (I) that the terms and conditions on page two are part of this
$ agreement; (2) to purchase the above home including the options; (3) they
'AL $ received and acknowledge receiving a completed copy ofthis agreement; (4)
1. Unpaid Bal /Amt h •nl $ that all promises and representations made are listed on this agreement; and (5)
C. Interest Rate /° there are no other agreements, written or verbal, unless evidenced in writing and
D. Finance Chary/ . $ si med b the arties.
E. Total of Pa .;Tents (n.n)
1 . '1d al Sa - ° Price mn. r SELLER: BUYER:
G. Num 4 ,1 ' of Payments # X
I I. Pa eat Amount $ (sr an •,y
,Irr This is not a loan commitment ; X /ST11nb,i,!
,'' X
(SW 7,0,1110
X
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(Sigiimure)
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Rev. 10/2004 NC Sales Agreement CMH 1178