DOCUMENTS l \`' \ 1 6 Application# 1. O,.-.JCJv—( -rg
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
r..{ �
(In vidual Trade Application) �y q/ (�
Owner(s)of Structure: AI 7" I Phone: �~ Y 3st
Owner(s)Mailing Address: Aa W Rl gra
Frc j,n ,U 2$339
Land Owner Name(s): 1 Phone:
Construction or Site Address: g 3c Y L $n�j71 c F no', n UC, 624 339
PIN# Parcel#
Job Cost: Description of Work to be done
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
Plumbing: Water/Sewer Tap Number of Baths Water Heater
Specific Directions to Job from Lillineton:
Subdivision: (.fir,, ',,,' 1 Lot#:
I U�Irl1h 1` 4 DVY�),will provide the 2/t1 w.fo.vt q labor on this structure.
ntracto Name rade)
I am the building owner or my NC state license number is /#4 ,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.
}alt's II6)WSJ bfVic .e-t);�<__—. 919- Ra.)-a31/lS
ContractWs Com ny Name Telephone
4,5-if PM (Corbin RdC
Address A53 Email Address
License# J / y
Structure Owner/Contractor Signature: I w._6Date: 7 /0/ I,
By signing this application you affirm that you have obtained permission from the above listed li ise 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 18-50044455 Date 7/11/18
Intersection
Property Address 8300 US 421 S
PARCEL NUMBER 07-0588- - -0122- - -
Application type description CP SEWER/WATER TAP
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20M
Owner Contractor
RYALS LAURA OWNER
PO BOX 318
ERWIN NC 28339
Applicant
RYALS LAURA & C/O ARTHUR
JOHNSON
109 W EDGERTON STREET DUNN, NC
DUNN NC 28334
(910) 897-8434
--- Structure Information 000 000 WATER TAP HOOK UOP
Permit RESIDENTIAL PLUMBING PERMIT
Additional desc .
Phone Access Code 1250877
Issue Date . . . 7/11/18 Valuation . . . . 0
Expiration Date . 7/11/19
Special Notes and Comments
T/S : 07/11/2018 09:34 AM JBROCK ----
8300 us 421
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 18-50044455 Date 7/11/18
Property Address 8300 US 421 S
PARCEL NUMBER 07-0588- - -0122- - -
Application description . . CP SEWER/WATER TAP
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20M
Permit RESIDENTIAL PLUMBING PERMIT
Additional desc .
Phone Access Code 1250877
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 HE HEATER /
HARNETT COIN '.ACY. KECEIK 3
*** C0STOMER RECEIPT ,**
Aper: JBROER Tvpe: C- "uraue-:
bate: ?/11/18 52 ieceipt. 'o: i4557
Year 0u84r Amount
2018 50044455
8300 LIE 421 5
ERWIN, NC 2&,35
81 8P - PEkKIi'
440.00
WATER TAP HOOK UP
ARTHUR JOHNSON CR
Tender detai'
CK CHECK PAY%EN 065 5x0.00
total tenderee *40.08
Total oayment $40.08
Trans date: 7/1:716 Tine. 5:y7:07
** THANK YOU FOR YEN PAYFE•T 4*