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LAND USE 09109/11 Application# Hamett County Central Permitting M tecbon below to M filled out PO Box 85 Liangton NC 27546 E M Each s whomever ow ng work 910 893 7525 Fax 910 893 2793 www Monett or9/pemats Must be owner or Incensed contractor Address company AooltcMlon for Residential Building and Trades Perini! coma 8 phone must match Owners Name Date Site Address Phone Drecbons to lob site from Lillington Subdivision Lot Description of Proposed Work #of Bedrooms Heated SF Unheated SF Finished Bonus Room, Crawl Space _Slab _ General Contractor Information win0)e-rE ; IcScrS `Pict- 66q 7d(� Building Contractbr s Company Name Telephone 02 5-63 CaA 6relCJ1 i24 AisleflC 27J / jrfro mbcrlq 45„l tfl . ecr Address Email Address 76 20 7 License glectrical Contractor Information Description of Work Service Size _Amps T-Pole _Yes_No Electrical Contractors Company Name Telephone Address Email Address License# Mechanical!HVAC Contractor Information Description of Work Mechanical Contractors Company Name Telephone Address Email Address License# Plumbing Contractor Information Description of Work St Baths Plumbing Contractor s Company Name Telephone Address Email Address License# Jnsulehon Contractor Information Insulation Contractors Company Name&Address Telephone 'NOTE General Contractor must fill out and sign the second page of this application I hereby certify that I have the authority to make necessary application that the application is correct and that-the construction will conform to the regulations in the Building Electrical Plumbing and Mechanical codes and the Harnett County Zoning Ordinance I state the information on the above contractors is correct as known to me and that IN mama below I have obtained all subcontractors permission to obtain these permits and if gpy changes occur including listed contractors site plan number of bedrooms building and trade plans Environmental Health permit changes or proposed use changes I certify it is my responsibility to nobly the Harnett County Central Permitting Department of any and all changes EXPIRED PERMIT FEES-6 Months to 2 years permit re-issue fee is$150 00 After 2 years re-issue fee is as per current fee schedule �Sg a /)� I -3 t- a�S r(tur6 of� / actor/Officer(s)of Corporation Date Affidavit for Worker's Compensation N C G S 87-14 The undersigned applicant being the ,General Contractor Owner Officer/Agent of the Contractor or Owner Do hereby confirm under penalties of perjury that the person(s) firm(s)or corporaton(s)performing the work set forth in the permit _____/7/Has three(3)or more employees and has obtained workers compensation insurance to cover them Has one(1)or more subcontractors(s)and has obtained workers compensation insurance to cover them Has one(1)or more subcontractors(s)who has their own policy of workers compensation insurance covering themselves Has no more than two(2)employees and no subcontractors While working on the project for which this permit is sought a is understood that the Central Permitting Department issuing the permit may require certificates of coverage of workers compensation insurance prior to issuance of the permit and at any time during the permitted work from any person firm or corporation carrying out the work n Company or Name ' 0 W - SRo;ICICC5 Sign w/Tide �/ AJflt ' C Date � J)- 7< HARNETT COUNTY CENTRAL PERMITTING P.O. BOX 65 LILLINGTON, NC 27546 For Inspections Call : (910) 893-7525 Fax: (910) 893-2793 Application Number 18-50043186 Date 1/31/18 Property Address 150 SANDRA CT PARCEL NUMBER 04-0663- - -0072- - - Application type description CP ADD & ALTER RESIDENTIAL Subdivision Name NEILLS CREEK FARMS PHASE 1 Property Zoning RES/AGRI DIST - RA-40 Owner Contractor JOHNSON DAVID M & PERRINE WIMBERLY TONY RAY 150 SANDRA COURT 2563 OAK GROVE CH RD ANGIER NC 27501 ANGIER NC 27501 (919) 669-7066 Applicant WIMBERLY TONY #35 2563 OAK GROVE CH RD ANGIER NC 27501 (919) 669-7066 --- Structure Information 000 000 REPLACE FLAT ROOF/EXTENDING OVER DECK Flood Zone FLOOD ZONE X Other struct info # BATHS 99 SEPTIC - EXISTING? EXISTING WATER SUPPLY COUNTY Permit RESIDENTIAL BUILDING PERMIT Additional desc . Phone Access Code 1226786 Issue Date . . . 1/31/18 Valuation . . . 0 Expiration Date . 1/31/19 Permit LAND USE PERMIT Additional desc . Phone Access Code 1226794 Issue Date . . . 1/31/18 Valuation . . . . 0 Expiration Date . 7/30/18 HARNETT COUNTY CENTRAL PERMITTING P.O. BOX 65 LILLINGTON, NC 27546 For Inspections Call: (910) 893-7525 Fax: (910) 893-2793 Page 2 Application Number 18-50043186 Date 1/31/18 Property Address 150 SANDRA CT PARCEL NUMBER . 04-0663- - -0072- - - Application description . . CP ADD & ALTER RESIDENTIAL Subdivision Name NEILLS CREEK FARMS PHASE 1 Property Zoning RES/AGRI DIST - RA-40 Required Inspections Phone Insp Seq Insp# Code Description Initials Date Permit type . . RESIDENTIAL BUILDING PERMIT 999 101 B101 R*BLDG FOOTING / TEMP SVC POLE 999 131 R131 ONE TRADE FINAL 999 125 R125 ONE TRADE ROUGH IN Permit type . . . . LAND USE PERMIT 999 818 Z818 PZ*ZONING INSPECTION /_/_ 999 820 Z820 PZ*ZONING/FINAL INSPECTION /_/_ HARNETT COUNTY CASH RECEIPTS wow CUSTOMER RECEIPT ♦ma Open SBROCK Type: CP Drawer: 1 Date: 1/31/18 52 Receipt no: 232844 Year Number Amount 2018 58043186 150 SANDRA CT 81 BP - PERMIT FEES 4125.88 BLDG Tender detail CP CREDIT CARD $125.00 Total tendered 4125.08 Total payment $125.00 Trans date: 1/31/18 Time: 13:27:02 ** THANK YOU FOR YOUR PAYMENT as