DOCUMENTS er
Application# 1750011i 37f a
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)
Pad I-Owner Information:
Home Owner Information (To be completed by owner of the manufactured home)
Name: /r rv/C r ` '1.-11C Address: 2 %5 Pewee State: Sf
/✓C Zip: /
City: v J4 ' t�s/,+.< 27.SZbDay[ime Phone:q/ S6 � Z7g�
Landowner 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,addressA8 Rhyne must watch into mation o liven3a1
A. Set-Up Contractor Company Name: Y 1u s C.U r1 54ruc-\G ( i_ I
Phone: 2 'io ty 5.-q})._,zLAddress: 405 Cran e5 C(e.�ie/le a1
City: n )1lY ) 0(01)- State: 71L- Zip: aTJ�--Sr
State Lic# L-IS5-10 Email: 0.R1Ugs�ruck tLD) -S3L ak.\Rh&a ,c 4
B. Electrical Contractor Company Name: i ii in l'4"'ct - 3011- < t.M.•-1 Con H.,. h'vS
Phone: c71 422 or% Address: 348 L.-61 Sin •'14. R3
P
City: rinrc4r State: A' C- Zip: 27 561
State Licit ?O 4 62. U— Email: .krrtr e?Jot4-4jo.4-,=-., nth
C. Mechanical Contractor Company Name: —5011- glitz. "r, I Leo -r< ...}OK.
Phone: 4l1 42t COY* Address: 36g L-4Si.. .1-• IZ 2City: I e rid. } + .
. . State: N c Zip:: 2 7$6 4
State Lic# (4551 Email: ''imr e ;,,,, 14 ,,e4.,..„... . Inc4-
D. Plumbing Contractor Company Name: -Co I - ?t€'A f.2. 1 Co.. I---It on
Phone: 1150721 cork Address: 7bY L,.h7 $rrrij. £4
City: I C•c4 hr. State: /V C._ !!11 Zip: 17 Ss.
State Licit )54sn, Email: �"mre Jo I4-e.3- 4.4t , nt 4-
Pan III-Manufactured Home Information c.
Model Year: 2 17 Size:1-7 X d it Complete& follow 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 if any item is incorrect or false information has been provided that this permit could be
revoke i
Signature of Home Owner or Agent Date
'Effective July I,2004, a County Tax Department Movin Pq ermit 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 if available,the serial number.
List of inspections and Egress requirements available upon request. Progress Energy customers must provide Premise Number.
SETUP 04111
HEAVENLY HOMES
4629 US HWY70 W
PRINCETON, NC 27669
(919)7354400 • FAX (919)7354494
buyheavenlyhomes.com
BUYERIS) PHONE qv" fl7 t)' DATE •
MaYK f:LLJcod Crane" d S1sti„ gyral% C/4m, 9,1 torr c&sw szois)
ADDRESS ,.., 2LSALESPERSO
2 1 uar u 4 _: I1^ 4CJS -
.
DELNERYA�ooDRESS—r C n 1 e-
'AC 445h11HIcer. ri.f,r e.� 1/c,6nc „J c, 2)s-L4
MA11Ed MODEL YEAR BEDROOMS FLOOR SIZE HITCH SDE STOCKNUMBER
CIO to. gj -j- ne. __ 'on 3 Ls w27 LTL w2:7 '—
SERA NUM.t elA1Y (� IA p COLOR PROPOSED DELIVERY DATE KEY NUMBERS
..1„W f W 5 1 3 � IfP ANEW ❑ USED iCi YI 3 ‘,.es —
LOCATION Si-VALUE THICKNESS I TYPE OF INSULATION BASE PRICE OF UNIT 5'qc QU,-7 00
CEILING OPTIONAL EQUIPMENT
EXTERIOR •
FLOORS SUB-TOTAL $
THIS INSULATION INFORMATION WAS FURNISHED BY THE MANUFACTURER AND
IS DISCLOSED IN COMPLIANCE WITH THE FEDERAL TRADE COMMISSION RULE SALES TAX
16CFR SECTION 460.16 ild11n,/ SO, ) a
OPTIONAL EQUIPMENT, LABOR AND ACCESSORIES NON-TAXABLE ITEMS
VARIOUS FEES AND INSURANCE
CASH PURCHASE PRICE $ 0 OJ
Black StoveFriq _ LEBAL.
ALLOWANCE $ / j�
Black LESS BAT.DE on above$
— Black Dishwasher NET ALLOWANCE - $
Upgraded_ Yhermal-guard windows _ CASH DOWN PAYMENT $
__ Upgraded Insulation package CASH AS AGREED $ ddee
Kitchen Island LESS TOTAL CREDITS $
1 Yr. manufactures warranty SUB-TOTAL $
—
SALES TAX(If Not Included Above) i 013
Unpaid Balance of Cash Sale Price $ g7[013 OO
Dealer and Buyer certify that the additional terms and
_This purchase includes the new home unit, conditions printed on the other side of this Agreement are
_dropped off only. - agreed to as a part of this Agreement,the same as if printed
above the signatures. Buyer is purchasing the above
described manufactured home; the optional equipment and
_Buyer is responsible for all items necessary accessories,the insurance as described has been voluntary;that
—
to complete home, including, but not limited to Buyer's trade-In Is free from all claims whatsoever, except
—satisfing zoning, permits, covenants, setup, as noted. L
inspections, and overall completion of home. ESTIMATED RATE OF FINANCING /
NUMBER OF YEARS
'wheels&axles were rented, will be picked up
ESTIMATED MONTHLY PAYMENTS$
THIS AGREEMENT CONTAINS THE ENTIRE UNDERSTANDING BETWEEN
DEALER AND BUYER AND NO OTHER REPRESENTATION OR
INDUCEMENT,VERBAL OR WRITTEN,HAS BEEN MADE WHICH IS NOT
Lk 1001 COVERED IN THIS AGREEMENT.
BUYERS)ACKNOWLEDGE RECEIPT OF A COPY OF THIS ORDER MD ORDMD THAT
BUYER S)HAVE READ AND UNDERSTAND THE BACK OF THIS AGREEMENT.
— I UNDERSTAND THAT I HAVE THE RIGHT TO CANCEL
THIS PURCHASE BEFORE MIDNIGHT OF THE THIRD
BAL'ANCE,CARRED TO OPTIONAL EQUIPMENT $ BUSINESS DAY AFTER THE DATE THAT I HAVE SIGNED
NOTE:WARRANTYANDERCLUSIONSANDLIMITATIONSOF DAMAGESONTHE REVERSE SIDE. THIS AGREEMENT. I UNDERSTAND THAT THIS
DESCRIPTION OFTRADEJV YEAR SIZE CANCELLATION MUST BE IN WRITING IF I CANCEL
MAKETHE PURCHASE AFTER THE THREE DAY PERIOD, I
MODEL BEDROOMS UNDERSTAND THAT THE DEALER MAY NOT HAVE
TITLE NO. SER COLOR ANY OBLIGATION TO GIVE ME BACK ALL OF THE
AMOUNT OWING TO WHOM MONEY THAT I PAID THE DEALER. ) UNDERSTAND
– ANY CHANGE�t�17TO THE TERMS OF THE PURCHASE
ANY DEBT BUYER sONTMDE-IN IS 708E PAID BY ❑ DEALER ❑ BUYER AGREE ENT
— T BY THE DEALER WILL CANCEL THIS
AGRE E •
•
HEAVENLY HOMES . SIGNED
Nal Vend WanSbnep and Accepted by en Ohkxu/ere CompanyDEALER BUYER
or an Authorized Agent
.(p/(
Approved BY SIGNED X '.4 zt) (qr.;4,a-- �/L'�✓L4.1)17 BUYER
StalfazIetiNamop Fneu anruu . 6 A PLAIN LANGUAGE PIIRr:HA9F A(:RFFupui I I
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 17-50041388 Date 6/16/17
Property Address RIVER RD
PARCEL NUMBER 05-0623- - -0010- - -
Application type description CP MANUFACTURED HOME RA 30 CRITERIA
Subdivision Name
Property Zoning RES/AGRI DIST - RA-30
Owner Contractor
BOYKIN LUTHER D A PLUS CONTRACTOR
7905 NORMA LN 5369 US HWY I N
RICHLAND HILLS TX 76118 VASS NC 28394
(910) 690-9222
Applicant
CRANE MARK
255 DEWAR ST
FUQUAY-VARINA NC 27526
(919) 567-2795
--- Structure Information 000 000 28X70 DWMH 4BDR
Flood Zone FLOOD ZONE X
Other struct info # BEDROOMS 4 . 00
MOBILE HOME YEAR 2017 . 00
PROPOSED USE SFD
SEPTIC - EXISTING? NEW
WATER SUPPLY COUNTY
Permit MANUFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1196419
Issue Date . . . 6/16/17 Valuation . . . . 0
Expiration Date . 6/16/18
Permit LAND USE PERMIT
Additional desc .
Phone Access Code 1196401
Issue Date . 6/16/17 Valuation . . . . 0
Expiration Date . 12/13/17
Special Notes and Comments
T/S: 05/16/2017 09 : 31 AM LBENNETT - -
NORTH ON 401 TURN LEFT ON CHRISTIAN
LIGHT RD - TURN LEFT ON COKESBURY RD -
LEFT ON RIVER RD AT THE NEW NORTHWEST
HARNETT COUNTY FIRE DEPT - TURN RIGHT
ON JASMINE RD TOWARD THE CAPTINS
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 17-50041388 Date 6/16/17
Special Notes and Comments
LANDING DEVELOPMENT - PROPERTY IS ON
THE IMMEDIATE LEFT AS YOU TURN ONTO
JASMONE RD AND IS BORDERED WITH RIVER
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 3
Application Number 17-50041388 Date 6/16/17
Property Address RIVER RD
PARCEL NUMBER 05-0623- - -0010- - -
Application description . . CP MANUFACTURED HOME RA 30 CRITERIA
Subdivision Name
Property Zoning RES/AGRI DIST - RA-30
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 / /