DOCUMENTS Application# LI I I LO V
Harnett County Central Permitting
PO Box 65 Liliington, NC 27546
Telephone Number: 910-893-7525 Fax 910-893-2793 www.harnett.org/permits
Application for Manufactured Home Set-Uo Permit
(Please fill out each part completely)
Part I—Owner Information:
Home Owner Information (To be completed by owner of the manufactured home)
Name: P-foAI ;P, Lt�145kAddress: Li 3 Si"r /ll e.."'1r
City: S State: ji Zip: 3,90
- Daytime Phone:( t -ryas-
Landowner Infoi ation (To be completed by landowner, if different than above)
Name: Address:
City: State: _ Zip: Daytime Phone: ( )
Pali II—Contractor Information(To be completed by Contractors or Homeowner,if applicable.
Name,address,Si phone must match information on license)
A. Set-Up Contractor Company Name:
Phone: Address:
City: State: Zip:
State Lic# 6 tuY2 F✓' Email:
B. Electrical Contractor Company Name:
Phone: Address:
City: State: Zip:
Slate Lic# er Email:
C. Mechanical Contractor Company Name:
Phone: Address:
City: State: Zip:
State Lic# Ocr. R Nr Email:
D. Plumbing Contractor Company Name:
Phone: Address:
City: State: Zip:
State Lic# ()(_t_zj er Email:
Pan III—Manufactured Home Information
Model Year: 19//9// /(7 Size: /9 X-A01 Complete& follow zoning criteria sheet
Park Name: /Y4i/P,5 /u NP Lot Number: Y 3
I hereby certify that Ihave 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
revoked.
;'� S - /6 2o/7
Sin r Horde Owner or A t Date
*Effective July 1,2004,a County Tax Department Movinc Permit 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 04/11
From Ha/nett County Tax 910 814 4017 08/18/2017 16:33 #121 P.001/001
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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 17-50041760 Date 8/16/17
Property Address 43 SARAH CIR
PARCEL NUMBER 01-0524- - -0063- - -
Application type description CP MOBILE HOME PARK
Subdivision Name
Property Zoning PENDING
Owner Contractor
HAYES RUSSELL & S OWNER
RT 1 BOX 476
SPRING LAKE NC 28390
Applicant
LAPINSKI FRANKIE
153 KELLY CREEK ST
SPRING LAKE NC 28390
(910) 728-5405
--- Structure Information 000 000 14X80 SWMH 3BDR 1997
Other struct info # BEDROOMS 3 . 00
MOBILE HOME YEAR 1997 . 00
PROPOSED USE SFD
SEPTIC - EXISTING? EXIST
Permit MANFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1205152
Issue Date . . . 8/16/17 Valuation . . . . 0
Expiration Date . 8/16/18
Special Notes and Comments
T/S : 07/03/2017 03 : 31 PM LLUCAS ----
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 17-50041760 Date 8/16/17
Property Address 43 SARAH CIR
PARCEL NUMBER 01-0524- - -0063- - -
Application description . . CP MOBILE HOME PARK
Subdivision Name
Property Zoning PENDING
Permit MANFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1205152
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 / /