DOCUMENTS S I Iu I l Sr Application#1 IS
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546 - Ph:910-893-7525 - Fx:910-893-2793 - www.harnettorg/permits
Certification of Work Performed By Owner/Contractor
(Individual Trade Application)
Owner(s)of Structure: Rn`i '.'J 1% n"S Phone: 41la -171-41,4,1
Owner(s)Mailing Address: I $`i S.in nrr CI?etc t
Svn Ford AlL 22 -S c}.
Land Owner Name(s): Phone:
Construction or Site Address:
PIN#gSaS— co SI tii3 parcel# DS Q Qo 0, 39
Job Cost: Description of Work to be done r'Y if
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 custom e need the premise number
Plumbing: tiNatciftewer Tap t/ Number of Baths Water Heater
Specific Directions to Job from Lillinoton:
Subdivision: Lot#:
will provide the t labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is , which entitles me to
perform such work on the above structure legally. All work shall comply with the State Building Code and all
other applicable State and local laws, ordinances and regulations.
Contractor's Company Name Telephone
Address Email Address
License#
Structure Owner/Contractor Signature: 97<:11---ra' Date: 5 / I'1) I f
By signing this application you affirm that you have obtain d 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 18-50044012 Date 5/14/18
Intersection
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - - -
Application type description CP SEWER/WATER TAP
Subdivision Name
Property Zoning UNZONED
Owner Contractor
WILLIAMS ROY A & WILLIAMS OWNER
MELINDA WIFE
184 SUMMER CREEK LN SANFORD,
SANFORD NC 27332
(910) 474-4064
Applicant
WILLIAMS ROY A & WILLIAMS
MELINDA WIFE
184 SUMMER CREEK LN SANFORD,
SANFORD NC 27332
(910) 474-4064
--- Structure Information 000 000 SPRINKLER TAP HOOK UP
Permit RESIDENTIAL PLUMBING PERMIT
Additional desc
Phone Access Code . 1242692
Issue Date . . . . 5/14/18 Valuation . . . . 0
Expiration Date . . 5/14/19
Special Notes and Comments
T/S: 05/14/2018 03 :44 PM JBROCK ----
184 SUMMERCREEK LN
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 18-50044012 Date 5/14/18
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - - -
Application description . . CP SEWER/WATER TAP
Subdivision Name
Property Zoning UNZONED
Permit RESIDENTIAL PLUMBING PERMIT
Additional desc .
Phone Access Code 1242692
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 307 P307 R*PLUMB WATER CONNECTION / /
HARNETT COUNTY LASH RECEIPTS
*** CUSTOMER RECEIPT ***
Der: Drawer: I
Date: 75/14/18 52 ReceiotTe: Pno: 356211
Customer Location Name Amount
152181 UT92963RWILLIAMTAP S, MELINDA d
UB S
5300.00
Tender detail S3BB.B0
CP CREDIT CARD 5300.00
Total tendered $300.00
Total Payment
Trans date: 5/14/18 Time: 15:49:55
** THANK YOU FOR YOUR PAYMENT **
HARNETT COUNTY CASH RECEIPTS
:ww CUSTOMER RECEIPT 0 *
Ope'r. SBROCK Type: CP Drawer: 1
Date: 5/14/18 52 Receipt no: 356289
Year Number Amount
2818 50044012
91749 TECH 2
LILLINOTON, NC 27546
R1 BP — PERMIT FEES
$40.00
PLUM PERMIT
ROY WILLIAMS
Tender detail q4B.B8
CP CREDIT CARD $40.BB
Total tendered g4B.B0
Total payment
Trans date: 5/14/15 Time: 15:49:13
am THANK YOU FOR YOUR PAYMENT **