TRADES 2010 -10 -12 21:43 DIXIE DENNING 9196392141 » 9108932793 P 1/1
Application #
Harnett County Central Permitting 0?°r'377
PO Box 65 Lillington, NC 27546
910 -893 -7525 Fax 910 -893 -2793
www.hamett.org/permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
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Owner (a) of Structure: r5 (r? n 1l ' k-rtu tc Phone: ( G
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Owner (s) Mailing Address: .9a •3 Ff 'Voss 2d
s to tic. _375 - y 17
Land Owner Name (s): Mr Bl Ili lA rs' I4{ Phone: 1/0 No
Construction or Site Address: A .a .3 k £os< 12C{.
PIN or Parcel # from GIS:
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Job Coat: Dt J • Description of Work to be done Pt tt rS
c4o1c.� 64J 11ac
fn 4e.- v 0 1 TL C71.C+f)I c IN Sick-
Mechanical: New Unit , With Ductwork _ New Unit Without Ductwork •„_ Gas Piping
Electrical': 200 Amp _ <200 Amp _ Service Change _ Service Reconnect T Other _
' For Progress Energy customers we need the premise number
Plumbing: Water /Sewer Tap _ Number of Baths Water Heater _
S Directions o I
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Subdivision: Lot #:
1 /11 j {, /c,,,, , _ will provide the / � • • n rt labor on this structure.
Contractors Name) R
I am the building owner or my NC state Iloense number is r) 7C 5 ,' ., which entities 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 local laws, ordinances and regulations.
Structure owner(s) signature: Date:
Company Name: 1 c V\ � 2 1-S G N' 1. Phone: ` lit `J' ( 7 u - 3'2 t/
Address: P L 604 5i'7 County: ._r.Ar 1a N
Contractor's License #: U S E all Address: ()Neat. in 3, .; L- ( C 1. et i n
Contractor's Signature: _ . /' t Date: /a' /3 ir✓
'Company name, address, & phone must match Information on license.
Indh'Idusl Trade Afllcauon 1 of 1 03110
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'`,P Owner Intent
1 NAME " ARNOLD BILLY L
ADDR1
/,� ADDR2
w� ADDR3 }• 2238 ROSS ROAD
tI CITY rl LILLINGTON __ e
I ' " ' ' STATE i0 NC
8 ZIP ,, uO 275460000 '-
Parcel lnfernation
PIN / 0 0569 -55- 4940.000
PARCEL ID-) 100569 0009
REID '- 0000791
{� SITUS ADDRESS 2016 NC SR X
Y`t / LEGAL .1 4 ACRES L A STONE
' LEGAL 2 YARBOROUGH LA
LAND UNITS- TYPE4.00AC
CALC ACRES 3.87590035
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0505 28- ILT#4A FE (r AYLOR RD
1010505 0025 03 7904 OOO 3.454 PC #E132 -D , X 3 00913 :0387
20 0209 10505-73- 1.45 ACRES i RA Y RD X 1.45 00893 10829
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http: // gistools. hamett. org /Freeance /Client/PublicAccess 1 /index.html ?appconfig= public I 10/13/2010