DOCUMENTS / RECEIPT Initial Application Date: 0-20(7 Application# ) r1.53(:)U t_ -2 Err
COUNTY OF HARNETT DEMOLITION APPLICATION
108 E. Front Street, Lillington, NC 27546 Phone:(910)893-7525 Fax:(910)893-2793 www.harnett.org/permits
Land Owner: k}-"-1 I S /-ca- 50 Mailing Address:
City: State: Zip: Home#: Contact#:
APPLICANT*: f (/e-VtA W✓U\ (.,t) v�-,g I ( `J?f2D
ailing Address: . Wt / 10 n. Or
City: F - State:/J(Zip:2,S)3Q tome#: PO-1-13i—,Sri/Contact#:q7/2 c<q -2 /CC Z
*Please fill out/applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE: Phone#:
PROPERTY LOCATION: Subdivision:- -t2f- ` t cif S.el Lot Acreage: ' -O S
State Road it \Gl State Road Name: l.7'O rat 0. (AJJC&X/
Parcel: 09 ti S7 6/ 015'5 PIN: CI S'75 -pfd -SSS►. O of T Zoning:jjf 4lood Zone:
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
Structure(s)to be demolished 8 removed: Single family dwelling Manufactured Home l/ Other(specify)
Structures(existing and/or proposed): Single family dwellings Manufactured Homes Other(specify)_
Water Supply: (J County (J 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
Compliance. Thus,future permits for the property will be denied, and fines may be imposed for failure to complete demolition/
smoval.
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.
lereby state that foregoing statements are accurate and coned to the best of my knowledge. Permit subject to revocation If false information is provided.
jc� 1 ° 7
°nature of Owner or Owners Agent pate
'This application ex• 6 months from the initial date if no permits have been Issuer
S:tPanning and inspections FilestFORMSICP Forme
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 codify 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-stageot work. --
CONTRACTOR/APPLICANT DATE LICENSE NO.(If applicable)
Please contact the Department of Health and Human Services for their requirements and permit Information.
http:llwww.epi.state.nc.uslepi/asbestoslahmp.html
S:'Planning and Inspections Files\FORMSCP Forms
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 17-50042788 Date 11/20/17
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - - _
Application type description CP DEMOLITION RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Owner Contractor
WELLS FARGO BANK OWNER
3476 STATEVIEW BLVD FORT MILL,
SC 29715-0000
TEGA CAY SC 29715
Applicant
WASHINGTON ABEAHAM
828 WILBOR DR
FAYETTEVILLE NC 28305
(910) 486-5911
--- Structure Information 000 000 DEMO DWMH
Other struct info PROPOSED USE DEMO DWMH
Permit RESIDENTIAL DEMOLITION PERMIT
Additional desc .
Phone Access Code 1219336
Issue Date 11/20/17 Valuation 0
Expiration Date . . 11/20/18
Special Notes and Comments
T/S : 11/20/2017 02 : 12 PM JBROCK ----
19 GEORGIA WAY CAMERON, NC 28326
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call: (910) 893-7525 Fax: (910) 893-2793
Bldg Inap scheduled before 2pm available next business day.
Page 2
Application Number
17-50042788 Date 11/20/17
Property
91749 TECH 2ARCELty MBERess - - -
PARCEL NUMBER -
Application description CP DEMOLITION RESIDENTIAL
Subdivision Name UNZONED
Property Zoning
Permit RESIDENTIAL DEMOLITION PERMIT
Additional desc .
Phone Access Code 1219336
Required Inspections
Phone Insp Initials Date
Seq Inap# Code Description
999 179 C179 C*BLDG FINAL —/—/-
999 131 R131 ONE TRADE FINAL /—/—
999 820 Z820 PZ*ZONING/FINAL INSPECTION —/ /—