SET UP Application # P 5 F0 2 c b 44
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 1 -Owner Information:
Home Owner Information (To be completed by owner of the manufactured home)
Name: feather oottlfrrri 1444 Address: 1 t4tni 1 DR
City: fa,Nla Lam State: /JO Zip: 2.4390 Daytime Phone: ( 395
Landowner Information (To be completed by landowner, if different than above)
Name: Ts K o 6 ad Address:
City: State: Zip: Daytime Phone: ( )
Part 11 — Contractor Information (To be completed by Contractors or Homeowner, if applicable.
Name, address, & phone must mate] i nformation on license
A. Set -Up Contractor C ompany Name: Ho-on -; �5e 1l .'
Phone: q/� i$' - 27Go Address: S3x larre2CenI bt" 6 Hwy
City: "' - Zip: e . Z.7 33 Z
Setup Signature: State Lic# e 1 1
B. Electrical Contractor Company Name: >iVID /1/ a ng4e.rCc7'
Phone: /4' -3S 3 4t ldress: 'S Z9 -04,44 Dec
City: State: Vt-L -i Zip: Z7 3 38
Electrician's Signature: ,IP State Lic# [ 1 Z
C. Mechanical Contractor Company Name:_ 1
Phone: Address:
City: State: Zip:
HVAC Signature: State Lic#
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D. Plumbing Contractor Company Name: 14. 2. Cc12T/s
Phone: ! ro' 6621 a . Address: Co 3 / C oIK./ �S
City: O(est) Staatte�/ — ' u 'C Zip: —3-7 33 z___ .
Plumber's Signature: 1.1. c- ! State Lic# »9 2'1
Part 111 - Manufactured Home Information
Model Year? -O (( Size: Z I6. Complete & follow zoning criteria sheet
Park Name: Lot Number:
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
informatio s en provid at this ermit could be revoked.
�// 3//0
Signature of ome Owner or Agent Date
`Effective July 1, 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. 11 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
HOMES BY VANDERBUILT
3300 Jefferson Davis Highway
SANFORD, NORTH CAROLINA 27332 , -
1- 919 - 774 -6319 • Toll Free: 1 -800- 537 -2448
BUYERts) 1 / P DATE,‘
, nT��tt �aulA1 .a 1J ,c oNfn! 7/a �/�c - f95:2- eV - 7 - ?6ia
ADDRESS ^ oihhoy / SALE §BSOAy�
DELIVERY ADDRESS Al / S
��
MAKE & MODEL /1 / YAR BEDROOMS L
''7 W,9fJ FLOOR SIZE HITCH /y/; H / ITCH SIZE STOCK NUMBER
e / '/ �� �/ Am (4 Lk VJols
SERIAL NUMBER COLOR ,. .„... PROPOSED DELIVERY DATE ' KEY NUMBERS
134EW ❑ .USED / "Cr
LOCATION R -VALUE THICKNESS TYPE OF INSULATION BASE PRICE OF UNIT $ 7?,f 93, bC
CEILING OPTIONAL EQUIPMENT S
EXTERIOR
FLOORS SUB -TOTAL $
THIS INSULATION INFORMATION WAS FURNISHED BY THE MANUFACTURER AND
IS DISCLOSED IN COMPLIANCE WITH THE FEDERAL TRADE COMMISSION RULE SALES TAX 6On.60
16CRF, SECTION 460.16.
OPTIONAL EQUIPMENT, LABOR AND ACCESSORIES NON - TAXABLE ITEMS 7111# 0' co
1. All Agreements must be in writing. No Verbal promises. $ VARIOUS FEES AND INSURANCE
2. Set -up does not include on site plumbing & electrical work. 1. CASH PURCHASE PRICE $ ' to
3. Buyer must grade lot and remove stumps and vegetation. There will be a TRADE -IN ALLOWANCE $
charge if foundation goes over 36" high. Buyer is responsit le for any LESS BAL. DUE on above $
Engineering Fee. NET ALLOWANCE $ /'
4. Buyer Certifies property is not located in a flood zone. CASH DOWN PAYMENT $ 7!/ *bb j
5. Porches, decks and steps are the responsibility of the buyer. CASH AS AGREED( $
6. Buyer is responsible for all permits including health & buildirg. 2. LESS TOTAL CREDITS $ 7V an No
7. Buyer is responsible to clear trees and provide access to site. SUB -TOTAL $
B. Buyer may not move any personal items into the. hone until SALES TAX (If Not Included Above)
-
all funds have been paid to HOMES BY VANDERBUILT® 3. Unpaid Balance of Cash Sale Price $ .i
9. HBV is not responsible for any costs incurred with land transactions. REMARKS:
Including but not limited to Title Search, Deed /Deed of Trust Preparation, BUYER UNDERSTANDS THAT BUYER HAS THE RIGHT TO
Revenue Stamps, Property Taxes, Recording Costs & Attorney Fees. CANCEL THIS PURCHASE BEFORE MIDNIGHT OF THE
10.Home must be released for production within 60 days to ho or this price. THIRD BUSINESS DAY AFTER THE DATE THAT BUYER HAS
SIGNED THIS AGREEMENT. BUYER UNDERSTANDS THAT
THIS CANCELLATION MUST BE IN WRITING. IF BUYER
$ paid as deposit to order home. CANCELS THE PURCHASE AFTER THE THREE DAY PERIOD,
$ due upon delivery of home. BUYER UNDERSTANDS THAT THE DEALER MAY NOT HAVE
Balance of $ due prior to occupancy. ANY OBLIGATION TO GIVE BUYER BACK ALL OF THE ,
HBV must be paid in full before any items are moved into the home. MONEY THAT BUYER PAID THE DEALER.
fa/Om/ i re, p�en Sl 4, 47 Sing A' term Ill
k' ,Ms Mtge ESTIMATED RATE OF FINANCI %
Ctil rg�onns,L /_w lir Any euodAitA, JJ4 J NUMBER OF YEARS
M 4 y' nrrtr/ ESTIMATED MONTHLY PAYMENTS,
BALANCE CARRIED TO OPTIONAL EQUIPMENT $
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NOTE; WARRANTY AND EXCLUSIONS AND LIMITATIONS OF OAMAGEVON THE REVERSESIDE Dealer and Buyer certify that She additional terms and
DESCRIPTION OF TRADE -IN VEAR SIZE conditions printed on the other' aide of this contract are
x
MAKE MODEL BEDROOMS agreed to as a part of this agreement, the same as if printed
above. the signatures. Buyer is purchasing the above
TITLE NO. SERIAL NO. COLOR described manufactured home; trailer or vehicle; the optional
AMOUNT OWING TO WHOM equipment and accessories, the insurance as described has
been voluntary; that Buyer's trade -in is free from all claims
ANY DEBT BUYER OWES ON TRADE -IN IS TO BE PAID BY ❑ DEALER ❑ BUYER whatsoever, except as noted.
ROT
'- . BEEME CO ACKNOWLEDGE EflSTAl10ING BERVEEN'OEALER AND,BUYER`AND ■110 OTHEHj REPRESENTATION:ORYNDUCEMENT, VERBAL'° RATHIEN,` ; HAS. BEEN NIADE;WHICH;IS', . CONTAINEDiTN 'THIS 'CONTRACT.
ii 1HIS;ACREEMBlFCONTNNS THE ENTIRE I1N0 t I
,RECEIPT OFA'COPV OF,;THIS ORDER AND THAT BUVER(S) FIRVE READ'AND UNDERSTAND THE BACK OF, THIS'AGREEMENT: ,-
HOMES BY VANDERBUILT® • � • 7 _) �rJ
SIGNED X BUYER
DEALER
Not Valid !/mess Signed and Accepted by an Officer of the Company or an Authorized SOCIAL SECURITY 0. / /
Agent � fq � .I � , O / .a.�
By SIGNED X Ft:, — t U BUYER
Approved SOCIAL SECURITY NO. / /
Dr- M.767 �� ® A PLAIN LANGUAGE PURCHASE AGREEMENT Rev D5/02
�r RR �olrm.1 1 CopyrInht01983 JENKINS BUSINESS FORMS 1-800-851-4424