DOCUMENTS / RECEIPT Application# IS- 5 42.- b 1
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
Telephone Number: 910-893-7525 Fax 910-893-2793 www.harnett.org/permits 1SO,DO
Application for Manufactured Home Set-Up Permit Stitt
L 1 pIJ''�11 J��,t 1
(Please fill out each part completely) Stitt l/w P..
Pari I-Owner Information: VVV
Home Ow Iniormatiog(Tof/11e Co rtmflp/lE,t�/py owner of the manufacturedurh e
Name: VA-F/lay �L! [ Alit ` Address:
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City: 5�t`irn�9 El t State:A C. Zip:ZOO Daytime Phone:(/O 73116 qv
Landowner Information (To be completed by landowner, if different than above)
Name: Address:
City: Slate: Zip: Daytime Phone: ( )
Part II-Contractor information(To be completed by Contractors or Homeowner,if applicable.
Name,ame:- „8 phonees ch into anon orn ense)
A. Set-Up Contractor Company Name: f,8 T1 I I alV
Pho,.* 4.0.' an ddress: e-335 NCR
City- Ilii Ite State: NI C, Zip:c 1 '2, d
State Lic# Lk r Email:
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B. Electrical Contractor Corn. ayvl�Q{T-n NamjII y( 1)1 A n \r-irt.)
Piton_ a tedI ��Address: ��9� ( Iy�S V�
City: ii a. I. State: l/{,vV Zip: - N..5 �C)J
State Lic# ' e5 L Email:
C.
Mechanical Contractor Company Namert\(�,�j
Phonef'iM' J4ddress:: ) \?r$D\ Ed �'T ci
City: C jT.� er i, State: � \ Zip: 1 ` �� 'I
State Lic# Ond- 1 3 Email: �
D. Plumbbiinng�Cyontr�acto�r Company Name: jam& •� ... _ �I si'�,r
Phona:��?� 1 ,,J (CalbAddress: �,r� a , �� 'EC's`
State Lic# 3I-- 0 0 EmaStateC: hiowS Zip: -1 ��
Part ill-Manufactured/7Home Information
Model Year::A/dm Size: I�X 'O Complete&follow zoning criteria sheet
Park Nameg�'C (.Q,tSj\ fleck_ YyA.t-.j(? Lot Number: 191 't eVIPc33Lj
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
revo�atl. IWlrl.
C Signal re right/Owner or Agent �Da1te I
'Effective July I,2004,a County Tax Department Moving 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 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
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Application Number 18-50043387 Date 3/08/18
Property Address 58 S PEGGY ST
PARCEL NUMBER 01-0515- - -0367- - -
Application type description CP MOBILE HOME PARK
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20M
Owner Contractor
NC LAND LEASE LLC RAVEN ROCK MOBILE HOME MOVER
PO BOX 2533 3335 NC 87 HWY.
CHRISTIANSBURG VA 24068 SANFORD NC 27332
(919) 775-3600
Applicant
MCNEIL DARRYL
1259 C ST
SPRING LAKE NC 28390
(910) 751-1644
--- Structure Information 000 000 14X80 3BD SWMH
Flood Zone FLOOD ZONE X
Other struct info # BEDROOMS 3 . 00
MOBILE HOME YEAR 1997 . 00
PROPOSED USE SWMH
SEPTIC - EXISTING? EXISTING
Permit MANFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1232784
Issue Date . . . 3/08/18 Valuation . . . . 0
Expiration Date . 3/08/19
Special Notes and Comments
T/S: 02/22/2018 03 : 21 PM BPETRICH --
58 S PEGGY STREET SPRING LAKE 28390
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 18-50043387 Date 3/08/18
Property Address 58 S PEGGY ST
PARCEL NUMBER 01-0515- - -0367- - -
Application description . . CP MOBILE HOME PARK
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20M
Permit MANFACTURED HOME PERMIT
Additional desc .
Phone Access Code 1232784
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
*** CUSTOMER RECEIPT ***
Oper: 7BROCK Type: CP Drawer: 1
Date: 3/08/18 52 Receipt no: 279966
Year Number Amount
2018 50043387
58 S PEGGY ST
SPRING LAKE, NC 28390
DI BP - PERMIT FEES
8150.08
SHAH
E7 WOMACK
Tender detail
CP CREDIT CARD $150.08
Total tendered $158.08
Total payment $150.08
Trans date: 3/06/18 Time: 10:43:29
** THANK YOU FOR YOUR PAYMENT **