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DOCUMENTS Application# 1 I Ot 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: Id•5C. McS)LU Address: -* In VVRI er �1 3IZLa �Rdl I City: IA( State:NC- Zip: 28.. Daytime Phone: 1'o)5/'-&2397- Landowner ndowner Information (To be completed by landowner, if different than above) Name: Address: City: State: Zip: Daytime Phone:( ) Part II-Contractor Information(To be completed by Contractors or Homeowner,if applicable. Name,address &� p¢one must match information on license) A. Set-Up Contractor Company Name: sIip{ 2 fVlohi1e -1oy11e moven Phone: ql°I qit- ivis Address: 10`65 Rqutlint Rd. city: 8Ci1Son NL. State: NC zip: 2?5tm State Lic# 295°1 Email: B. Electrical Contractor Company Name: LAQbf`1 %Ifr.IYc&t Sffvi ce I!IC. Phone: 9C0191F1 4 11 ' yl1 Address: 1311 Mclbry (14 City: ArK�IaIY State: Nc Zip: 27591 State Lic# I5D11V Email: � C. Mechanical Contractor Company Name: tettiMedian ICG1 Phone: CIA U14 '1,\1L1 Address: YO fo q3 City: DiN}r vy1�V� 'i It8. State: NIC- Zip: Q553%91 State Lic# 10'519 Email: • O D. Plumbing Contractor Company Name: Pci rim T Iutv\blr15 Phone: t\iO W9 1to0 Address: VO Box 254 I City: Willow Ser5s state: NCS zip: 21591 state Lic# IS550Q- I Email: Part III-Manufactured Home Information Model Year: i.QI IP Size:ZB X 9, Complete&tallow 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 have obtained their permission to purchase these permits on their behalf, 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 it any item is incorrect or false information has been provided that this permit could be revo /IAA. to. , 13 igture of Home Ow/ror Agent Da 'Effective Ju 1,2004, a County Tax De.:Omen(Movina Permitmust be provided before a Set Up Permit will be issued Itis 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 if available, the serial number. List of inspections and Egress requirements available upon request. Progress Energy customers must provide Premise Number. SETUP 04/11 SALES AGREEMENT �/ CUSTOMER No.: DATE: --3/2 ! /7 BUYER(S): Jalisa Massey SSN: SSN: ADDRESS:3917 Walker RD. Linden, NC 28356 DELIVERY ADDRESS; 3917 Walker RD. Linden, NC 28356 TELEPHONE: 919-773-4340 SALESPERSON:Cathy Long Base PRICE: $ 67,386.00 Make:CHM ac modt. MH Dealer Prep $ Yea Length‘M Width Stock k:HA7919 SUB-TOTAL $ Serial No.:CLH037919TNAB _ 0 New 0 Used Sales Tax $ 1.548.42 TRADE: Make: Model: Title Fees $ 52.00 Year: Length: Width: Title#: $ Serial No.: $ Amount owed will be paid by: ❑ Buyer © Seller $ Owed to: I.CASH PRICE $ 68 986 42 - - - Trade Allowance $ OPTIONS: 14 Seer Heat pump installed, Plumb Water up to 751t and Less Amount Owed $ Sewer up to 20Ft connections,wire Danel box to home for power,white Trade Equity $ vinyl skirting. 2 sets of wood stens to code Cash Down Payment $ 500.00 SELLER RESPONSIBILITIES:Delivery and Setup to County Code, Contractor Other Payments $ 3,000.00 Permits. 2. LESS ALL CREDITS $ 3,500.00 3. REALUNINc BALANCE $ 65,486.42 Location R-Value Thickness Type of Insulation BUYER RESPONsialLITi : Zoning Permit, Septic Reinspection Permit, Ceding Water and Sewer working correctly is customers responsibility Exterior ENERGY SMART RATED Note: Price shown does not reflect closing cost and fees charged by Floors bank. This insulation information was furnished by the Manufacturer May not meet local codes and standards. New homes meet Federal Manufactured Home Standards. and is disclosed in compliance with the Federal Trade Commission Rule 16CRF Section 460.16. I UNDERSTAND THAT I HAVE THE RIGHT TO CANCEL THIS PURCHASE BEFORE MIDNIGHT OF THE ESTIMATED MORTGAGE.Buyer is voluntarily purchasing THIRD BUSINESS DAY AFTER THE DATE THAT I HAVE SIGNED THIS AGREEMENT. I UNDERSTAND any insurance products listed below.All numbers are THAT THIS CANCELLATION MUST BE IN WRITING. IF I CANCEL THE PURCHASE AFTER THE THREE- estimated DAY PERIOD,I UNDERSTAND THAT THE DEALER MAY NOT HAVE ANY OBLIGATION TO GIVE ME A.OILIER CHARGES BACK AU.THE MONEY THAT I PAID THE DEALER.I UNDERSTAND ANY CHANGE OF THE TERMS OF Property insurance $ THE PURCHASE AGREEMENT BY THE DEALER WILL CANCEL THIS AGREEMENT. HBPP Insurance $ ESTIMATED RATE OF FINANCING: NM % NUMBER OF YEARS: NULL License Fees $ ESTIMATED MONTHLY PAYMENTS$ N/A $ $ NYFI(R). gree (I)04. hetartR1.0044#gpP.*,'.RtIPPR 49,11 Pal p&this. ..,. $ 9 eeingi (2)tclPNTc11Me Eh01-?lg,4 ham° °),'9g d14°Pll°nsa they • TOTAL $ 48e1ved and ackn°W1et0receiving atomNded copyollus agieement (4) B.Unpaid BaFAmt Fin.O.q $ that allpromises aqd re sesentattuns Ede FF Istel bn this asr wenj and(5)- C.Interest Rate % t 05,119.l9 ther grj4c iq�1FIR OFy` Inlggs ey dG'ISG(p Wntmgynd D.Finance Charge $ tiRnedby theperhies.�&o$ .Y .0 ae aliST ri.e F.Total of Payments ItogatA*D $ , 8,,,,,,,, F.Total Sales Price mEm $ / (U/�jj G.Number of Payments # / X p&&.s �j: H. Payment Amount $ A aa""""`1 //// X Thk is not a loan commitment abn'a"ro X adralwelX tiara Rev. 10/2004 NC Sales Agreement CMH 1178 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 17-50041011 Date 4/13/17 Property Address 3917 WALKER RD PARCEL NUMBER 12-0555- - -0039- - - Application type description CP MANUFACTURED HOME RA20R/RA20M CRITERI Subdivision Name Property Zoning PENDING Owner Contractor MASSEY JERRY L STATE MOBILE HOME MOVERS PO BOX 371 1085 A AQUILLA RD BUNNLEVEL NC 28323 BENSON NC 27504 (910) 894-8038 Applicant MASSEY JALISA 3917 WALKER RD LINDEN NC 28356 (910) 514-2382 --- Structure Information 000 000 28X56 3 BR FUTURE REAR AND FRONT DECKS Flood Zone FLOOD ZONE X Other struct info # BEDROOMS 3 . 00 MOBILE HOME YEAR 2016 . 00 PROPOSED USE DWMH SEPTIC - EXISTING? EXISTING WATER SUPPLY COUNTY Permit MANUFACTURED HOME PERMIT Additional desc . Phone Access Code 1187020 Issue Date . . . 4/13/17 Valuation . . . . 0 Expiration Date . 4/13/18 Permit LAND USE PERMIT Additional desc . Phone Access Code 1187046 Issue Date . . . 4/13/17 Valuation . . . . 0 Expiration Date . 10/10/17 Special Notes and Comments T/S : 03/24/2017 08 : 01 AM DJOHNSON -- 401 S RIGHT ONTO MCNEILL HOBBS RD THEN LEFT ONTO WIRE RD AND THEN RIGHT ON WALKER RD. 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 17-50041011 Date 4/13/17 Property Address 3917 WALKER RD PARCEL NUMBER 12-0555- - -0039- - - Application description . . CP MANUFACTURED HOME RA20R/RA20M CRITERI Subdivision Name Property Zoning PENDING Required Inspections Phone Insp Seq Insp# Code Description Initials Date Permit type . . . MANUFACTURED HOME PERMIT 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 /_/_ Permit type . . . . LAND USE PERMIT 999 818 Z818 PZ*ZONING INSPECTION /_/_ 999 820 Z820 PZ*ZONING/FINAL INSPECTION /_/_