DOCUMENTS 11Application#_I–u5cO 4O
Initial Application Date: \DIJ 1 I el
COUNTY OF HARNETT DEMOLITION APPLICATION
108 E. Front Street, Lillington, NC 27546 Phone: (910)893-7525 Fax:(910)893-2793 www.harnett.org/permits
I.. .
h ,ghara0Tenlef 101/071 /202(a NC I�al 1/ �uf
Land OQQwner. (a IV in F. , len of �Z Mailing Address:
ll
City: JprThc3 I-[,ake state:�UCZip:Z8390Home#: 9/O3ii975 2 Contact#: 9/9-5'/8-4/(pb9
APPLICANT*:
'Shafo, /en�/ ....i„ 71 Mailing Address: 3190/ AnIhicrofieOdaCe
City: HIP 01 170620- State/iC- zip?75�Home#: 9/9- 207/555. Contact#: 9/9-1/98 9
*Please fit out ap licant information if different than landowner
CONTACT NAME APPLYING IN OFFICE: — Phone#:
PROPERTY LOCATION: Subdivision: I a?o40 A) 4- ?-10 S Lot Acreage\.U3 /4 4--
State Road I1N C_?ID$State Road Name: .\
Parcel:n I O6 '4 phSA PIN: �y / ;–S4f•000 Zoning:gRabmrlood Zone: >0
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
Nc, c2105
Structure(s)to be demolished &removed: Single family dwelling Manufactured Home V Other(specify)
Structures (existing andel/or proposed): Single family dwellings Manufactured Homes Other(specify)_
Water Supply: (id'C my (� Existing Well
Sewage Supply: ( Existing Septic Tank ( )County Sewer
• If a new structure is to be replaced on this lot, please ensure that existing septic system is not damaged.
•If an existing well is on site and is to be discontinued, please contact Harnett County Environmental Health for assistance.
*Upon the issuance of the Certificate of Compliance, the Harnett County Tax Department shall be notified of the removal to
ensure proper listing.
•The demolition contractor is responsible for submitting verification of proper disposal prior to the Final inspection.
"PLEASE NOTE••Failure to completely demolish, remove, and clear the premises will result in the withholding of the certificate
of Compliance. Thus,future permits for the property will be denied, and fines may be imposed for failure to complete demolition)
removal.
If permits are granted I agree to conform to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby stab foregoing statements are accurst a d to tote best of my knowledge. Permitsubject to revocation if false information is prodded.
\-35I -r_hillA. -/f//lW 3 OCT 20/ 7
Signature of Owner or Owner's Agent Date
"This application expires S months from the Initial date if no permits have been Issued••
S:tPlanning and Inspections FdesIFORMSICP Forms
•
Asbestos requirements are applicable if the occupancy use is or changes to Commercial (not residential),
or if multiple structures are being demolished & removed at one time.
•
•
•
An Asbestos Inspection Report prepared by an N.C. Accredited Asbestos Inspector must be provided with application to
demolish any building including residences demolished for commercial or industrial expansion or structures. It is the contractor's
responsibility to properly notify the Department of Health and Human Services Division of Public Health — Health Hazards
Control Unit at least ten (10) working days before the demolition is to begin whether or not the building is known to contain
asbestos.
I hereby certify that the Information on this application Is correct and that all work in connection with the above
referenced job will be performed under my supervision and that such work complies with the requirements of the NC
State Building Codes and applicable Harnett County Ordinances. Call for inspection at proper stage of work.
CONTRACTOR/APPLICANT DATE LICENSE NO. (If applicable)
Please contact the Department of Health and Human Services for their requirements and permit information.
http://www.epi.state.nc.us/epifasbestos/ahmp.html
S:Planning and Inspections Files\FORMS\CP Forms
HARNE'TT 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 17-50042450 Date 10/03/17
Intersection
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - - -
Application type description CP DEMOLITION RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Owner Contractor
TENHET CALVIN L SR & WILLETT OWNER
SHARON TENHET
12026 NC 210 SOUTH SPRING
SPRING LAKE NC 28390
Applicant
WILLETT SHARON
12026 NC 210 SOUTH SPRING
LAKE, NC 28390
SPRING LAKE NC 28390
(919) 567-1555
--- Structure Information 000 000 DEMO SWMH
Other struct info PROPOSED USE DEMO SWMH
Permit RESIDENTIAL DEMOLITION PERMIT
Additional desc .
Phone Access Code 1212729
Issue Date . . 10/03/17 Valuation . . . . 0
Expiration Date . 10/03/18
Special Notes and Comments
T/S: 10/03/2017 02 :38 PM JBROCK ----
12040 N 210 S
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 17-50042450 Date 10/03/17
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - - -
Application description . . CP DEMOLITION RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Permit RESIDENTIAL DEMOLITION PERMIT
Additional desc .
Phone Access Code 1212729
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 179 C179 C*BLDG FINAL /
999 131 R131 ONE TRADE FINAL /
999 820 Z820 PZ*ZONING/FINAL INSPECTION /
HARHETT COUNTY CASH RECEIPTS
*mm CUSTOMER RECEIPT ***
Oper: JBROCK Type: CP Drawer: 1
Date: 18/83/17 52 Receipt no: 103245
Year Number Amount
2817 50042450
91749 TECH 2
LILLINGTDN: NC 27546
Bl BP - PERMIT FEES
DEMO PERMIT $75.00
SHARON TENNET BILLETT
Tender detail
CK CHECK PAYMEN 325 475.00
Total tendered $75.00
Total payment 475.88
Trans date: 10/03/17 Time: 14:39:32
** THANK YOU FOR YOUR PAYMENT **