SET-UP & PERMIT Harnett County Central
Application
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Telephone Number: 910-893-7525 PO
Fax x 65 910 893-27on, NC 93 www.harnett.org/permits
Application for Manufactured Home SM-Up Permit
(Please fill out each pan completely)
Part I—Owner Information:
Home ner Inforrlpall (To be cornplHated by owner of the manufactured home)(� L
Name: ehp 1 �c�\te LJp Address:lay I I af-C1 Lif�lc era
city: l Y\I\ �Avi r1d� Stale: N, C . Zip: Z
7 S 7G,aylime Phone:( )
Landowner Information(To be completed by landowner, if different than above)
Name: Address:
City:
State: Zip: Daytime Phone: ( )
Pad II—Contractor Information (To be completed by Contractors or Homeowner,if applicable.
Name,addreA &phone rint mach Infor do o license
A. Set-Up Contractor Company Name: Jc n Knct in VOA)/
C
Phone:OUCH-(S-3(non Address: 3335 1 lv C ` OA)/IL Cl L i
Cty: ,NCS State: K
r __ Zip: c-712)32__
State Lick '14-c3 Q Email: (4 (
k.
S. Electrical Contractor Company Name: .i-j- "---\
e c , l L
Phone: � q Address: 204((3 (A h1‘1,- 1� Lc\V-1 V I
City xa Ir‘\) V or 1 rlc.fState: � 1'C, Zip: c2 "'(S J( C r\ h V r7
State Lic# I Q u(-7. I Email: 1�� m �- c(
C. Mechanical Contractor Company Name:-I\c`c t C 44!Y
Phone: Address: 3, J\ I CUR' \„, VI01,0-C � V
City° '�yl--1 l State: N C - Zip: c� 1 r.(t
Stale Lice cy u 1 Email:
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D. Plumbing Contractor Company NameQfl
SQ(\ V-Q t ne)ki IYWve
vPhon %1Mtra ( Address3�3� � C )City: _� ay State: Zip: )
State Lic# , DC)1 EmaiC
Part III—Manufactured Home information
Model Year:2.-D '
D S Size:1 -UC 7 1' (n 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 ha • •stained their permission to purchase these permits on their behalf, and that the construction or
install on will c• form • the applicable manufactured home set-up requirements, and the Harnett County Zoning
Ordirr�Ce. I on.-rstand t :t if i em correct or false information has been provided that this permit could be
evorl e/Q
Signature o Home Owner or Agent Date
-Effective July 1,2004, a County Tar Department Moving 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
Fenn 500 and if available,the sena/number.
List of inspections and Egress requirements available upon request. Progress Energy customers must provide Premise Number.
SETUP
04/11
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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 17-50042052 Date 8/30/17
Property Address 118 MYATT LN
PARCEL NUMBER 04-0682- - -0093- - -
Application type description CP MOBILE HOME PARK
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20M
Owner Contractor
MYATT NANCY ROSE SILVERS RAVEN ROCK MOBILE HOME MOVER
4586 NC 55 W 3335 NC 87 HWY.
ANGIER NC 27501 SANFORD NC 27332
(919) 639-2250 (919) 775-3600
Applicant
BIGGS ANGELA #118
(919) 880-7787
--- Structure Information 000 000 14X76 3BDR SWMH
Other struct info # BEDROOMS 3000000 . 00
MOBILE HOME YEAR 2001 . 00
PROPOSED USE SWMH
SEPTIC - EXISTING? EXT TANK
Permit MANFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1207299
Issue Date 8/30/17 Valuation . . . . 0
Expiration Date . . 8/30/18
Special Notes and Comments
T/S: 08/14/2017 02 : 42 PM JBROCK --- -
210 TO ANGIER TURN R ON 55 GO APPROX 4
MILES TURN L ON GUY RD PARK ON R
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 17-50042052 Date 8/30/17
Property Address 118 MYATT LN
PARCEL NUMBER 04-0682- - -0093- - -
Application description . . CP MOBILE HOME PARK
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20M
Permit MANFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1207299
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 / /