TRADE Application #
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Hamett County Central Permitting
PO Box 65 Lillington, NC 27546 , F
910- 893 -7525 Fax 910- 893 -2793
www.harnett.org/permits
Certification of Work Performed By Owner /Contractor r.
(Individual Trade Application) `
Owner (s) of Structure: 4 IA Ow bu n Phone: 0 ( Q rS 2- a2-a -1
Owner (s) Mailing Address: t OU 6 1 CeAcir fr
c' ,n4rel Ivy 42,v,
Land Owner Name (s): Phone:
Construction or Site Address: D Coo • ..j._, - it ah3'32 t
PIN or Parcel # from GIS: 9 9 S — ?UY, pBo 2 3 7574_ Zo 02 ✓ 7
Job Cost: Description of Work to be done
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork _ Gas Piping 3.
Electrical': 200 Amp _ <200 Amp Service Change Service Reconnect _ Other _ t
' For Progress Energy customers we need the premise number i
Plumbing: Water /Sewer Tap _ Number of Baths Water Heater _ 1
Specific Directions to Job from Lillinaton:
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40 S 1,0 � '-, - v�lc.c ie) al
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Subdivision: 4 ?, fS /9/ r Lot #: 2
I ! 15 ✓ 1U 9 iO will provide the / J/n,1 - labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is Az ✓.WFW" , 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 IIq /teaa laws, ordinanc s and regulations. /
Structure owner(s) signature: l /(%"" K I a Date: / t( } &)
Comp: ' = Phone:
Address:
County: Con r - . ' - ' ense #:
Contractor's Si tuna: Da =.
'C any name, address, & phone must match information on license.
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Excise Tax , ? r, a " p<INA GENERAL WARRANTY DEED •
Tax Lot No. Parcel Identifier No. 9585 -54- 9688.000
Verified by a Oautty on the day of , 20
bY Mail after .••1 • r ,., , b Ztaraee
P/13101 • . - Place, Payet tevine, NC 28305
This instrument was •. • C. litdeaa
Grief Description for a • . = LOP 207, CSan sal LA1018, MOB 7,
WA M.'
7Hffi IBS made this April ,ti2Ri0, - __ •
aniNTOR GRANTEE
MALL= 07482F03:17 tire7IP, " - WNW and husband
N17LR73 10335$881 n0 fl 2476 / .J) AqRES.9a 1064 =OMAN SitY •
S4A2T83518, SE 28106 8ANKIO, NC 27332
The designation Grantor and Grantee as used J - 1 include eairl parties, their
heirs, successors, and assigns, axd shall incl - - . , plural, masculine, feminine
or neuter as rewired by a ntext.
Wf1NES3E11i, that the Grantor, for a valuable ••-_ d by the Grantee, the
receipt of Which is hereby aokn 1edged, has and by is does grant, bargain,
sell and convey unto the Grantee in fee simple, al •. . lot ar parcel of land
situated in the City of SANFO D, Step ltwnship, _, t , Carolina and more
particularly described as follows:
MID ALL CO LOT /RI
207, Mier ON A P 09 BOOM :..
. . • �-. , ■. LA10�, MOE
VII-81,00C 't•, 8AR1aa= INP., 1ThW rfT COMM t S w. , , Z:'- 621 6, 1995,
P703PARP21 82 BRAWN b ASOCC A188, MO BEI M ______ ' 1 v PAGES , PA 495P,
SAIOa rr COMM 1166x6 RY.
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