TRADE Applicatio # /1 o ' 2‘ Z 7,7
Harnett County Central Permitting
PO Box 65 Lillington NC 27546
910 893 7525 Fax 910 893 2793
www harnett org /permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (s) of Structure —J l i A E) 7 4 3 ti„- Phone 1 _ 2 rf q
Owner (s) Mailing Address '7t> ( 1(9 /-h u ci 0✓2
L !( .04e GU( 7Sy
Land Owner Name (s) C, Phone
Construction or Site Address / a
// 1
PIN or Parcel # from GIS / - - - 0,; n O 9/ 00 f , 7 4
Job Cost 5OO Descnption of Work to be done t r- c ^ w/ r3aig-1 (o-o o tn
Mechanical New Unit With Ductwork _ New Unit Without Ductwork _ Gas Piping _
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 Lillinaton o .. s r
y �c � � _\
F 2 ` ' ...� +� t2 tM C c t J 54 ..Q- .� 2 ( (AA-30-Se J J
•
Su bdivision 111 9/7,( / Lot# (p , t, / 2 5
r will provide the k ti� /Dr 3 e&' . labor on this structure
(Contractors Name) J (Trade)
I am the building owner or my NC state license number is /6T3C ( 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
Structure owner(s) signature Date
�
Company Name 1 trr 8., 9 O'` L c Phone 5 ( 797- 9 --3f
Address !/ r c 9 Aie j) 0,e 6,43r,-Let a 7Sz j County c-Oartic
Contractor s License # 16`1&5 /t< 0o3 Email Address Dc--- /( ae %Ga 1/4 Co
' 20
Contractor s Signature (- A ��—� � Date 3 -23- C
Company name address & phone must match information on license
Individual Trade Application 1 of 1 06/10
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Exc ise Tax L.{ 11)
Parcel Identifier No 1 '' a i " ' Verified by County un t day of 20
By
MadIBox to The Barfield 63• ' Gee, Fayetteville NC 28305
This instrument was prepared by i e fie] w Finn, 639 Executive Place, Fayettevi lie, NC 28305
Brief desenption far the index L h da�tt Bell ' dge
THIS DEED made this 22nd day SS ove • i • - _ 20 by and between
GRANTOR GRANTEE
Puce Builders Inc
80 Russell Drive D Vaughan and wile
Erwin NC 28339 Stef: e C Vaughan
jt ells Newington Dnve
n&tin NC 27546
Enter an appropnate block for each Grantor and Grantee name mai i g s • • if appropnan. character of entity e g
corporation or partnership
The designation Grantor and Grantee as mod herein shall Include sa • • e . r successors and assigns and shall include
singular plural masculine, feminine or neuter as required by context
WITNESSETH that the Grantor for a valuable consideration paid by theta i.11 -- Ole of , Inch is bent), admowledged has and
dime e presents does grant bargain sell and convey unto the Grantee in fee •. p e : 1 lot nT parcel of land situated in the
City of Ltlbngton Upper Little River Township — • • 7 ` County North Carolina
and more particularly deacnbed as follows
Being all of Lot 66 of MAMIE BELL RIDGE SUBDI VISION as shown on plat m; • • • • • • • tuber 2007 256 Harnett
County Registry North Caroli
The property heremabove described was m.quarcd by Grantor by instrument recorded in Book 2 pa a •e 2 ' 1
All or a portion of the property herein conveyed _ includes or/L. does not include the pnmary rest • - i ce . i G • •
A map showing the above described property to recorded in Plat Book 2007 page 256
NC Bur Assembly* Firm No 3 0 1976 Revised C I /Ia201 D
Printed by Ave alma w th the NC Her Assocet
l(P>
E AND l•O HOLD the aforesaid lot orparcel of land and all privileges and appurtenances thereto belonging to the Grantee in
••e
6s ;1) e
ti d the i • ..r covenants with the Grantee, that Grantor is seized of the premises in fee simple has the right to convey the same in tee
si ' . e .alt tie is marketable and free and clear of all encumbrances and that Grantor will warrant and defend the ink against the
w e. clot of all persons whomsoever other than the following exceptions Restnctive covenants recorded in Book 1867
• :4 minty Registry
0 IN W EO' ; rantor has duly executed the foregoing as of the day and year fast above wntten
Ail;j; Inc (SEAL)
l r T • ds ``viii upunlPraa rype Name
lir 2v '10% MAU
Pntttlfypa Name & i .::... P rtn sine
By =- o •ry C ou n ty (SEAL)
Print/Cype Name & Tine 1111LOPMWAIIPW Prm4ye Name
MI:" By � CAR � ` (SEAL?
ti'
Pntnt/Type Name &Tula lanai 'n ntfrypc Warm
-11111\ D State of CgGi t»or Cit of
1 the undermgned Notary ' e : •n : I 0 .1 and State aforesaid certify that
personally appeared before me this day and
acknowledged the due execution of the forc:.r •;. to t forthepu • .. es therein expressed Witness my hand and Notarin'statupor
seal this day of 2 0.._._.
My Conitmsaion Expires Notary Public
(Affix Seal) � Notary a Pnnted o T yped N ame
State of North Carolina County or City of . , II-,
1 the undersigned Notary Public of the County or City . san and State aforesaid certify that
-0 We . ,• • . fore me this day and acknowledged that _he as the
President of Price Builders Inc • 'orth .Iona or
corporationllitaite d liability company /general parniership/limtted partner: ip (' • th • ugh the inapplicable) and that by authonty
duly given and as the act of such entity he signed the foregoing matru in its • on its behalf as its act and deed Witness
my hand and Notarial stamp or seal this 22nd day of Novemb=
. I. � � _ i' �e...A. ,1,
My Commission Expires. August 10, 2015 Ja !r_ kson " Notary Mac
(Affix Seal) • a • lror ' yped Name
State of County or City of
1 the undersigned Notary Public of the County or City of �._ S af•, m id • that
Witness my hand and Notarial stamp or seal this __ day of , r
My Comarisston Expires '�'� airy Public
(Affix Seal) Notary s Printed or 'rte
NC Bar Asocial o 1 Form N 3 6 1976 Revised 0 1/LR010
Printed by Ageemein with the WC Bit Aswdalon
de;7