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TRADE .. .. Application #... 1 1 5 V / 5 _ 2, • •Harnett County Central Permitting PO Box 65 Lillington, NC 27546 \ 910- 893 -7525 Fax 910 -893 -2793 www.harnett.org /permits Certification of Work Performed By Owner /Contractor , (Individual Trade Application) CV Owner (s) of Structure: EMMA DAUBERT Phone: 910 -315 -5568 Owner (s) Mailing Address: 165 PINFRIf7GF fRIVF CAMFRON,NC 2R37R Land Owner Name (s): SAME Phone: SAME Construction or Site Address: 165 PINFRIlrF f)RIVF CAMFRON.NC 28326 PIN or Parcel # from GIS: Job Cost: 3950.00 Description of Work to be done HFAT Pt lMP CHANGE-0(1T (1 st F R) • Mechanical: New Unit With Ductwork _ New Unit Without Ductwork X Gas Piping Electrical*: 200 Amp _ <200 Amp _ Service Change _ Service Reconnect — Other X • For Progress Energy customers we need the premise number MECHANICAL Plumbing: Water /Sewer Tap _ Number of Baths Water Heater _ CHANGE -OUT Specific Directions to Job from Lillinaton: 27 WFST TOWARf7 .IOHNSONVII I F CROSS OVFR R7 SOUTH • Gfl 1 8 M : I FFT ON PINERIDGE DRIVE : .1 M (home on left: white 2 -story wl green shutters) Subdivision: Lot #: I CFNTFR HTG & A/C will provide the MECHANICAL / ELECT labor on this structure. (Contractors Name) (Trade) I am the building owner or my NC state license number is 4627 / 17001 , which entitles me to perform such work on the above structure legally. All work shall comply with the State Building Code and all other applicable State and local laws, ordinances and regulations. Structure owner(s) signature: Date: . Company Name: CFNTFR HTf.& A/C Phone: 919- 775 -2500 Address: 511 E. MAIN ST. SANFORD.NG 27332 County: , LEE Contractor's License #: 462 / 17001 Email Address: centerheat @windstream.net Contractor's Signature: _ — Date: Al - 10 100.00 Company name, address, &phone must match information on license. 3.00 Individual Trade Application 1 of 1 06110 ,Il In IC° u I�II1 ��lil l i III \ \ I l i ti 191 `'IIII 2 as f' ^ ` ` COUNTY TAX )D# FOR aKlMBtalNLVt6 YtD OF Dartoa „Ra P CS1 511 :6 1 . 43 AA "; 11.06 tlrr 1 1 .,au∎ 1 1 — 85, 560PG:515. tie SIAPP:S .F1 � I� , G;li,� ..I i�► ,i, Salk r k IRW1Gltl CAROLINA GENERAL. WARRANTY DEED Excise Tax: $310.00 Parcel Identifier No. Q5¢5 -89 98.0004 , eri : cd h _ ____ County on the day of , 20, By: —. �` -- --- Mail/Box to: . 1 - 1 1 n ' ' r t ' • • ee • • tit • w 926 Port Bragg Road, Fayetteville. NC 28303 This instrument was prepared by Ir : e letf 19961 Brief description for the Index: T HIS DEED nude this l 4th clay of October, •0' ten — — — -- GRANTOR 1 GRANTEE — J ~ — ~ - -- AARON PETERS AND WIFE, I t A DAUBERT AND WIFE, ERIN R. PETERS i 1' t J. • AUBERT ,- A n EDR1VE to 1 1 • a r,. NC 28326 I I Enter in appropriate block for each party: name, address, and, if a • • • plate, ,it. entity, e. L. corporation or parmcrshi • . The designation Grantor and Grantee as used herein shall include said parties I air ., sue essors, and assigns, and shall include singular, plural, masculine, feminine or neuter as required by context. W ITNESSETH, that the Grantor, fora valuable consideration paid by the G , ee, di ec • of ich is hereby acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee Rump , all t • cc.. 'n lot or parcel of land situated in the City of Cameron, Johnsnnville Township, Harped County, North Carolina , I m •. y 'tats: • ' described as follows: BEING all of Lot 69, Ina subdivision known as MIRE BRANCH ESTATES, SE e. 0 • to a plat of the same being duly recorded in Plat Cabinet E Slide 45-D, Harnett County Registry, No • The property hereinabove described was acquired by Grantor by instnnt+ent recorded in B •• A map showing the above described property is recorded in pint Cabinet E, SLdk 4„,j2. TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances • -4 o • lo•gi th. Gramee in fee simple. NC Bar Association Form No. 3 Q 1976, Revised tre 1977, 2002 4111 Primed by Agreement with the NC Bar Association — 1981 - Chicago Title Insurance Company A • . e Cr tor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the same in et: si • • e hat title is marketable and fee and clear of all encumbrances, and that Grantor will warrant and defend the title against t. • aw • ;ins of all persons whomsoever, other than the following exceptions: .t• . ts, rights of way, and restrictive covenants appearing of record. WHEREOF, the Grantor has duly executed the foregoing as • s and y and . r first :..• ve written. A n (SEAL) B y' - -- — . —. -- _ lir ..�'� , H 4 L ,r ;'!. ERtlsTRP _ __(SEAL) Title P , - • • — By: = - . aIARY - • • -. u Et (SEAL.) Title: • c. (SEAL) Title: SEAL -STAMP State of North C:W • ••• .f • _ • r .. • I, the undersigned N. "dtUc • th• d State aforesaid, certify thatMBON_PETERS AND WIFE, I:RINR.PETERS • •rt ttfapp.� e. ••fore e this day and acknowledged the due execution ofthefotegoing instrument for the purp • . es • • • xp -- - d. Witness my • d and Notarial stamp or seal this 14th day of y C . / /or. 2008. My •-2 � Q` My Commission Expires: L'� , 04/76P0}1 otary Public SEAL-STAMP State of North Carolina - County of _ I, the undersigned Notary Put is of ti: County and State aforesaid, certify that personally came before me this day and acknowledged that he is the a North Carolina or corporation/lira' ed .. co • tpany!general partnershiptlimited partnership (strike through the inapplicable), and that by • • • i ; • my ' : +• • • • as the act of such entity, _he signed the foregoing instrument in its name on its behalf as it • .. i this day of , 20, . My Commission Expires: . myhandandNotara1stanipOrSea1. SEAL -STAMP State of North Carolina - County of _____ .__-- 1, the undersigned Notary Public of the County and State aforesai , . • ify • et Witness my hand and Notarial stamp or seal, this _ day of ,— _ _ , 20 . My Commission Expires: Notary Public 0 NC liar Association Form No. 3 C 1976, Revised ®1977.2002 Printed by Agreement with the NC Bas Association - 1981 - Chicago Title insurance Company