DOCUMENTS A a-2-I ( n Application# )1-1 500 49-311.5
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546 - Ph:910-693-7525 - Fx:910-893-2793 - www.hamett.org/permits
Certification of Work Performed By Owner/Contractor
(Individual Trade Application)
Owner(s)of Structure: �' E'Del we-bb Phone: 'Ili-45o - t/4.3
Owner(s)Mailing Address: I
Land Owner Name(s): Phone:
Construction or Site Address: ,-?2 rfil Sri,t-4(r, S/Keel- i'ni4)s t i_C• AK?3
PIN# DLoQO -9t ' r-I'7.1:7•aYn Parcel# Dl blocip /(nc1ea)
Job Cost:'/34:0.°4°Description of Work to be done /Look 1v,w. > 42, 3C tievl
Mechanical: New Unit With Ductwork New Unit Without Ductwork_ Gas Piping_Other
Electrical*: 200 Amp <200 Amp_Service Change_ Service Reconnect_ Other
'For Progress Energy customers we need the premise number
Plumbing: Water/Sewer Tap Number of Baths Water Heater
pecific Directions to Job from Lillinolon:
Subdivision: / Lot#:
I' nn Aid snort 144 will provide the /•)lux. b:rt.y labor on this structure.
(Contractors Na e) (Trade)
I am the building owner or my NC state license number is 4t4i191o34, ,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.
2.,Nal.l /Sv„ce L. 'Ats,a./ fro-tcw- h9 s'7
Contractor's Company Name / Telephone
PO d/ 0a jgaitcnin n4. aicctl in,44.1,1L...ielciay/9 MC yelhoc Cont
Address Email Address
¢,-29t. 3 '
License#
Structure Owner/Contractor Signature: 'Kr..Q P �...... Date: 9-4l-/7
By signing this application you affirm that you have obtained permission from the above listed license holder to
purchase permits on their behalf. If doing the work as owner you understand that you cannot rent, lease or sell
the listed property for 12 months after completion of the listed work.
*Company name, address, & phone must match information on license
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 17-50042345 Date 9/22/17
Intersection
Property Address 328 E SOUTH ST
PARCEL NUMBER 07-0690-16-52-0002- - -
Application type description CP SEWER/WATER TAP
Subdivision Name QUAIL RIDGE EXTENSION
Property Zoning COATS
Owner Contractor
WEBB GARY D & V RONALD BRUCE LINDSAY
P o BOX 1092 464 PARKER MILL RD
COATS NC 27521 BENSON, NC 27504
(910) 897-4420 BENSON NC 27504
(910) 658-7957
Applicant
WEBB GARY D
P 0 BOX 1092 COATS, NC
27521-0000
COATS NC 27521
--- Structure Information 000 000 SEWER TAP HOOK UP
Permit RESIDENTIAL PLUMBING PERMIT
Additional desc .
Phone Access Code 1210749
Issue Date . . . 9/22/17 Valuation . . . 0
Expiration Date . 9/22/18
Special Notes and Comments
T/S: 09/22/2017 04 : 13 PM JBROCK ----
328 E SOUTH ST COATS, NC 27521
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 17-50042345 Date 9/22/17
Property Address 328 E SOUTH ST
PARCEL NUMBER 07-0690-16-52-0002- - -
Application description . . CP SEWER/WATER TAP
Subdivision Name QUAIL RIDGE EXTENSION
Property Zoning COATS
Permit RESIDENTIAL PLUMBING PERMIT
Additional desc .
Phone Access Code 1210749
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 305 M305 R*PLUMB SEWER CONNECTION / /