SETUP / PERMIT / RECEIPT Application* 1,.1. )P--9
Harnett County Central Permitting
PO Box 65 Lillington,NC 27546
Telephone Number: 910-893-7525 Fax 910-893-2793 www.harnett.org/permits
AooHeetion for Manufactured Home Set-Uo Perot
(Please Illi out each pan completely)
Part I-Owner Information:
Home Owner Information (To be compllee`eedd by owner of the manufactured home)
Name: 1"L\ Address:_ .
City. _ _ State: Zip:_ _ _ - Daytime Phone: • - - .
Landowner Information (lo be completed by landowner,if different than above)
Name: Cm f€' c Address:
City, State: Zip: Daytime Phone:( )
Part II-Contractor Information(To be completed by Contractors or Homeowner,if applicable.
Name,addre8 phone�rp5t ma ch info aligC^
n o I
A. Sepl
t•Up Contractor Company Name:Vlt i\ KLiY�X- .,L�7►!1{,li-
PhoneC\r- ` . I Address: s35 NC IA V1
City: 411.111 4. State: �Zip:2133
Lig/ L1
State Lia Email: % l
B. ElectriicaalyC�ontractor Coryp�p,,y�'ame: £�4 C N
Phony,N 111,,,.O���{{{v ' address:� , eu 1Dr
City: Stale: Zip:
State Licp Pet Email: f.
C. Mechanical Contractor Company Name: 7�* l��i*y�1� I�
Phone • - SIC C.', ddress: a aw��elli—{��ailliFe
City: Pie . a State: `L Zip: -air
State Lich ►.lyyrdairt. Email: . ►. 4 __ •if
D. Plumbing Contractor Company Name: .t ' .l1 a 11�.a
Phone. 1t' II — ". t .1 Address: r. . nillitEL
--�y�y
City: EC. , State: Zip: ►�G�a�
State Lick APR
i Email:
Part III-Manufactured Home Information
Model Year:•• Size: _X= Complete&follow zoning criteria sheet
Park Name: _ - Lot Number:
I hereby certify that I have he authority to apply for this permit, that the application is correct Including the contractor
information and have obtained their permission to purchase (hese permits on their behalf, and that the construction or
installat n will conform to the applicable manufactured home set-up requirements, and the Harnett County Zoning
Ordina I understand that ' m is incorrect or false Information has been provided that this permit could be
revokep.
r.t.
- \ lir
nature oma r or Age I Date'
'Effective July I.2004,a County Tax Depanmenl Mama Permit 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 front I/the home is horn a dealer, we need proof of year on the
Fonn 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
DATE: ( - S -I ® SALES AGREEMENT
BUYER(S): j• - • r - � S
it //fir i'D .Z/1-4- M TO NG a7flt
ADDRE ' 307 - • ks • I. C a 7 Sb
DELIVERY:DDRESS: 4( ]' LIP/n" ST 4,1/6/E4 /IC s27,5-49( .or 1%
TELEPHONE CYO -78/'•6(,SSALES PERSON FULL NAME:
BASE PRICE: /(p 500.OD Make: rt-e- LJ 0,1 Model:jho tcopJ Ni 11
Year. WA Length:. N/A Width: N/A Stocit.
State Tax: Semi No.:A/c FIN &cm(A)oola16N New U Used ®,
Local Tax:
TRADE: Make: Model:
(1056). coSeriall No.:r. Length: Width: Title N:
,. CASH PRICE Amount owed will be paid by: ❑Buyer❑Seller
Owed to:
OPTIONS:
2. TOTAL PACKAGE PRICE ((0 sop '2 -kap tQMLT A>v D be-LAN-2
Trade AllowanceSELLERREISPONSIBILITIES:
Less Amount Owed Int - - 1908 FL<BTL. at Will
�4 X 4
Trade Equity BUYER RESPONSIBILITIES: B
Cash Down Payment /0q'-- LA-pa CPcSFJ- {`�1..}C. 15t L�1^0-, Ti CL
11C�i V
3. LESS ALL CREDITS May not meet local codes and standards.New homes meet Federal Manufactured
r-
3. Standards.
I UNCERSMIa1THLTI HAVE RYYRTO CONCELT SP0RO41f BEI0tEMORCNr6TETNp
4. REMAINING BALANCE 9145 - CANSIA1EHIMST N°,YEE'SF ICNr4LTE BEo4 MIRE1W1iaMYEPFApgI
UEEPSfND11WTTfEUeN81µ,YNOTHAVEPNYOBUGGTpNTOONE IE BACIC ALL lit'Ory
Location Type of Insulation Thickness RA/eine TMT I PM)Tit
EELBRBYTitOFIrAEELNAELR I WIMLLBCA&SINrCNCaBL..IRNMita49a.B?10.13li1tENT1E®IMRMOF OIFEiHP4mNCN4G
XFloors NUl®10EYMM®aNnB18
Exterior
is o I ! x, " " vim' k vh. 1$
r t.Fi i ;r _ ] ,4+ k htv 4 71 1 1
Ceilings t
This insulation information was famished by the Manufacturer '� I f. •s �'�xS' „'� a A!u
and Is disclosed in aunphance with the Federal Trade d4"'t 'd'^ v + f�t'
Commission Rule/l6CRF,SECTION 46016. ^"'�° 'ax^a^*I E
Mc.. 8137 8137 SELLER: :UYER: ..
( - S -(s ���Q7 • , U f _ 1
/ Air
4aa P` CMH Hanes,Inc.d/b/a- ' Ignatius
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ignature of
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NC Sales Agreement-2042.7/2017-Slsagr11014 Page 1 of 2
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 18-50043029 Date 1/30/18
Property Address 61 THELMA ST
PARCEL NUMBER . 11-0662- - -0014- -02-
PIN 0662-91-5682 . 000
Application type description CP MOBILE HOME PARK
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20M
Owner Contractor
BUTTS HAROLD T JR RAVEN ROCK MOBILE HOME MOVER
3335 NC 87 HWY.
2191 KEITH HILLS ROAD SANFORD NC 27332
LILLINGTON NC 27546 (919) 775-3600
(910) 893-4240
Applicant
BUTTS HAROLD
2191 KEITH HILLS RD
LILLINGTON NC 27546
(910) 984-6115
--- Structure Information 000 000 28X48 3BDR DWMH
Other struct info # BEDROOMS 3000000 . 00
MOBILE HOME YEAR 1988 . 00
PROPOSED USE DWMH
SEPTIC - EXISTING? EXT
Permit MANUFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1226950
Issue Date . . . 1/30/18 Valuation . . . . 0
Expiration Date . 1/30/19
Special Notes and Comments
T/S: 01/05/2018 01 : 53 PM JBROCK ----
TAYLOR VILLAGE #46
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 18-50043029 Date 1/30/18
Property Address 61 THELMA ST
PARCEL NUMBER . 11-0662- - -0014- -02-
PIN 0662-91-5682 . 000
Application description . . CP MOBILE HOME PARK
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20M
Permit MANUFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1226950
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 / /
HARNETT COUNTY CASH RECEIPTS
mea CUSTOMER RECEIPT wam
Oper: MOCK Type: CP Drawer: 1
Date: 1/38/10 52 Receipt no: 2310B4
Year Number Amount
2018 58043029
61 THELMA ST
ANGIER, NC 27581
81 BP - PERMIT FEES
$280.00
DNMH
HAROLD BUTTS
Tender detail
CK CHECK PRIMER 8146 $288.00
Total tendered $288.88
Total payment 4288.08
Trans date: 1/38/18 Time: 12:37:27
xm THANK YOU FOR YOUR PAYMENT as