SETUP & PERMIT Application# 'T I !
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
Telephone Number: 910-893-7525 Fax 910-893-2793 www.harnett.org/permits
Application for Manufactured Home Set-Up Permit
(Please fill out each part completely)
Part I-Owner Information:
Home Owner Information (To be corn leted by owner of the manufactured home)
Name: Mf 1.C,11190(..\ Tay. t14� Address: 100 1RaA yYTCc( n� '
City: L l be ,`t,,yl Stale: yJC, Zip: Daytime Phone: ( ) I 1
Landowner Information (To be com leted by landowner, if different than above)
Name:1- E[ \ - 9ropf'P` CSS Address: H(15 La 1(1 net A.
City: '&R'bLipuc:JQV State: 1\31--yy 1\31-- Zip: (;)7Daytime Phone: ( TCITCI710 -010
G'
Part II-Contractor Information (To be completed by Contractors or Homeowner,if applicable.
Name,address,&phone must ma h inform tion on li ense) N td 'n If �e
A. Set-Up Contractor Company Name: LAS teS` -`t QY1 C{ I _t
r6
Phone:('\ 0 10 - I1W Address:it{4 1k. r &4 Lc - az
City: SG'.y oCa. State: u G Zip: AC1 R 3 D
State Lic# Q A liill Email:
B. Electrical Contractor Company Name: ccawn
Phone: Address:
City: State: Zip:
State Lic# Email:
C. Mechanical Contractor Company Name: C.W
Phone: Address:
City: State: Zip:
State Lic# Email:
��
D. Plumbing Contractor Company Name:
Phone: Address:
City: State: Zip:
State Lic# Email:
Part Ill-Manufactured Home Information�t
I
Model Year: 4 0 Size: ((I { {X 0 Complete& follow zoning criteria sheet
Park Name:N r 1puonOS M T' Park Lot Number: LQ,/
I hereby certify that I have 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.
\ 1\Q6,/\t4j - O U'S ttSll�l`�rl
Signature of Home er or Agent Date
'Effective July I, 2004, a County Tax Department Moving Permi(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
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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 17-50041892 Date 10/17/17
Property Address 67 ROMAS DR
PARCEL NUMBER 13-9681- - -0038- - -
Application type description CP MOBILE HOME PARK
Subdivision Name
Property Zoning PENDING
Owner Contractor
T & T PROPERTIES LLC CHRISTIANS MOBILE HOME MOVERS
465 LAWRENCE RD 544 GOLDEN HILLS LANE
BROADWAY NC 27505 SANFORD NC 27332
(919) 499-6720
Applicant
TAYLOR MICHAEL
100 RAYMACK DR
LILLINGTON NC 27546
(910) 514-9752
--- Structure Information 000 000 14X70 3 BR NO DECKS OR PORCHES
Other struct info # BEDROOMS 3 . 00
MOBILE HOME YEAR 1989 . 00
PROPOSED USE SWMH
SEPTIC - EXISTING? EXISTING
Permit MANFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1214980
Issue Date . . . 10/17/17 Valuation . . . . 0
Expiration Date . 10/17/18
Special Notes and Comments
T/S : 07/21/2017 12 :44 PM DJOHNSON --
421 TOWARDS SANFORD. LEFT AT LIGHT ON
MCARTHUR RD. THEN FIRST RIGHT ON
ROSSER PITTMAN GO ALL THE WAY DOWN
UNTIL YOU SEE WHITE FENCE ON RIGHT.
ALMOST AT THE END OF ROSSER PITTMAN.
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 17-50041892 Date 10/17/17
Property Address 67 ROMAS DR
PARCEL NUMBER 13-9681- - -0038- - -
Application description . . CP MOBILE HOME PARK
Subdivision Name
Property Zoning PENDING
Permit MANFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1214980
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 / /