DOCUMENTS lication
Harnett County Central Permitting # tAC>J OO
PO Box 65 on, NC 27546
Telephone Number: 910-893-7525 Fax 910 893-2793 www.harnett.org/permits
Application for Manufactured Home Set-U0 Permit
Pan I-Owner Information:
(Please 011 out each pan completely)
Home Owner Information(To be completed by owner of the m ufacctured�pme) _ C
Name: C` S 4, tecb Address: -A el ‘ jrk 1✓ 1 i1 1 1`V
City: ._4! Vate: Zip.^-r�' ,
�� Stc�t�7�p Daytime Phone: ( )
Landowner Information(To be completed by landowner, if different than above)
Name:
Address:
City: t
Slae:
--- ---ZAP: Daytime Phone: l 1
Part II-Contractor Information (To be completed by Contractors or Homeowner,it applicable.
Name,adds 8 phone mu atchc' rmalimon Tice se _J
se) -_ c
A. Set-Up Contractor Company Name: �1y� .o1 r )
Phonsaa• 115• Address: J3 35 (1 C t • . Wi S
City:af-115- Inn Stale: N C . Zip: I 1c3ZZ
State Lic#_, 7--,0 0 Email. t ' /
D. Electrical Contractor Com an Name: V‘IThr-1t --- cr\
Y e-. IV C_^
Phon=. Address: 6„ TDenin
City. ' 4 ' 4' -1.At State: ZipaIO'
(6
State Lic# ...Nal, i Email
C. Mechanical Contractor^pCompany Name. i • --'- "-
Phon:ci�Q-1h-yy- LJ Address. —111 .1.214M1110,41.1.1
A
CitY: ' ft IL, _ �
Slate. Zip: I
State Lic# for -
Email- /_, _-
D. Plumbing Contractor Company Name:[ ,f\ ;CC
-t . rni-
Phon�e ip--)-6—.���/ address: '+Z 3 S tOc C't W(� p'7 ' �
City: tea" /.C1{ State. -_._( ____Zip: oil I 'D. t' l
State Lick L 0[,) Email:
Pad III-Manufactured Home Information
Model year:\l 9 3 Szep7-. X Lea Complete 6 follow zoning criteria sheet
Park Name- _ ___ Lot Number:
I hereby certify that I have the aulhonty to apply for this permit, that the application is correct including the contractor
information and have obtained their permission to purchase these permits on their behalf, and that the construction or
installation will centrum to the applicable manufactured home sal-up requirements, and the Harnett County Zoning
Ordinan•S I understand that II any41 Is -- • t or false information
revoked has been provided that this permit could be
s .nature of Home Owner or Agent Date
'Effec vs July 1,2000,a County Tax Deeannrant Movmn Permit must be provided before a Set Up Permit wlh be Issued It is
purchased#nm the tax office of the county that the home is moved from, It the home is from a dealer, we need proof of year on the
Form deo and/l available,the serial number.
Ust of inspections and Egress requirements available upon request Progress Energy customers must provide Premise Number.
• SETUP
e/ft1
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Bldg Insp scheduled before 2pm available next business day.
Application Number 17-50040520 Date 4/20/17
Property Address 36 MAHALIE CT
PARCEL NUMBER 11-0662- - -0014- -02-
Application type description CP MOBILE HOME PARK
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20M
Owner Contractor
BUTTS HAROLD T JR RAVEN ROCK MOBILE HOME MOVER
3335 NC 87 HWY.
2191 KEITH HILLS ROAD SANFORD NC 27332
LILLINGTON NC 27546 (919) 775-3600
(910) 893-4240
Applicant
BUTTS HAROLD #50
2191 KEITH HILLS RD
LILLINGTON NC 27546
( 910) 893-4240
-- - Structure Information 000 000 24X60 3BDR DWMH IN MHP
Other struct info # BEDROOMS 3000000 . 00
MOBILE HOME YEAR 1993 . 00
PROPOSED USE DWMH
SEPTIC - EXISTING? EXT TANK
Permit MANUFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1188267
Issue Date . . . 4/20/17 Valuation . . . . 0
Expiration Date . 4/20/18
Special Notes and Comments
T/S: 01/06/2017 02 : 44 PM JBROCK ----
HWY 210 TOWARD ANGIER R ON HARNETT
CENTRAL RD PASS HCHS GO 1 MILE 1ST DR
ON R IS MAHALIE CT THELMA ST
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Bldg Insp scheduled before 2pm available next business day.
Page 2
Application Number 17-50040520 Date 4/20/17
Property Address 36 MAHALIE CT
PARCEL NUMBER 11-0662- - -0014- -02-
Application description . . CP MOBILE HOME PARK
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20M
Permit MANUFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1188267
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
10 501 T501 R*MOBILE HOME FOUND. / M. WALL / /_
10 814 A814 ADDRESS CONFIRMATION /_/_
20 818 Z818 PZ*ZONING INSPECTION /_/_
30 507 T507 R*MANUFACTURED HOME FINAL / /_
999 H824 ENVIR. OPERATIONS PERMIT
999 H828 ENVIRO. WELL PERMIT /_/_
999 307 P307 R*PLUMB WATER CONNECTION /_/_