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SET UP Application # ,02 £ 2 7 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 I -Owner Information: Home Owner Information (To be completed by owner of the manufactured home) Name: la ° £_ % F,r c . 4 e r e _ Address: t a- '(31 U-e, q t 6 City: S I % tc IC.P State: /%/C Zip: 7 B34n Daytime Phone: () k 3la - 3988 Landowner Information (To be completed by landowner, if different than above) Name: S R tin P AS a 6e.g Z Address: City: State: Zip: Daytime Phone: ( ) Part II — Contractor Information (To be completed by Contractors or Homeowner, if applicable. Name, address, & phone must matcp information on license) A. Set -Up Contractor Company Name: r-7 yn A b t 1 P )fcme m © VC Phone:9l -6.2... - 95 Address: ,3 413 6 v cre t' Rr' City: Po 1 0-Te r• Sit t e: Zip: 2 e S 71 Setup Signature: �.� State Lic# 3 5 3 7 B. Electrical Contractor Company Name: G) A - ) nt IL Nr e,,.. C ' * Phone: Address: City: State: Zip: Electrician's Signature: /t )G,x�2 t7 �rP^-° - 'State Lic# C. Mechanical Contractor Company Name: [U q y r e-- Lr9 tt E=. Phone: Address: City: State,; p Zip: HVAC Signature: In k 4_ 1 State Lic# Co to `1-- J D. Plumbing Contractor Company Name: ( r C 12 A Ok /7 (r Phone: Address: City: State: Zip: Plumber's Signature: to :P, State Lic# ° us -I-- Part III - Manufactured Home Information Model Year: n/5 Size: 4.3 X 2 8 # of Bedrooms 3 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 information has been provided that this permit could be revoked. Wn. 9.oi�ik.�.� 2,23 — t o Si nature of Home Ow e or Agen 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. If the home is from a dealer, we need proof of year on the Form 500 and it available, the serial number. List of inspections and Egress requirements available upon request. 2/08 • Cn 1 le LU FT ..1 Q N I tJT U : y W • co 0. LU i oo i : N r 1 d 5E m c'a c J IF.) m O cis E w 0 1 ° v d p 3 g C {p O CO �• 2 yy ; O a m F " r hi N G1 O N Z. Q 0 E }- v g °U ID va vg d p O ° 00 O G fQ . j a 1 y ,. t‘ ' , .1 co 1 �.. i as w e $ E c 2 O d at 16�1F� O H a € i c E t '� o ti z U N a • U F o I LU IIM z ies ■ 1 ¢ i ..3. E — ` 3/4 p Z Z r F 1 ris c c 0 2 .o , : o EJ � a o k • • om ■ 0 ILI L A O 1 L LI CV) ti '13 • CD Z o CCI Z a < N 1 o o 1 tti m m r U E ... 1 d' d— 0 c c J / o Z a a= W O R ;1;8 �� of m ID cn ui 1 as m m o , ¢ ¢ � ` E •o v �U y 0 i 0 Ya c Ei Q * ti la d , o v 144 ca i y r c H NI C so D \ _? F € W • g 0. i } LL Z 0 al C C l N 6 ' S"3J O O 1 °' € I--= a I- 0 03 dy.' ¢ € € E E �' E b yZ O H m 6 m � W o 1d3 - _ - U W a U° M 1— 0 Aug 10, 2010 1:11:21 PM VQ30 VR5I LIEN DETAIL 08/10/10 13:11:08 HHC006606NCAB FUEL CUST ID 000005687014 1994 HEND WAYNE DAVID LAFRENIERE CUST ID 000013690391 LEONA STILLWELL LAFRENIERE TITLE 000001328150126 XFER DATE 09/22/1993 PRINT DATE 09/22/1993 OWNERS 2 LIEN 1 OF 1 LIEN DATE 09/22/1993 ACCOUNT NBR LIENHOLDER ID: 000011714487 VANDERBILT MORTGAGE LIENHOLDER ID: LIENHOLDER ID: RESIDENCE ADDRESS: PO BOX 4007 MARYVILLE TN 378024007 MAILING ADDRESS PO BOX 9800 MARYVILLE TN 378029800 ONE TIME ADDRESS : PF1 /HELP PF2 /IMAGE PF3 /RETURN PF4/ PF5 /ADDRESS PF6 /OWNERS PF7/ PF8/ PF9 /PRINT PF10/ PF11/ PF12 /MENU