DOCUMENTS S_ Application#1?S Tt`it. S
Harnett County Central Permitting
PO Box 65 Lillington,NC 27546 - Ph:910-893-7525 - Fx:910-893-2793 - www.hamett.org/permits
Certification of Work Performed By Owner/Contractor
(Individual Trade Application) �I �y p !�
Owner(s)of Structure: [LIY7) T .S'tF3/v7
cA L Phone: Io " 01 (1" 652/)
Owner(s) Mailing Address: P, 2 (1 ( 1Jnn + PCnN -k
CltAvlvl AiL33
Land Owner Name(s): .. _ .r_l Phone: a 6' • - 6 1
Construction or Site Address: j{,�14 woo a + Pn YJ d �'d at-inn)
llt.vN C -
PIN# 1S) $` �1 - D �#b& parcei# b9 IS it) O'4 to
Job Cost: Description of Work to be done ( G, Q� e,— tap
U 9 r
Mechanical: New Unit With Ductwork_ New Unit Without Ductwork_ Gas Piping_Other
Electrical': 200 Amp <200 Amp_Service Change_ Service Reconnect Other
For Progress Energy customers we need the premise number
ate
Plumbing: Sewer Tap ,/stNumber of Baths Water Heater
Specific Directions to Job from Lillington:
Subdivision: ,^, 11 Lot#:
IUJI will provide the (\ a labor on this structure.
(Cont actors Name) (Trade)
I am the building owner or my NC state license number is_CIA r j_^ a.Cwhich entitles me to
perform such work on the above structure legally. All work shall comply with the State Building Code and all
other applicable Stale and local laws,ordinances and regulations.
Contractor's Company Name Telephone
Address Email Address
License#
Structure Owner/Contractor Signature:7; fnriji g .�..rn.✓ Date:Slryiu— ®17
By signing this application you affirm that you have obtained permission from the above listed license holder to
purchase permits on their behalf. If doing the work as owner you understand that you cannot rent, lease or sell
the listed property for 12 months after completion of the listed work.
*Company name, address, & phone must match information on license
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Application Number 18-50044005 Date 5/14/18
Intersection
Property Address 240 WOODS POND LN
PARCEL NUMBER 02-1517- - -0410- - -
Application type description CP SEWER/WATER TAP
Subdivision Name
Property Zoning RES/AGRI DIST - RA-30
Owner Contractor
STANCIL SHELBY DEAN & LARRY T OWNER
RT 3 BOX 281-A
DUNN NC 28334
(910) 892-6541
Applicant
STANCIL LARRY T
240 WOODS POND LN DUNN, NC
28334-0000
DUNN NC 28334
(910) 892-6541
--- Structure Information 000 000 WATER TAP HOOK UP 3
Permit RESIDENTIAL PLUMBING PERMIT
Additional desc .
Phone Access Code . 1242478
Issue Date . . . 5/14/18 Valuation . . . . 0
Expiration Date . 5/14/19
Special Notes and Comments
T/S: 05/14/2018 01 : 33 PM JBROCK ----
WOODS POND LN OFF OF FAIRGROUND RD
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 18-50044005 Date 5/14/18
Property Address 240 WOODS POND LN
PARCEL NUMBER 02-1517- - -0410- - -
Application description . . CP SEWER/WATER TAP
Subdivision Name
Property Zoning RES/AGRI DIST - RA-30
Permit RESIDENTIAL PLUMBING PERMIT
Additional desc .
Phone Access Code 1242478
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 305 M305 R*PLUMB SEWER CONNECTION / /
999 307 P307 R*PLUMB WATER CONNECTION / /
999 309 P309 R*PLUMB UNDER SLAB / /
999 131 R131 ONE TRADE FINAL
999 125 R125 ONE TRADE ROUGH IN
999 315 P315 R*PLUMB HW HEATER /
HA***T CUSTOMER RECEIPTCASE r***TV
Oper: IBROCK Type: CP Drawer: 1
Date: 5/14/18 52 Recent no: 355415
Year Number Amount
2818 59844E05
249 WOODS POND LM
DUNN, NC 28334 c _4
B1BP - PERMIT EES
$40.00
PLM
LARRY STAHEEL
Tender detail 840.98
CA CASH PAYMENT ;48.00
Total tendered ;40.00
Total payment
Trans date: 5/14/18 Time: 13:41:05
** THANK YOU FOR YOUR PAYMENT **