DOCUMENTS 50O413A
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
Telephone Number: 910-893-7525 Fax 910-893-2793 www.hamett.org
Application for Manufactured Home Set-Uo Permit
(Please fill out each part completely. Must be accompanied by moving permit)
Part I-Owner Information:
Home Owner Information (To be completer} by owner of the manufactured home)
Name: DP�•itS 140‘41514 R - Address: /too 1 l(Mc./4 SQ(lu.ac-oral City: Wi`Ilot.D S91Iap-as State: AJC Zip: alt`A• Daytime Phone: a% -ora-9
Landowner Information (To be completed by landowner, if different than above)
Name: 1 gdtD 7i '@Sit Address: a84 ids•-40Jar. zo-8
City: a Ca-R-• State: p3C. Zip: Z:7501 Daytime Phone: (Ts '?A4 4 t I.5-
Part II-Contractor Information(To be completed by Contractors or Homeowner, if applicable.
Name, address,8,phone m st match information on license)
A. Set-Up Contractor Company Name: CAO HH HOva.R53tate Lic# DD 3.10 n_
Phone: 919-944-O4 Address: 3-t-t.e t oft. '• Ka-nt.AJr
City: K-o--..11w-y State: p...7 C._ Zip: 3-1 541,-' ;Jr
Setup Signature: II
B. Electrical Contractor Company Name: 6-tte-N,•-1 Ctn. LC. State Lic#n, /a 8 /b �-
Phone: a/Iy' 115'0849 Address: (p OOs tQpsjt P-0-02.#1 gyp,
City: *&,- .-13i-4 State: Ai c Zip: 0.3
Electrician's Signature:
C. Mechanical Contractor Company Name: 6L.?w.rn) SUQ Co State Lic# /3 23'1 I-)3
Phone: 91'i-7-79-0949 Address: 6p G105 .9 Reck &[.Awe; h
City: -6-47State: Ivo G Zip: -1 b ria
HVAC Signature: lI,� � ������
D. Plumbing Contractor Company Name: �(1�p'Q. L(]�,2 'aluSnl .state Lic# C B S d'P
Phone: lf'4Y>- 4' 3CAddress: T•a i ra^F310 '1
City: CO; lino 5ppvltrc_ State: /1/4i C-- Zip: e1592-)
Plumber's Signature:
P rtManufactured Ho Information
ew_Used Singlewide_Doublewide_Triplewide
Model Year: abil Size: 14 X 4C. Private Property Manufactured Home Park
Park Name: t-44-- Vt LA.,A'6'E Lot Number 9
Directions to site or Manufactured Home Park from Lillington:
N,
an c. M Rau "'(-D a4D o 3o Cc L-. TO k# or.) kki2 c*t
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I hereby certify that I have the authority to apply for this permit, that the application is correct including the contractor
information an• -ignature d that the •nstruction or installation will conform to the applicable manufactured home
set-up re• if ants, ar.•lir�= Ha`-/ ounty Zoning Ordinance. I understand th. if any ite is incorrect or false
inform: 1.Ar sb-- x11111' ASs permi -HA be revoked,
/t ti✓i/l rO/
' '.l..(ftp, • Wirt:ner or rge t Date
'Effective July , r0-, a Harnett ounty Tax Department Moving Permit must be purchased bef•re a Set Up Permit will be issued.
10/06
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 06/26/2017
Entry #: 676591 Initially filed by: ralelghcleyton761
Designated Lien Agent Project Property
Print & Post
Imcxmta Title hnWonce Company 2R4 IlArold Driee lot
Angier.NC 27501 Qi " ---
Dallas:
Dalloe:gas 0 Dasas sn:n Haman Count, R ra
Address: IS N.ILryntil 1w:e'dr NLeigl',Sf rti' �i1
27501 a{,
enane:aavaanral Property Type
Contractors:
Fa:a 11-40-523: Please post this notice on the Job Site
1-2 Family Dxclling
Faun:reonauamaim,ma: Suppliers and Subcontractors:
Scan this image with your mart phone to
Date of First Furnishing
view this fling von can then file a Notice
to Lion Agent For this project.
Owner Information
00 20/2017
Dennis Marshall
2i4 Harold Urine Loth
Angier, NC 27501
United States
Email'.MINIM clmtunhomm.mm
Phone.919.772.5013
l'mw Comments 101
Technical Support Hotline:OM
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 17-50041324 Date 6/28/17
Property Address 284 HAROLD DR
PARCEL NUMBER 11-0662- - -0014- -01-
Application type description CP MOBILE HOME PARK
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20M
Owner Contractor
BUTTS HAROLD T JR KARL CARTER
371 WOODRUFF ROAD
2191 KEITH HILLS ROAD SELMA NC 27576
LILLINGTON NC 27546 (919) 422-0428
(910) 893-4240
Applicant
BUTTS HAROLD #8
2191 KEITH HILLS RD
LILLINGTON NC 27546
(910) 984-6115
--- Structure Information 000 000 14X80 SWMH 3BDR
Other struct info # BEDROOMS 3 . 00
MOBILE HOME YEAR 2017 . 00
PROPOSED USE SFD
SEPTIC - EXISTING? EXIST
Permit MANFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1198043
Issue Date . . 6/28/17 Valuation . . . . 0
Expiration Date . 6/28/18
Special Notes and Comments
T/S: 05/08/2017 10 : 44 AM LBENNETT --
210 TOWARD ANGIER - RT ONTO HARNETT
CENTRAL RD - 1 1/2 MILES ON RIGHT -
THIRD ENTRANCE INTO TAYLOR VILLAGE -
8TH LOT ON THE LEFT
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 17-50041324 Date 6/28/17
Property Address 284 HAROLD DR
PARCEL NUMBER 11-0662- - -0014- -01-
Application description . . CP MOBILE HOME PARK
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20M
Permit MANFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1198043
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 —//