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DOCUMENTS Application# Harnett County Central Permitting PO Box 65 Lillington,NC 27546 - Ph:910-893-7525 - Fx:910-893-2793 - www.hamettorg/permits Certification of Work Performed By Owner/Contractor ��11 (Individual Trade Application) Owner(s)of Structure: Eat( I/'��///'10MSrj nr4x� t3 Phone: fit -✓5-71 a ,//�� Owner(s) Mailing Address: orf' G *j2 t" L 7yt•e' �-� sAN ,"k- a 7-3a Land Owner Name(s): J gent — Pone: Construction or Site Address: S�JS i L rtfrTh K� , PIN# Parcel# I Job Cost: Description of Work to be done ``�/ Mechanical: New Unit With Ductwork_ New Unit Without Ductwork Gas Piping_Other_ Vim_\/���j Electrical*: 200 Amp_<200 Amp_Service Change_ Service Reconnect_ Other *For Progress Energ customers we need the premise number Plumbing: Water/Sewer Tap Number of Baths Water Heater Specific Directions to Job from Lillington: Subdivision: Lot#: I 144/143* fl 414lt' will provide the /N� 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. q ��'>' -Y1 t�' YN r(..A4 t—�,-./ /0- 741-0961 Contractor's Company Name Telephone Address Email Address License# S Structure Owner I Contractor Signature: / Date: �-1174-/S By signing this application you affirm t - 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 18-50044358 Date 6/26/18 Intersection Property Address 535 VIC KEITH RD PARCEL NUMBER 03-9586-12- -0120- - - Application type description CP SEWER/WATER TAP Subdivision Name BUFFALOE LAKES MAP NO 2 Property Zoning RES/AGRI DIST - RA-20R Owner Contractor MCQUILKIN JAMES R CUSTODIAN & OWNER EQUITY TRUST CO CUSTODIAN 14 CADE LANE SANFORD NC 27332 Applicant MCQUILKIN JAMES R CUSTODIAN & EQUITY TRUST CO CUSTODIAN 14 CADE LN SANFORD, NC 27332 SANFORD NC 27332 (910) 574-0968 --- Structure Information 000 000 WATER / SEWER TAP HOOK UP Permit RESIDENTIAL PLUMBING PERMIT Additional desc Phone Access Code 1249101 Issue Date . . . 6/26/18 Valuation . . . . 0 Expiration Date . 6/26/19 Special Notes and Comments T/S: 06/26/2018 01 : 56 PM JBROCK ---- 535 VIC KIETH 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 18-50044358 Date 6/26/18 Property Address 535 VIC KEITH RD PARCEL NUMBER 03-9586-12- -0120- - - Application description . . CP SEWER/WATER TAP Subdivision Name BUFFALOE LAKES MAP NO 2 Property Zoning RES/AGRI DIST - RA-20R Permit RESIDENTIAL PLUMBING PERMIT Additional desc . Phone Access Code 1249101 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 /_/_ HARNETT COUNTY SASH RE rC;=l4T.9 mac CUSTOMER RECEIPT tt+: Uoer, :WKS Type: CP Drawer: i Date: 6/86/i6 32 Receipt no: 401765 Year Number Amount 2016 50044356 535 VIC KEITH RD SANFORD, NC 27332 E1 EP - PERMIT FEES 340.00 PLU PERMIT EQUITY TRUST Fender detail CK CHECK PAWN. 702653 440.08 Total tenderee 440.00 Total payment $40.00 Trans date: 6/26/i8 Time: 14:05:53 44 THANK YOU RUR YOUR PAYMENT ** HARNETT L9UNTY CASH RECEIPTS *** CUSTOMER RECEIPT awr: Uper: JEROCK Type: CT. Drawer: 1 Date: 6/26/16 52 Receiot no: 401768 Customer Location hams Amount 227883 24062 MCOUILKIN JAMES R CU U0 UT-''ATER TAP REES $860.88 227663 24862 MCOUILKEN JAMES R CU U9 U'-WATER CAPACITY FEES 41200.06 227063 24062 MCOUTLKIN JAMES R CU UD WA UTILITY DEPOSIT • 425.00 227063 24062 MCQUILKiN JAMES R CU U7 UT-SEWER TAP FEET 4950.00 227083 24062 MCAPALKIN JAMES F CU Un UT-SEWER CAPACITY FEES 41608.80 227063 24062 MCOUILTI:1 JAMES R CU UD SW UTILITY DEPOSIT 425.00 fender detail CK CHECK PAYMEN 702053 44600.00 Fotal tendered 44600.00 Total payment 44600.00 Trans date: 6/26/16 Time: t4:07:32 tt THANK YOU FOR YOUR PAYMENT t=