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HomeMy WebLinkAboutJANUARY 28 2016 BUILDING APPSNEW HANOVER COUNTY BUILDING PERMIT APPLICATION TYPE: RESIDENTIAL PLEASE ANSI,IER ALL QUESTIONS APPLICABLE TO YoUR PROIECT "Project ResPons ibil ity" e> )pttr bbo APPLICATION Number (office Use) DArEt lz- //-/5 .- 7 <:, cr\) - ;-r t6' zIP I APPLICANT'S NA|IE : DEVELOPER: PROJECT ADDRESS: SUBDIVISION: B Et t_ PHONE #: \li4 t'.A LrcENsE #: 3l 131 crTY: l-l v4 LOT #: srtQ(zw: 2rYY 3 PIONE #: ?/o 9Zo 066 I BLOCK *: Dre,.r.D K".^MPHoNE#:1-/_p - f rz 11 rrPROPERry Oh'NER'S iIAIIIE: OTflER'S ADDRESS:CITY: CONTRACTOR: ADDRESS: o Efi,IAIL ADDRESS:. (d rb- PRO]ECT CONTACT PERSON: It-.^* DeftN{i-<, EXISTING CONSTRUCTION:ALTERATION f] nrruovarroru ! eerurnal nrenrns ! RELocArroN NE!'/ CONSTRUCTION: F ERECT NE}'I RESIDENCE OTADDITION TO EXISTING RESIDENCE ,**PLEASE CHECK AND AI'ISUIER BELOW ALL THAT APPLY TO YOUR PROJECT: fl nrr cnnnce _ sF tr d d SF DET GARAGE - SF POOL _ SF DECK SF PORCH SF STORAGE SHED5F SFGR E ENHOUS ESFOTHER: TOTAL HEATED SQFrt I -1 97 TOTAL PRolEcT CoST,Lessrorr | $ l, O,o0O # oF sToRIEs: { 0.., plil'3a Is Any ELECTRICAL, PLUMBII{G or MECHAI{IGAL Work Being oone to the Accessory Structure? p V"t E If the project is a Relocation, is there a Natural Gas Line on the current sitel I ves Is there Electrical Powen on this Buildingl l--l v"r S r'ro PROPERTY USE / OCCUPANCY: F SINGLE FAMTLY DUP LEX TOh]NHOUSE DESCRIPTION OF WORK: DTSCLATMER: th6reby certity hat all inbrmation in his applicaton is corecl and all work willcomply wih he Slate Euilding Code and all ohet applicable StaE and local laws and ordinances and regulalions. The NHC De pment Services CenEr will be noiified of any changes in tre approved pspec frcalions orchange io cootracloror conracbr intormauon "'NoTE Any enW/O lhe Appropriate Permitswillbe in Violation oflhe NC l b Fines Up To $500 00"' OWNER/CONTRACTOR :SIGNA + ir * * j* r(,f *,*1. + *,li + * r.**r. *+* **{r+ * *rt* **1. +* + it,* *,t *,t* *,* ** +,t + r. *** *+ +,r *,r + * + *+ * +,r + {.* +*,t * i. * No El,o ) I5 THE PROPERTY LOCATED IN A FLOODPLAIN? I-I VCS E[ ruO WATER : SEWER: tr CF PUA CF PUA cor"rmuNrry svsrrm S pRrvATE vlELL ! crtrnnl well cENTRAL sEprrc ! enrvare seerrc S coMMUNrry sYsrEM tr *** SEPARATE PERMITS REQUIRED FOR ELECT, MECH, PLBG, GAs EQUIP, PREFABS & INsERTS '*** pAyr4Er,{r rirETHoo: Icrsn flcnecK (pAyABLE ro Hnc; I menrcAN ExPREss E n./,rso 8,, EXISTING IIIIPERVIOUS AREA: NEW IA4PERVIOI,S AREA: - SQ FT zoNE: _ 0F FICE R: SQ FTTOTAL ACRES DISTURBED: EXIST LAND DISTURBING PERMIT: fi ves l-l ruo 8? R ****++***+++x*r(*,tiri.+*x,tr.,*,*+**r(,t,ti.++1.+****,t+,*****)*)****xx)k)*:*'****'**)k**+i"(*****i<+*+**x**)*)*** (foR oFFrcE usE ol,lLY) REVISED oATE 04111/12 SETBACKS: F:_ LH:- RH:- B:- Approval:- City:- DATE:- FLOoD: - BFE+2ft= - AVN ST:_ZIP:_ PHONE #: Sn-yr* <- I surunoom n ToTAL sQ FT UNDER noor, -3 tA( ToTAL aREA sQ Fr: - I I t,{ N,TLDING PERilTT tL-t2t (tk{;a,t,,-b8? T,PLICITTol,ai(. * {tJ Piol€cr rDorEsS: SITSIVISI : $ ll"lrcrlr's ,anrt : IrflrEl.eel: NEt,' ttPll(trun tx: le$IDBff l,AL xralt a!.tr rlt qjaSia(r6 taarl{..!, to rqt nctt(t rproJcct r6to..lltutf t/l*.tlat PioeatTY *r,I{r, s r$llr : crxfR'5 aDonEss: coaTir<foi: AD €ST: (ir"x tv/r*ar) plor E CITY: ,,/tl)zl9 | ?-r(/Z EIQCI r: _ lot ,: _ rxott r: , --k!/a!zk&L tt. ---ne.-&rz lrCEEt€ lr CIIY: L.rt ur't, n;A ^)s1-. xrzr?; za?z rrytIle .. ,/O.ln-,/n'L ,ttrxf a: Eta:L lDottss: ,iottcl (ol.lt(r r€R3€n:<n1a 5rarn al:r E c(r6trrcrt*: I rrr.rnol f] reio,verror flcrnrna_ rerrrs [ rcro(ATtd Gr Crrirrrfl: O:rrcr E rtsroarr or Elrprrran m Exrrrrr EStDffr..,lr,gt o.!fi l,o rml rllc rat I rr?ty Io tal tlrtcr! flerr axroe _ sF fl xr anras sr D eacx _ sr E** _r I rot _ sr I rouea $ro _ sr fisnrrrorr _ rF Soec* _ sr u*e, # @-* T0rlr IGITED S{ FT: 4do rorat t{l Fr lEr wz _L Torlr aGl sQ eT {2a TOrAI P*OJECT COlTra r,q t t 7-\w r Of STOiTES: / tr ,., ELE([l!Cr!, tLl/|lra q. iGtXfICla rbrt !.int Oorl to th. t er!o., Sthrtultr St Ves ! fL th€ proJcct i3 . ntlxrtlon, ,3 thr." r B.tw.l 6.3 t1n on ti. Ct.rsn Jlta? fi V., ftfro 15 thcrc {I..1.1(.rl ,ror,t. o{r !i1: Blildng? Sl vct fJ lo ,lerr?y u5€ / oaqrr'c?: d srx.r r,'irrv I arta fttofioux o€s{ttalrou of r&tx: &Jr. tACg &e Vr'seQr* /Sra&tl Darct/arl[i r t'crern E.a 6t r.rr D n{ aar.<.t . . (aitl lrr a €r s.,'t.ri b i- Lale leita dnti{r.1..r .s !.c01-.5 tn \|{1 o.di6*r :.r c-t. -r r ,tortd c! .r, crrF . n .rlrd tsi nar..r-D,.b6aor "raql€ rr! xro.r ft.t-.d.yro n r-!rr- t-tr. !.. vbrei6rn. trc !D it qa. -4, en rirkAt tr-.rxrtmrocb-! , cnl^c! . c!tr..nr . qffA,rcfiTllcTor fde SIOIATURE: (rrinr i-l rr nc prr?Erry Lo(AtE rx e rroxrrrr I vs fi n m Dri ,?tLvlqrs llEr; _5Q lI rullr A(M glgntl€D: lltrl t D€,lvfqrs rUA: - JQ Fr Erl'r Lrx, DISIlrlrE ftrnr: l-l * .B * srEr: E cFnJ^ ! cornrrrv srsnx Q errvere re . I cE{rur l.Grt su: F ctpuA fl (rrrn r sernc f] pitvrrE stprtc D co*rrw y$r.r ... Stirul llrtt3 ttgrlr9 a ELKT, ta.l,l, ?rr. alt c(Irlr, tt:E a IEtlI! ... pArr$rl ,6rrID: E <ror Eo*c (rrYr&r ro rrl ! rrr:crr err*ss pransr E orsoe. lrt ot'l(l ull lrY) ravl$t }tr x./r!/:f zOaE: oFtlctn:STTBACXS: F:_ Ltl:Elr i: Br[r2+t. _4provrl:- GtY:- oAtti- FIO; - l#rs il NEW HANOVER COUNTY BUILDING PERII|IT APPLICATI$I TYPE: RESIDENTIAL PLEASE ANSI{ER ATI QUESTIONS APPLICABLE TO YOTJR PRO]ECT "Project Responsibilitf, tllnx ltrtt CITY: /,tt t r,/Nl 77)A,/ ?ab*t4?1 tL'"12|, APPLICATION Number (office Use) s112, /' K'-7 bAPPLICA T'S M}tE : DEVELOPER: O${ER,5 ADDRESS: Ptl()tlE S: Z- PRO]ECT ADDRESS: SUBDIVISION:BLoCK #: _ LOT f: PHOI{E #: CITY: _ST:_ZIp:_ LICET{SE *: CITY:5T: _ ZIp: _ ZIP: Zf)(zZ COiITRACTOR: ADOftESS: EitAIL ADDRESS: pHONE f: PRO]ECT COI'ITACT PERSON :<Me PHONE S: EXrSr rtG CONSTRUCTrO]{: f} rlrrnarrOru ! neuoverroH ! crtrnal REpArRs n RELocarroN NEr,J COr{sTRUCrroH: ! enrCr NEH RESTDET,ICE o" sl morrror To Exrsr {c RESTDENCE *.PLEASE CHECX AND At',Sl.lER BELOh, ALL TIIAT APPIY TO YOUi PROJECT: ATT 6ARA6E _ SF I Oer Cnnecr sF E poRcH _ sF suNRooM _sF I eool _ sF ! sronaer sHeo sF SF I oecx SF OTHE R: ec,SF tr tr GR EENHOUS E PROPENTY US DESCRIPTION TOTAL HEATED SQFT: ,IOO TOTAL SQ FT UNDER AWT: {?-o ToTAL AREA sQ FTI 9o TOTAT PROJ ECT COST tess lou t $ Z(, awf OF SToRIES: I Is Any ELECTRTCAL, PtUl4BItlG or I.IECHAI'IICAL t^,ork Being Done to the Accessory Structure? p V", I No If the project is a Relocation, is thene a Natural Gas Line on the Current Site? Is thene Electrical Power on this Building?Elv"r lIruo tr Yes Elto E / OCCUPAT{CY: fi srrorr rar,ulv ! DUpLEx f] rol.rNHousE OF WORK: ul'fr 6 9ltt fi@ DISCLAIMER: lh6reby certify fiat all intormalron in his applica{on is corecl and sll workwiltcomply urih he Stat€ Buitding Code and ordinsnces and rcgulations. The NHC Development Servic€6 Cenbr willbe notfed olanychangos in he approved plaflsand contacbr inlcmaton. "'I'IOTE: Any Work Performed W/O fie Appropri€b Pemits willbe in Violelion ofthe NC StaE Bld! Code and sll oher applicable StaE 6nd tocat Iaws specifications orchange in contracbror To $500 0(r" OWNER/COTITRACTOR:(tle SIGIIATURE: ,r *, )r+ *,* +++ + **:i,i. * * * ****** * *(I'*'ll Jil"J ** **** * ** * +*:r *:**)r:r* *,r**,r*,*:**+: + *+ + r*r ++ * rs rHE pRopERrY LOCATED rN A FLoooPLATN? fl vrS M no EXISTING IIIPERVIoUS AREA: -SQ FT NEtd II4PERVIoUS A'REA: - SQ FT MTER: SEI{ER: TOTAT ACRES DISTURBED: EXIST LAND OISTURBII{G PER IT: N YEs pm fi creun E corr,auNrry sysrEt,t E pRrvArE wELL ! crrrnal wrli fl crnun f] cenrnnr sEprrc E pRrvArE sEprrc ! cottt'tururrv svsrrr,r *** SEPARATE PERI'UTS REQUIRED FoR ELECT, i4ECH, PLBG, GAS EQIJIP, PREFABS & INSERTS *+* pAyrrrENT irETHoD: EI .os, flcnrcK (PAYABLE ro rxcl I ArtrucAr,l ExPREss EDtczrrto fl orscovrn * * * *,N r,* + *)* *,1+ + +* * **,t {.+ + :i :f:* +* * *,t:t * *)* *,} * * *,t * * )t *,},** **** '}:* * * 't ** *'t * +:t * ** +** * *,}* *:t** * * *:t * * !t,t * )i (FOR OFFICE USE ot'lLY) REVISED DATE O4l11/12 ZONE: - OFFICER:SETBACKS: Approval:- city:- DATE:-. FLOOD: - - BFE+2ft AVN $rt PROPERW OU,I{ER'S tlAfiE : Q*le d olb-(pqf ffi NEI^I HANOVER COUNTY BUILDING PERMIT APPLI.ATIoN rYPE; COtIItlERCIAL PLEASE ANSWER ALI QUESTIONS APPLICABLE TO YOUR PRO]ECT "Project Responsibility" Dnvid L.Ioxes, 9e. ?EL tb -1,1 APPLICANTJS NAI'IE: DEVE LOPER:PHoNE f : 5aO'4312- PRO]ECT ADDRESS: OCCUPANT/ BUS IN E SS NAI'IE; PROPERTY OWNER,S NAME:S CONTRACTOR:LICENSE S: CITY: t i\miuqtDN zrP | ?8403 ?63 . 'rrl+ Rlx 9ao.4ar2 PHoNE f : Flb3- btlgO l12 sr: NC zrr:3 94Cl sr: hlc zrP: l84oJ CITY: ADDRESS: EI'4AIL ADDRESS: PRO]ECT CONTACTERSON: uc)PHoNE s: qbA-L.lgOy15 PHONE S: ADD TO EXIsT STRUCTURE (Che€k all rhat Apply) EXIST CONSTRUCTION: lf Relocation. is there a Na ALTERATToN fl nercvlrror Dl cerenal nrplrRs l-l RELocArroN Gas Lrne on rhe 6irent sirez flvei-Sruo ts eroc spil KreRrot f] v"r flruotural NEI.] CONSTRUCTION:EREcr NEr,.i srRucruRE ! rasr rnrcx f] snrr-r ! uerrr ACCESSORY STRUCTURE: If UPFIT - The shell Penmit #: IF Yes, what was the Previous Occupancy Type? ***** rs rgrs a 6HANGE oF occupa1cy user !ves Ero ----. Is Elect Power on this Building E Yes E ,o what j.s the Neu occupancy Type? NC REG # NC REG # ARCH OESIGN PROFESSIONAL: ENGR OESIGN PROFESSIOIU\L: PH DESCRIPTION OF WORK: ls food or beverages prepared or served in this structure? EYes $llto ls Th" Property Locsted ln The Floodplain? E Yes Nl ruo DISCLAIT'ER: Ihereby nd ordin cerufy that alllnformation inthe state Building Code and in rhe approved iire€i3 all other a icable Slale The in conlractor $500.00-'Subtecilo 707'5950 al least l B oWNEFVCONTRACTOR: DnVid L. frreer 9e. STCUTU TOTAL PROJECT COST: A54qO BUILDING HEIGHT (Oualirieo (Pd Name) Note:Demolition notilications t asbestos r€moval pemil applicaljons are to be submitted using the applicalion form (DHHS-3768) co arn Asb€sros or nor. You ar€ roquked to callthe Narional EmEsion Standards lor Hazardous Air Pollurants {NESHAP) at (9'19) dernoliton of any lacility or building. See Asbestos Web Site: htipl /vww.epi.staie.nc.us/epi/asbeslos/ahmp.hlml # OF UNITS TOTAL AREA SQ Fr : r 3OO APPAO^ TOTAL SQ FT UNDER ROOF: _ So Fr PER FLR: l?0O ApProx # OF STRUCTURES: \ ACRES DISTURBEDNO NC EXST TAND DISTURBING PERMIT? I_IYES EI NO NEW IMPERVIOUS AREA; SQ FT EXISTING IMPERVIOUS AREA pRopERTY usE: EfoFFrcE !nesraunarlr lueRceNrtre !eouc APTNDO OTHER: SQ FT WATER: EJCFPUA SEWER: [}CFPUA .. SEPARATE PERIVIITS REQUIREO FOR ELECI, MECH. PLBG, GAS EOUIP, PREFABS & INSERIS -' ZONE:_OFFICER: (FOR OFFICE USE ONLY) SETBACKS: F:-LH:- RH:- B: REVISED DAIE IU11N2 Approval:- City:- DATE:- FLOOD: -- - BFE+2ft= AVN f]COMMUNITY SYSTEM EWELL f]ZONING USE CLASSIFICATION: E]CENTRAL SEPTIC L]PRIVATE SEPTIC f]COMMUNITY SYSTEM PAYMENT METHOD: flcnsn flcxecK (eAvABLE To NHcl fieuentcaru exeness fll,tcrutse I otscoven b Comment PERI,/lT FEE: $ APPLICATION Number (office Use) DArE:-!-:Lq:!!- owNER',s ADoREss: 3392 Clc.o lirln BeBch RA crrY: l.)ilmiNg\pN , - # OF STORIES: I # OF FLOORS: - 1T (r T DF e.F frt NEW HANOVER COUNTY BUILDING PERMIT aPPLICAT,N TYPE: CoMHERCIAL PLtAsg AII5I.JEF AII Q|'ST:OH5 APPI ICAAL' TO YOUR PRO]ICI "Project ResponEibility" Dnvid u. J-ores. Sa. Qotb*V? 'itET. tU -1t APPLICATION Number APPLICANT'5 NAflE: DEViLOPER: PRO] ECT ADORESS oCCUPANT/BUSINE5S NAx E r crrYr 16li 16 iNq+oN , r,J( PHONE f, ?aO-43t?- zI P: p8403 ?63 -[f]+ Fnx 9ao 163 u PROPERTY OT,UNER'S NAHE: L 5-43rf PHONE ': -6qd0 rtz sr: M: zIP:artr4oi sr: 5l! zre: 1840J PtroNE it nQZ - Ln &A \ tg PHONE A: CONTRACTOR Nes- 'qr ADoREss: &qe Gnolim B€Arh Ad EI4AIL AODRESS: u PRO] ECT CONTACTt R50ri l)a.rid L-\7 LIC!ns r *: C I'TY: Exrsr coNsrRucrroN: I ALTERATT.N 3 -r*;ii!llJ 'ii:';ii, ,r Relocarion. ,s lhere a Naru.al Gas Lrne on rhc Ei rc.r Snc? [v.I"fi1" AL REPAIRS RE LOCATION IS BLDG SPNINKT i: RFD' f, ve' ffiro NEl./ CONSTRUCTl0r,l:IR ECT NEW STRUCTURE FAST TRACKSHELL UP FIT ADD .TO EXIST 5TRUCT|,]RE ACCE5SORY STRUCTURE; If UPFIT - The 5he11 Pe.nit s: Is Elect Power on rhis Buj.lding El yes f rO a cHAr,r6E oF o(crlparcy usE? f,vrs ffi lro .",' lF Yet, uhat was the Previous oacupancy Type?l,,lhat i! the Ne!, OcauDan<y Type? ARCH 0ESIGfl PRCFI55iotiAL INC RE6 n EI/GR DESIGN PACFESSIONAL ,/)_ "-/ lc REc s DESCRIPTICN OF WORK: a ls lood or bsverages prepared or s6rved in this strrcture? [ves [lNo b The Propedy Localod ln The rtoooptarn? [ ves fi] No OWNERYCONTRACTOR:Dnvid u. Ioree, 3c. srcNeru ;Curaai igqt Ne.) Nore: Oefl1oioon ncrrnc&o.3 t s$b.sros ,6rnov.l !.fin app[c'r'oru .,. to 06 rr/brl,tad .3d$ tt arpka'on lorm (OHHS-3766) eh.!h.r lnc ttc,l ccirnn Arb€Eos o, n (. You a,r roqurrcoloca t( N!11o.!l €mrssion S cn6rds tror B.ardols Ar PollLtunt' INESI IAP) !t (913)107 5950 at leasi oe.Er'li6 ol yli In - rr, or r- 1,1 ) S.. Asbasiot w.b S;:. :rra i\er eo s'rr. '/ i!.3i:,, Lri.5.'r":\lntl 1OIAL PROJECT COST: A5,4qD BUILDING HEIGHT, OF UNIIS ToTAL ARFc sQ r L r"OO ApfPox IOTAL SQ FT UNDTR ROOF: .- ACRES DISTURE"t"0 e EXST LAND DISTURBING P'IJIIil? [ves ffiruo WATER XCFPUA SEWER ECFPUA T"" =t." ) so FT PER FLR: _I3Qo_APB.QA # OF STRUCTURES: I # or sloRrEs # OF FLSORSi SO:; pRopERTY usE: E'oFFtcE ! nrsraunaNr f]rir rncrrurtlr I eouc ! rer NDO C'|HER -coMMUNrry SYSTEM t] ELL EzoNlNG lsE clAsslFlcArroN - CE\IRAL SEPTIC f] PRIVATE SEPTJC f]COI!tMUNI'} SYSTEM ;. r:)n:.i'r: \r:,'iti:. ,:I| -LII ;:r ''sir':tr'r"' pAyMENT METHOD: fiCrcx ficnecx (PAYABLE TO NHC) fllUentcaru exeRess f] uclvtsr f] otscovrn zONE:cb OFFICER SETBAC Approval:-f,!--City:tL,itft DATE: i l4 liz FLOO ^1-2 F,lrm , , ''usE oNr-Y) KS: F'.N/A LHjNA RH:$U!- 8r O: ' 7cr.. I' Br adttrcpaU E.2rr i\nlT rEE: $ ){r.notu Com DArE: I - 13-lL or.lNER's Ao0REss: ?39a Cqen lir.ro BpAc h M crrv: t,)ilmir.rgtoN . '--Siii. ,rl 1 NEW Ii4PERVIOUS AREA: .-.--__=._.- SO FT EXISTING IMPERVIOUS AREA: & olb-1dx L6 - 00079NEW HANOVER COUNTY BUILDING PERilIT APPLICATION rrpEr RESIDENTIAL Pt€asE ANSTER Atl QUESTIOIiS APPLICAELI T0 youR PRoJICT "P.oject Responsibi.Iity" APPLICANT'S flAllE: Robuck Homes Ti:'an .qi e, LLC oEVELOPER I Robuck Xonus Triancje, rJLC PROJECT ADORESS:720 Antler liiv.CITY: SUBOIVISI0N: elron oeks PROpERTy oWNER'S NAI.IE i :tobuck Homes rrianqie, LLC O0INER'5 AOORESs: 6131 Falls ol Nelrse Rd. Ste 2CU CITY:Ra -L e rq) COiITRACToR: Robuck Homes Tr1 1e i:,c LICEII5E *: 5?c8l ADDRESS: 6131 Falls of Neuse Rd. Ste 200CITY:ia I eiq:1 EmAIL AoDRESS: i ncrbecil@robuck:1omcs . com PROIECT COI{TACT PERSON: ,rd: lior:ec:l - r.r !eca- , r.)! r.rir -ia: . ao:l #APPLICATIO}.I Number (Offi.e us€ ) DATE: c 1,,12it6 PflOl'lE #: 919 876,9200 ZIP:2a403 BLOC( #: LoT t: 16 EXISTIN6 CONSTRUCTIOI'I :ALTERAIION R ENOVATION fl ernrnaL nrrnrns ! RELocArroN NEW COT,TSTRUCTION, fl rnrCr NEW RE5IDINCE o" I lOOrrrOl TO EXISTING RESIOENCE ..PI.EASE CHECK AI.{D ANsI./ER BELOI{ ALL THAT APPLY TO YOUR PRO]ECT: ATT GARAGE 504 SFPoRCH lss SF suNRooN _sF GREENHOUSE SF I eool - sr STORAGE SHED SF 5F I oecr DET GARAGE SF ST: \'c ZIP: :?609 ST: J!_ZIP i 27599 PtEl'lE #: r19-a?6-920c I No Yesr No 5F OTI.]ER ToIAL HEATED 5Q FT: zsrs ToTAI 5Q FT UNDER R00F: r7-cJ ToTAL AREA SQ FT: -i:os TOTAL PROIECT COST rress rorr : $ zz,iI50 ls any ELECIRICAL, pLUltBItlG or |IECHIIIICAL wo.k Being Oone to the Ac.essory Stru(tu.e] E Yes If the pnoject is a Relocation, j.s there a Natural Gas Line on the Curnent Sitei I Is the.e Electrical Power on this Euildin8l pRopERw usE / occlrPAr,tcY: E] srNel: rurlv DESCRIPTION OF WORX: new home I Yes No DUPLEX fl ro^rHnouse O6lClAlMEtt I hereby cedifo mar ali inbnnBtion in his Epplcalion is core.t and allwod willcomplywih $e Slale Euilding Coce and allo0ter applkab]e SlaE and bcallaws .ndo'dn ce5 ald .ca! raions tiie NH C Oe Ebpmen r Se ry ices CenE. will be notl5ed oi an y changes h Oe appoveJ plan s ,r d spetituarcns cl cnange n co.racbr or contact)l'nhrmarion"'NOTEAny!/orlPedomed$/,OteApp.opriaEPermiEwilrbeinViorationolrh6NCSiaEgrdgCodeandSlblecrtiFltrc5LrpIo55000.' OWNER/CONTRACTOR: cb:o tsishop SIGNATURE: I NO TOTAL ACRES DISTURBEo: . r?t EXIST LAND DISTUREING PERHIT: i-l ves I NO SETBACKS: F:j_:-j:_ LH:--t- RH:- B:--:+ *** *** * +r**** *,* *,* * * *,* i. * * ** *,i ir * * rs rHE pRopERTy LocATED rN l rrooorurrl I vrs EXISTING IMPERVIOUS AREA: -9--_ 5Q FI NEI,U IIIPERVIOT,S AREA: 19s6 SQ FI hrarER: I crcua f]COI{MUNITY SYSTEMPRIVATE WELLCENTRAL XELL SETJER:crrur I cENTRAT sEprlc I enrvare storrc I coMMUNrry sysrEm "' sEPARAIa pERi:r-'-S REQU;RED FCR El rai [ECH,p186, 6A5 EQLIl ','2:.A8S & INJ-.i' '-' PAY|I€Nt fi!ThOO: Icosn fianaa* (,A'ABLG ro rttl ! -.*rcnli txrxtss tr rr/v15A 0rScovER ZONE;-.; l OFFICER: Approval:- City (s : oars, l 6 FLOOD: Coflment: . BFE+2ft= N PERI4IT FEE: $ PHoNE s: 919-8?6-920c PIIONE S: 9r9-?r7-r:28 # 0F STORIES: 2 .! 'ffi, APPLICANT'S 2olb-lod 16-0007 9 APPLICATION Number (offi.e Use) NATIE: NEW HANOVER COUNTY BUILDING PERMIT APPLICATION TYPE: RESIDENTIAL PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PRO]ECT "Project Responsibility" !:.:ii) :.i: :l!:-,,e:i l: 1ar,ql., :L: DATE: ir r:'r6 DEVELOPER: Robuck Homes TriansIe, LLC PHONE #: 919-Er6-92cC PROIECT ADDRESS: -: .:,- ., rr :CITY: tr,itmi noron ZIP: )b1a:.) SUBDIVISION: Me I r orr ,,'dks BLOCK #:LOT #: I r, PROPERTY O NER'S tlAlr4E: R.buck Home:i Tri.rirrle, 1,La PIIONE #: 911 8r-6-:r2aa OhTNER'S ADDRESS: ajl ll F'al l:i of ]el.:re F.1. l-:r e ;'lrlCITY: RalejqilST: r.. ZIP: ] r.|? CONTRACTOR: Rcbuck Homes Trransle, LICLICENSE #: srn83 ADDRESS: 61.11 Falls of Neuse Rd. Ste 2a-. EI4AIL ADDRESS: r I-.orbech.0 r obucktrcme,r ccm PROIECT CONTACT PERSON: Jar Norbech - rnorbecfrGrcbuckhomes. comPHONE #: .':-. : .a ATT GARAGE 5' 1 SF SUNROOM SF DET GARAGE - SF POOLSF DECK PORCH i!,SF STORAGE SH ED GR E ENHOUS ESF SF OTHE R SF SF sQTOTAL HEATED SQ FT: z:qi, TOTAL SQ FT UNDER ROOF: r2.5 TOTAL AREA TOTAL PROIECT COST 1r-u"" ro1 : $ ::r, ,rs'.. # OF STORIES: Is Any ELECTRICAL, PLUMBING or IIIECHAT{ICAL Work Being Done to the Accessory Stnucture? E Yes If the project is a Relocation, is thene a Natural Gas Line on the Curnent Site? [ Is there Electnicat Powen on this Building? fiV"t ["-l ruo PROPERTY USE / oCCUPANCY: SINGLE FAIII1Y DUP L EXTOWNHOUSE DESCRIPTION OF IJORK: :,e; i.,,,,1r- OI^INER/CONTRACTOR i l,rp e i..:lop SIGNATURE: IS THE PROPERTY LOCATED IN A FLOODPLAIN?YES I FT: r2rs No Yes!No and ordinances and regulations The NHC Developmenl Services Center willbe noliJied ofany changes in he approved plans and specifcations or change in contracrcror conEacbrinformaton "'NOTE:Any Work Pe omed W/O he Appropriale Permits will be rn Vio lation of rhe NC SraE Bldg Code and Subject b Fines l.lp To $500 00"' + + + * 1. 1. * i. i. + + + ,r + + + + ,t 1. 1. ,* ,* ,t ,t + + + ,t ,r + ,t ,t ,r ,t ,* ,* ,* 1. * * * * ,r ,* * )r * )* + * * ,f * * * * )r * * * * ,r * * * * * * + + * * + * + * * ,* ,* ,* ,* * ,r + i. * r. * EXISTING IIiIPERVIOUS AREA: .SQ FT SQ FT SETBACKS: NO TOTAL ACRES DISTURBED: , ]2 ] EXIST LAND DISTURBING PERMIT: [*l ves lTl uo DISCOVER F : LH: RH: B: n I.IATER: SEt/ER:cFpuA E CENTRAL sEprrc f] enrvare seerrc COi\4i\4UNITY SYSTEI4 *** SEPARATE PERIIIITS REQUIRED FOR ELECT, MECH, PLBG, GAS EQUIP, PREFABS & INSERTS *** pAyr4ENr nErHoD: Icasx flcxrcK (payABLE ro NHc) EA ERTcAN ExpREss E r'rc/vrsn U **x*x:L:*:*:*:**,*,*)*,**,*,******,t1.*+i.li*i(*{r1.**,*******r.r.,i*{.*ir+****)****,1**1.*1r,*)t+*:}*++x*)*,t***,tr(,***+l1r (TOR OFFICE UsE ONIY) REVIsED DATE O4l11/12 NEW II4PERVIOUS AREA: 1 . CFPUA COT4MUNITY SYsTET,1PRIVATE WELL CENTRAL WELL aLl I BFE+2 tr sT: :_:_ zIP : .:--: PHoNE #: 919 !rr6-9i00 EXTSTTNG CONSTRUCTTON: ! nrreUrrOru ! neruOVnrrOH ! Cer,irnal REpArRs f] RELocArroN NEW CONSTRUCTIOru: I enrCr NEW RESTDENCE o" ! eOOrrrOru TO EXTSTTNG RESTDENCE **PLEASE CHECK AND ANSWER BELOt/ ALL THAT APPLY TO YOUR PROIECT: ZoNE: _ 0F FICER: Appnoval:- CitY:- DATE:- FLOOD: - AVN a !(t r ,c+ "ft NEW HANOVER COUNTY EUILDING APPLI catlott nzPE: RESIDENTIAL .11/: // ) r. --'u-'\_-./1\/)_ /Lt /PERMIT t/( ,/ Q-/e3 PLEA5E ANSI{ER ALI QUESTIOI{S APPI-ICAEIE TO YOUR PRO]ECT "Project Responsibility'' 4rJ//c clw: APPLICATIOiI Number (Offlce Use) Plot{E # BLOCK *: LoT #: PHONE #:-lzo-szy'o APPLICA'{T' S ilA'48 : DEVELOPEN: PRO]ECT ADDRESS: SUBDIVISIO : PROPERW O^,I,,ER'S tIAIqE : Oh ER,S ADDRESS: cafiRAcfoe; LLry'' /tz ADDRESS: EfitAIL ADDRESS I CITY: LrcE,sE f: Z//ol CTTY:ltztt ,,AZ Sr*orotrot f] cerurnnl REPATRs n srt <,arPt422? ,rrl ,rorry*:9V-Otz4t '7' PHOT{ E RE LOCATION sF Tl PoRcH qE L-I 5TORAGE SHED OTHER: SF SF NEI,I CONSTRUCTIOI: I TNTCT NEH RESIDENCE O" Er',,,,* TO EXISTING TESIDEiICE ,.PLEASE CHECX AND AllSllER BELOII ALL TIIAT APPLY T0 YOtR PRoJECT: EXISTING CONSTRUCTIO :ALTERATION fl nrr crnnce _ sF I oer canace ! suunoor"r _ sF I eool _ sF 5F SINGLE FAMILY ! cnrerurouse - sF ! oecr ToTAL HEATED SQ FTI ,T.2 ToTAL sQ FT UiIDER R@FI 'I?Z ToTAL AREA sQ FT: ToTAL PRolEcT CoSTquessr,oj , S fit33O. * OF sToRrEs: Z PROPERry DESCRIPTI UsE / OCCUPAucv: Io oF ltloR*: *lna fuOzo/ 7o ouelex ! ToulNHousE foo., /z-*rrta/, Is Any ELECTRICAL, PLUITTBING or itECHAr{fCAL Work Being Done to the Accessory Structure? fl V", I No If the project is a Relocation, is there a Natural Gas Line on the Curnent Site? u Yes K,"Is there Electrical Power on this Building? (v"' EIro /O h€ hr'flrz DISCLAIMER: I hereby certjry }lat all infomston 6nd ordinances and regulations The NHC D€ contacbr iniomalion. ".''lOTEr An is corecland all work will comply wih he Stat€ Building r willbe notlied olanychsng€s in tie appmvsd plan Permits willbe in Violation orlhe NC SIGT'IATURE: applicable Srare and locatt6ws change in conFactcro. Up To $500.00"' !t*+ *,t* * * ++ * )i:tr++ + *,t )* + + OWNER/CONTRACTOR: :t**,t + + * ,* :t :1.,* * * + * **,1* ** * tt*:r Print Nahe )* ** **t )t*)t* :** * * * ** * ** IS THE PROPERTY I.OCATEO IN A FLOOOPTAIil} E EXISTING II.TPERVIOUS AREA: -5Q FT NEr{ rilPERvror,s RE ;3bs? se Fr YE5 X.,o MTER: SE!t,ER: H TOTAT ACRES DISTURBED: EXIST LAND DISTURBI 6 nrnurr: I veS !-] rc CENTRAL WELI. ! comr,tururw svsrrr,r **+ SEPAITATE PERiIITS REQUIRED FOR ELECT, I{ECH, PLBG, GAS EqJIP, PNEFABS & I SERTS *+* Ecsn E CHECK (PAYAELE TO I'IHC) tr AIiIERICAII EXPRESS lJ nc/vrsr Ll DISCOVER creua ! cotllluNrrv sysrEt't D pRrvATE wELL creua I cENTRAL sEprrc I nRrvarr secrtc PAYttEt{T I,IETHOD: :t***,t**:t *,t ,t + * :t,* * * + ,f )i ,l * ,t,l ,l + * * * * * ,t * *:* *,1. * * * ,1 ,* ,t * * * 'l * * * + * *,1 * * 't *:i *!** *:t*tl)t***,**+*,t)*,*++*:r *+++ ** (FOR OFF1CE USE OI{LY) REVISED DATE O4l11/12 to- ZTP ': pRorEcr colrAcr eeesar htc/qf fa26 PHoNE s: a '- 62- fltrtru )(z- ZONE: - OFFICER: sETBACKS: F:- LH:- RH:- B:- () Approval:- city:- DATE:- FLooD: - BFE+2ft= -J Av N\ec NEW HANOVER COUNTY BUILDING PERJ'IIT APPLICATION rypf : COITIMERCIAL P|-EASE A,lsll ALL Q{IE5TIO|{S APPLICABLE TO YOJR pSOl€CI rProjcct Responsibllity" ker,r'r Kc J Ii" 8olb 1cgB 15-00019 # APPLICAI{T'S NA'iE: DEVELOPER: APP L ICATIOT{ Nuober (otti.e use) PRO]ECT ADDNESS i 0 crTt I V ,lra i.rA f.^ PHO E #: zIPl et grz pfour c, 11, .?i) - 17? ( sr tty2zw.t ?!2t1 OCCUPANT/BUSINESS NAI1 V AN' PROPERTY OW ER's M',IE: OtfiER'S ATDRESS: t?l /L.J irIn tt 6t4 r tzll a 0N <rnof h'"f;35aY C\arl*k ) commcron: t, g,D,LICEiISE *: ADORESS;CTTY: EltAlL A0DRE55 | PRO]ECT CONTACT PERSOI,': 3 \\ 5Tr _ ZIP: _ PK)NE T: P}}or'rE s: Exrsr coNsrRucrror{: fi*renrrror ; *.*Jrl[ffi'fi^o?]iko. *carns ! tf Relocadoo, is here 8 Narurar Gas Lrne cn the Cunent S s? Ll"cs XlNo tS BLDG SPP N nErd co srnucrro : I rnecr NEH srRUcruRE I rlst rnlcx fl sner,r- fi uerrr ACCESSORY STRUCTURE: RELOCATIOI{ r<r.eneor p ves I r'ro ADD TO EXIST STRUCIURE If TPFIT - The Shell Pennit #: If Ycs, *lat t,a5 the p.evLo!5 occupancy Type? Xo DESCRIPTION O, NSPK. IT,.tc,/.,."41 w,tf Is Elect Por€r on thls Eullding E Yes [ rc $iat ls ect dr, w,'{47.\lL -hI I rc nra r, lts-7 ?a: 1b1-7.at/'-Z-1lt Nc REc r: 6il?/2 r,.rr rs rHrs A our{GE or occulucv usel f] v:s fi1m ""'tlle Neu Occupancy Type? - n*vor St, Cal<r ls ftod or bolrerEgB p.sp{€d q sswd h t s saudwef I vofiNo b lho Propqry tocatrd h tho Floo+bh? E v*.8[uo DISCI I.EAI Ih!..by clnily ul€l olllnfo.mstion in thB Epglr3uql B co.recr and atl so,a I co?rCy wlh Ih€ Sr6te Buitdlng Coda end 6lt oih3r.ppticalb SraG ano locil l.,s and orddances and reoda{o.rs. The NHC Oeveloon'ern S€(vics€ Csnlar wilr D€ dodrijd o, ery 6a.qe, ln t,r€ oosDve, plarE arld sD€cfEations or cilnse n Clllt,ado. o, conr'ado, Flqtu)non. "'l.lOTE: Any Wo k Pedorrrd WrO tE Appropnits PenniG w,ll5€ i. Violeroi or rne NC SLru 8ld! Cods rn, Sulie{r-io Fd}e. Up To lt00.00 ' "rle c.l l,SIGNATURE: pRopERwusE: EoFFrcE Inesmunnn ffiuenorrle n eouc EAPT flcoruoo orHER:- EICOTTMUNTTY SYSTEM -WEII flZONlt'lG USE CL SSIFICATION! -- fi c:rrn* serrrc [ fi'vnre s=prc pE6uuuxrrv svsreu WATER: ICFPUA SEWER: IICFPUA -. S EPA'IATE PEI tII 15 AEQU R'CJ FOR ELECI, M ECH PLSG, GAS EOI,IIF, PRE'AAS & INSEFTS '' pA\GrEirr METHoD flcsx f] cnecx (PAY BtE To Ntrc) EAMERIcAN ExPREsssa E orscown (FOR OfftCE USE ONLY)REV]sED DATE 'U f 2 SETBACKS:F:N\f\LH:t\ARn-NigB:!-I3x BFE+ar-_ N cICofimBnt FLOOD: ,'', lnSnecltO.rr Req,.lr:m, 9l[t25{-0$li oare: l) ' { -/ f'\l-(\ -J \ tL, =<P \< \- v ARCH OEsICI{ PROTESSIOMLI EII6R DESI{it{ PROFESSIOMLI '{ . codba tub.lb! or nsl You al! llqsLld t0 cd nll Ndo..a E ll.h. Star6.d. to UE d.r! A. PolLtro (I€6HAP) d{019)707-5050 atb-l t0 dart F16b ir ---.-/.-I . TOTAL PROJECT COST:, OF UNITS: #OF STRUCTURES: I #OFSTORIES: I fOF FLOORS: 'AcREs DISTURBED: M/* NE]W IMPERVIOUSAREA A//L SO TT F*o PERMIT FEE: 9-- SC 6cttr- 1ll lk' ilg,,,....-..;.' i.-&, APPLICAT{T,S I{A'4E: NEW HANOVER COUNTY BUILDING PERMIT APPLICATION TYPE: RESIDENTIAL PLEASE ANSWER ALL QUESTIONS APPLICABTE TO YOUR PRO]ECf "Project Responsibility'' ITY: BLOCK *: CITY: LICENSE fl: CITY: APPLICATION Number (office Use) DEVELOPER: PRO]ECT ADORES SUBDIVISION: DATE: ztP : tOT $: JA 4 ?7'( PHONE #: NAITIE: CONTRACTOR: ADORESS: rs rHE pRopERTy LocATED rN A FLooDILATN? E ves *hra.lry &/ sr,/v-'zpJaq// r jt24zrPtzfu/cly'rtlo) z z-)Bi.S' s ETUIL ADDRESS:pHot'lE # PROJECT COiITACT PERSON: .) /?ewte *{Q/o l -?.1-2?fr7 EXISTIN6 CONSTRUCTIO : tr A LTERATION P ner'rovarroru ! cerenal neerrns !RE LOCAT ION NEW CONSTRUCTTOT: I rneCr NEI RESIDENCE o" ! AOOTTTOH TO EXISTING RESTDENCE **PLEASE CHECK AND ANSI'JER BELoel ALL THAT APPLY T0 YoUR PROIECT: ! arr cnnnce _ sF ! oer eenacr sr ! noncu - sF SUNROoM _ SF POOL 5FSToRAGE SHED _ sF I enerruxouse _ sF f] oecx SF OTHER:t.' fztlt sF -)ft) TOTAL HEATED SQ FT: //?TOTAL SQ FT UtrtDER ROOF: dJ,)r TOTAL AREA SQ Fr | )) 2i TOTAL PR0IECT COST lress r-oty : $ /Q{a.'a f OF 5TORIES: / Is Any ELECTRICAL, PLUmBfNG or ECHA,{fCAL Work Eeing Done to the Accessory Structure? {r", D*oIf the project is a Relocation, is there a Natural Gas Line on th€ Current Site? [ Ves ffWo Is thene Electrical Power on this BuitdinB? ffV"s l-''l ruo pRoPERTy usE / occuPANcY , {rrroi ranrr-v ! ouer-rx f] TowNHousE DESCRIPTION OF WORK: DISCLAIMER lh€rcbyfi31all anlormetion in his applicaton is corect 6nd all work willcomply wih lfle Slale Building Code and a oher applicable State and tocat taws and o rdn ances and regulations The NH C De velopmen t S€ rvices Ce n;r will be notfted ol any changes in he ap prc vsd p specifcalhns or change io co.]iacbr intormation. '1IOTE: Any Work Performed W/O fie Appropriats Pefinits will be in Viotation ofthe NC Stab and Subjecres Up To Ol{NER/COilTRACTOR :SIGNATURE: * ** )*:t1.*,t *,irr * * *,1* *:l *,f *,* ,i +,* )* i.,t * * * * )* ++ ri +,t* ** *,*,*,f *,r )t * *:r )r * )r r* ++** )r * +* + *,r *,i*,t) EXISTING IITPERVIOUS AREA: NEI{ IfiPERVIOI'S AREA: d*o TOTAL ACRES DISTURBED: EXI5T LAND DISTURBING PER IT: I:.I ves I Tio SQ FT SQ FT COI,4I'IUNITY SYSTEM tr PRIVATE liE LL fl crrurnrl wruL ! cour.luutrv svsrem MTER: SElt,ER: I cerurnal seerrc I PRTvATE sEprrc *** SEPARATE PERI'IITS BIQUIREo FoR ELECT, MECH, pLB6, GAS EQUIP, pREFABS & TNSERTS *** pAyrirEuT t4ETHoD: I casa ffcuecx (PAYABLE ro txcl I mrucA ExpREss I rczvrso fi orscovrn ,* + )r * * **,t ***,*,* ** * * )k i. )t * )* ***,1+ + *,t,t * * **,1*,f )* )* * * !r )*,t *** *:* )* )i ,r ,* * * * )** * * * )* ****,r *** * **,* * t* )** )r * + +,t ,t ,* ,* ZoNE: 0F FICE R: (FOR OFFICE UST ON!Y) REV]5ED DATE O4l11/12 SETBACKS: F:_ LH:_ RH:_ B:_ {rrouo flcrua N Approval:_ City:_ oATE:_ FLOOD: _BFE+2ft= PROPERW OdI{ER, 5 O ER,S ADDRESS: PHONE Pt,^,,^ '.,eJ /^ )A A,'f.r/ta ^, 1/*/.<7< , l! , "E .= bfopg r' Aoit-_11c{ # CONTRACIOR: ADORESS:,/, 710. tXa APPLICATION Nunber (offi(? us!) 1", /'6 NEId HANOVER COUNTY BUILDING PERMIT APPLICA|IA TYPE; R ES IDENTIAL PI!A5E A''ISWEi ALL QUESII]!I5 APPITCABIE TO VOUR PRO]ECT "project Responsibilitf, APPLICAI,IT' 5 IIA,'IE ; DEVELOPER: t'--) DA'! PnolECT ADDRESS: _ SUEDIVISIOt{: CITY; l,r,' PHONE # A€l2Lf4.) P(OPERTY OWIIER'S NA,qE !" ohliER'S ADDRESS r Zt'1 , A.,t<,.1^4', <)' )^LICEI,ISE f: 3 zIP t7-1rt / PttoNE *: 7/D'Z9 z -O/>ZC sf I lllztP I z,gto I sr ':/!lL. up .24/2 s-' qhc,jE *: q)r'ZZ-9./D pBa1e *i 9/o 3//-iF. < ELOCK f: 4, 7 y: v6att P00L _ sF DECK SF .<-TairaGE sltED --- sF oTHl R: __ *_ SF grtlrCITY i CITY: /., J e, ,' / Cc) f';z: EI{AIL AIDREs5: DESCP]PTION OF IISCLAIMEF Iherenycort ol,Jt(ER/c0 TRACT0R zoNE: j:-,i oFFICER Approval.:.- Cit 5 ar: ! PROIECT CONTACT PERSON: | /../1';,;td---|- ! o.- caarce sr f noecr ..i EXIS']'IM CONSIRUCTION:A LTT RAT ] ON flftnerrovarloru ll GEN!RiI F::;.AIRS I ee Loci-:,,-,l rrrEw coNsrRucrro , I rrrcr NE!/ RESTDENCE o" ! morrrou To EXISTTNG RESIDEiICE .+PLEiSE CHECX At'lD ArlStlER BEI-OII ALL THA, AppLY To YOUR pROrECl: i_J aTr 6ARA6E _ 5F f] surunoon _ sF ! e n:i:'rnousr _ sF TOIAL HEATED 5Q FI ToTAL PRoJ EcT C05r ,ras" ror) , t 1f,' /1 f oF sroRrEs : Z- Is Any ELECTRICAL, PLU,{BIIi6 or }'IECHAI,IICAL tlork 8€ing Donc to the Accesso.y St.ucturc? lZ Yes trroIf the project is a Relocation, ls there a Natun Gas Is there Electrical Power on thi BLllding?Yes PROPERTY USE / OCCUPANCY::AT1I LY f] oucr-ex f] rowrurousr Line on the curr€nt Slte? f vnt figo NO t.,/,'ir4 drd o,dnances Bnd telulauons n! NHC OevBbpmlnt Serv..6s L:oner wrIbe nolfcd oi anycna.!e!s ln r€ +i ai,ons or chr.€. i! conk&rcro.colr?.b. nlo6alion "'!OTE: A.y work d w/O lhe Appop. ac P.willbe,r Violation ollhe NC SlaE To 1500 00"I 516NAIURE: llll.iil"l -... -r.-:* i* *,|* ** * * *,r, ,, r*;tr* J-41t"/, ara 't K: ;/J.-:/ Le .i.I hb,r:aon n his appri."*n o.o*"t rnO ur*or"* €€c- Buildin! Codc .nd at char argfcalte Slab ond toc.t tes EXISTIT{G II'IPERVIOUS AREA: --_ 5Q Fr NEI.I Ir{PERvIoUs AREA: _.- 5Q FT rs rHE pRopFRTy LocarED rN l rlooocurll f vrs E Ho TOTAL ACRES DISTURBED: TXIST LAND 0ISTURBTN6 ptRlrlr: I-'-l v:S [-* no I.rarrR: I creur ! coM]luNrTy sysrF{ l _] PRIVATE WELL fl cerlrnnr wrir SEIER: ! crnua f-'.] CENTRAL SFFTic i- pnrvarE seerr: ! cofifluNi-r' syirlH !*a srpaRlTE 9FiHITS REQJIPE0 FoR E|-ECT, tlECH, PLBG, GAS EWrp, pREFA8S a ll\lsrn.s .., payrENl rlbrhoo: I casx f] curcx (payaBLE ro nuc; I orrnrcm rxeness f r./vrso l- orscwen r * r. **r *: *1*+,|r * +** r** i + ** *,| +, tr* 'rit r.ri: *a, * irr.r - (roR aif:(E u5f oiJty) F[VrsrD oayl 04/li/12 qbl .* iL '\r.,\ \ u1l3-{ TorAL sQ FT uNDER eoor t /7O4 ioTAL AREA sQ Fr: _ _ cv);Pct b-]t DATE : PTIONE *: 7 11p't?Q APPLICATION Number (office Use) NEW HANOVER COUNTY BUILDING PERMIT APPLICATIOTI,YPE: RESIDENTIAL PLEASE ANSI.JER ALL QUESIIoNS ApPLICABLE To YoUR PRoIECT "Project Responsibility" APPLICA T,S NA'4E : DEVELOPER: o a-t'a o, PRO]ECT ADORESS: SUBDIVISIOI{: CITY: LOT f: ztP tZS4n / *: 7/o'231-6QO s'tlLLL.ztP;"4{O / BLOCK * PROPERTY OWNER'S NA'ITE: OII{ER'S ADDRESS: CONTRACTOR:I PHON E t\4 CITY: (. lbvl grtf'oucuse *,l7?z2 ADDRESS:CITY: ET,IAIL ADDRESS: aJet 1 6-pPtfiiE *: 9)O' Zz-gsO PRO]ECT CONTACT PERSON:/v1 6rt.a PHoNE *: 1re' z/7-oe75 EXTSTTNG CONSTRUCTTON: ! alrenarrOru snrHOVnrrOru ! e erurnal neenrns f] RELOCATTON EU CONSTRUCTIOT: ! rneCr NEW RESTDENCE o" I AOOTTIOI'I TO EXISTING RESIDEiTCE **PLEASE cHEcK Al'lD Al{st{ER BELO{ ALL THAT APPLY T0 YOUR PRolEcT: f] arr cnnnce - sF ! oer eaRaoe sr ! eonoi - sF ! surnoom 5F f] eool _ sF I sronacr sHED _ sF ! cnrrruxouse _ sF ! oecr SF OTHER:SF TOTAL HEATED SQ t,H7/ TOTAL PROI ECT COST rr-ess rotr : $1r/1 f OF SToRIES: Z- Is Any ELECTRICAL, PLUitBIt{G or I'IECHA{ICAL Work Bei.ng Done to the Accessory Structurel tr No If the project is a Relocation, Is thene Electrical Powen on thi 1S sr:/@zw:2€/2:;* there a Naturrl Gas Line on the Current Site? Building? Wv"t fluo tr Yes El+" PROPERTY UsE / OCCUPANCY:5I NGLFAMILY tr DUP L EX ! rowruuousr CRIOFWORK:*lq J-.n t Uttl t) t /eJr;cc,/ 4€ DISCLAIMER: Iherebyce iarallin tion in his applicaton is cor.ecland allworkwil Euilding Code and alloher applicabl€ SraE and tocattaws and ordinances and.egulalrons. Ths NHC Developmenl S€rvices C€nEr willbe nodiied of any chang€s an he approved plans and speci ns orchange io contracbror DE IS THE PROPERW LOCATED It{ A FL@DPLAIN? EXISTIT{G I!.IPERVIOI S AREA: _SQ FT NEW IIiTPERVIOUS AREA: - SQ FT !,rArER : EI cF PUA sEwER : EI CF PUA :/ ts willbe in Violation ofihe NC Srare 8ldTo $5oo 00"' SIGNATURE: conracbr inbmatoa "1'IOTE Any WorltBerformed W/O he Appropnate Pen l owNER/coNrRAc roR :,feh4 lv1 V 5 rt e < - I/t , (Print [ane)t,i + + + + )r * + + + * + *,* * + + +,* + + + + + + *,*,i,r * :i )r )i * E YES Ero TOTAL ACRES DISTURBED: EXIST LAND DISTURBING PERfitIT: tl YES Euo ! coNrlururw svsrelr I pRrvATE wELL ! crrurnal welr f] cerurnal srerrc I pRrvArE sEprrc ! cout'tururrv svsrrm *** SEPAIIATE PER'I,IITS REQIJIREO FOR ELECT, MECH, PLBG, GAS Eq'IP, PREFABS & IiISERTS *** paynEr{T irETHoD: ficsn flcrrcx (PAYABLE ro rxcl [ +renrca ExpREss ! rcTvrsa f] orscov:n **,t*i(i.***,t{.+++,rrr*+*+*)*)*)*)*)t***,**)t)t,t,**,t,t,t***++,t****+***)**)***+****)****,t****+*+,*r.*)***,i*x,t,t,t1. ZoNE : _ 0F FICE R: (FOR oFFICE USE oNLY) REVTSED DATE 04111/12 SETBACKS: F:- LH:- RH:- B:- .[re Appnoval:_ City:_ DATE:_ FLOOD: _ BFE+2ft= AVN ._&-, I t')cc rorAL sQ Fr UNDER aoor, /1ffi roTAL AREA SQ Fr: d NEW HANOVER COUNTY BUILDING PERMIT APPLICATT1N TyPE: RESIDENTIAL PLEASE ANSIdER ALL qUESTIONS APPLICAALE TO \OUR PRO]ECT *project Respons ibilitlp fiw lplLa-^ BLOCK *: _ LOT *: 2c(G'7Q lL-tL-7 APPLICA T,S Ml'tE: DEVELOPER: PRO]ECT ADDRESS: SUBDIVISION: PROPERTY OU ER,S I\IAIIE: Sc"Tf OI.INER' S ADDRESS: coNIRAcToR, aa6 3 C ADDRESS: ? ac CTTY, LICEI{SE *: T, t1 iq ACCOU]'IT *: APPLICArION Nunber (OFfic€ Use) DATE; I.?\ -t b PHOfiE #: Zfrt ZE clol l't PHoNE #: 1./a a3?-?Zoy sr| Nczrptz& qq A PHONE PHONE sTt ttL ZIp:?&ylz *: 'l lor/ /.2z- t7Lb ETIAIL ADDRESS: PRoIECT COUTACT pERsoN: GACAItt <r*<l zusrr'lc coNsrRucrroil: f] alrenarrolr I neuovarrou I ceueur- neccns I RELoCATTON NEW COI'ISTRIETIOiI: I ERCCT NEhI RESIDENCE Or ffi EOOrrrOr TO DOSTII,IC RESIDENCE .*PL€ISE CIiEC( I'@ AIIS}IER EELOI{ ALT THAI APPLY TO YOUR PRO]E6! flerr ceuce _ sF I sur'rnoou _sFI onerruuo:se _ sr ! orr oeaaoe sr I mr+r _sF I oe cr _ sr o'nER: E POOL q-to SF I srouoe riHED _ sF SF DII'CLAIMER. I horaby cenjt tlar a[ hbmadoo in hi€ appfcatoh ie cofiect and sJl and odhanc€s and rggularilns. The NHC Dg!€lopment Sorvicss canbr ',{ll be not contacl]r inbrmaton, .-NOTEI Any Work perbrmed w/O h6 ApplopritsB p6.miE vDrkvil complywih l1o Stst3 &ildh9 Code and di ohor agp$c.bte SEE, ard to.al la /€ fied of an y changes h he app o \€d ptan6 and Cecifcsions or cfiangs h conE&br o. willb€ in Molaton of heNC SEb tl Fin66 l, To 9500,00..' * ra+**:t* +:i + +* ** ** ++ * * ** ohlNER/coNTRAcTOR: 6 tc t1A <.,-^.t STGMTURE: (print firee))t+:f **++**+**:i+**+++***+**+***:'***+*+*+*+:t +**+***:i*** **** *x*+ r ** YEs ffim TOTAL ACRES DISTURBED I I5 THE PROPERTY LOCATED IN A FLOODPLAINI EXISTING IfiPERWOI,S ARrE: 3 I CIIC SQ rr P- \h oFFrcER: $+e sElJltulTE pEtU.ttTS REqUTRED FOR ELECTT |{ECH, PLEG, GAs EqJ pAyr4Er{T }rErHoor fl csn f] crecr (IAvABLE ro n*; [ ,r,.i r."-,., *;1.* *x** *:******* *:tst*i****!t:t***r.)t****** **t:i**rt* **:t :l;i+***,Ft ***t* NEN ilIPERWoUS AREA: 10 Z0 SQ FT E(IST LAro DISTURBII{G PERIIIT: [-i vrs f ii r'p rr$rER: I cFpuA n com4uNrry svsrem I pRrvATE HELL I cerurnnl uell sEr.lER: I crpuA D CENTRAL sEpTrc I rRrvarr senrrc f] co&luNrw sysTEM ZONE: approval: OY City:tr)lLlY1 DATE: coffEnt: I& "'-al nn: Ah/e:.10 !P, PRIFAES & I&sERTS i*:} E] ficlwsA I orscoren +:F * *;i:i :* '*:*+ * fr:i *:t:t )t :t:t*:t :t* )t;a:t:t N PERfiTT FEE: $ (ro8 ofFrcE usE o L L j &EVISEO OATE 64111/!2 ETBACKS: F: FLOOD: - Zog,a.-,f, BFE+2rt= --(a cttl-ztchrd P o \:e \ocak d c\o*r Jhaq \O/s.rr.\ Pr""Fr^\ L'-r.e 5 . CTTY: u,k-A,^. ToTAL HEATED SQ FT: _ TOTAL SQ FT UNDER ROOF3 _ ToTAL AREA SQ FT: _ ToTAL PROIECT COST (L""s r_o0 | g 3)/?oo # oF sToRIEs3 rs Any ELECTRTCAL, pLUtlSrNG on t4ECHAIrrrCrlL l^Jonk Being Done to the Accessory structure?fr ves I uorf the project i.s a Relocation, is there a Natural Gas Line on the cunr€nt site? flves EltoIs there Electrical power on this Building? f]ves ffino pRopERw usE / occurpA cyr [} srruole FAmrLy E BJpLEx f] rouurousE DESCRTPTIoN oF NOR(: -.rl STAIJ. v{G,L.,.d^ rIBeI,6LAc( Po6C NEI,{ I-]ANOVER COUNTY BUILDIN6 APPLIC^IION TYPFI R ESIDENTIAL PLEASE AuslrE8 ALt- QUEsrrOfls AppLICAsLs T0 youfi pflo:lEaT r?roJect Responsibillty,, ,ctb-nJr PERMrr Wzlu]g APPLICATION Number (ofB(a Ure) APPLTCANT'5 DEVELOPEN: -Ttx+ (,,t: PRoJECT lDDnEss: 23l SUBDIVISJON:L PROPERW OI,INER'S NfuIE; OUNERJS ADDRTSS: s CONTRACTON: -ADDRESS: $t J CITY I BLOCK II; LIcENsE *: a3311 DATE i Pll" IOI Jt: ztP: z€441L2\ F Elt {L. tro( J s't|-l!_Lztpt28451 sTtNC zrp:2Eqq tIO( CITY:..rd E]4AIL ADDNES.'; IP|'NE $: lEz.zrx PNOJECT CONTACT PERSON: l./,olt,^a \ rlJ PIIONE iI: FXISTING' CON5TRUCTION: E ATTENAIION' f]RENOVATION 6ENERAL nEpAlRs I naocarroru NE!,1 coNsrRucrroN , {rnua NEr,l nEsIDENcE or flloorrron ro ExrsTrNc RESTDENcE '*PLF^SE CIjEC( /lNo A SIJER BEt fln-, uo*uu t55 sr. f] orr enracr sr fleoncu 318___sr 0l,l ItL THLI IIPPLY T0 YoUn pRotEaT: suNRoot'l sF GREENHOUSE - 5T P00L -- 5F I oecr .-- sn orHER: f! sron,ree sHED --.sF ' rs Any n.EcrRrcil, P,-ur,l81N6 on dEcSlNrcAL l,tork Belng Done to the .Accessory structuroi B ves [ ruoIf the project ls a nelo.atloh, is there a N;tunal 6as Llne on the Current slte) Eyes llo fs there fl.ectrlcal Por.rer on tts outldlnsr fl ver fi r,ro PRoP[RTy USE / 0CCUPANCy: OISCRIPTION OF !ON(: ToTAr HEATED Sq rr') 1131 T0TAL 5Q FT UND Z,toT0TAI. PR0IECT C0sltr.o.srd) ; $o6O 5I 6LE TAfiILY DIJPLTX s,\L 5t ER ROOF: ?-/L\7 TOIAL AREA sQ FT: .-=- ,l OF STOnIE5: I ,5 DlSCtAiMen: I herel,y cerli, tal all hbnnstlo^ h t,s applcgIon i!.o,rocl ind altryArkwlll 3od ordhEncss ard rsguhl,ons, Ths iSlC tuvobpm€nl S6rv[es csntar !,,llb6 nottud orsn coa! dcl]r hbrnalor, '"NO]'tt Ar'y WotX ?ulom.dWO h. App.op.tat pslmrhvilbe jn cornply rrlltl t\o S lots oulHhg Code and a, oth 6rarpllcablo Slals and locsl lsws OI{NER/CONTBACTOR: rl rl d<r sI6NATURE; , +{, r* ++++r* }*+}+****. *. i* #l'Il liTl***++**+*++++++*+++-+++*****+++*++i.*++*+++*++**f +***+t r.s rHE pnopEnry LocATED r,l a rlooorLarN? lf, ves Wa I ycharges l4 tu approved p,an s Bod spsclnca onsorchangs h 6ntra6bror l$s NCSlah 8d0 C{d6 sndb fines uplo i500.0d]. TOTAL ACRE5 DISIURBEDI O. 01EXISTING rl,lPERVIoI,S AnrA, - -SQ FT NEl,, II4PERVIoUS AREAT j.tL,_ se FT-Jr"droEXrST LAN0 rrrSTURErNG pERltrT: E yEs cot4t4ufiIry 5Y5TE I rnrvare r,rLL I CENTRAL I'fLt COIIIMUNIry SYSTEMll celrrar- srrrrc l] cnrvarr srenc I Approval:-. cl ty:*t|\A* DAI E;BFE t2ft= rm:'En: ffi crrul sEr.,rR I zl crPUA +'' SEPAIATE PEIi}IITS REQUIN€D fOR EI.ICT, T,IECII, PLO6, 6A5 EQU]P, PfifFABS E IISERTS I*1 pAyfiENT r,rErHoDr ffi crsrr fiorecr (pAyiBLE.ro fiHc; flI}rrnr.nr **urr f{ ,.zrr* [lorscover:t++++++-tt*+*+*+*+*+*++*)t*++++:*,+*++***+*++*+tt*+:r.**+*****++++**+*tt+++***1**+f1.*****+++,1* zoNE; *[Li< orrrcgn:dL .) (roi offIcE usE otl SEIBACKS: F:'rd r,,-$- nn: {.1.1 s;J'vtsEo o^rE o4t'1t'2_vv rl\ qcomrnent: FLOOD: Enl,lli r:EE | $ PHONE,i': 162-zaoc, I ,l-roututousr a Y NEh] HANOVER COUTITY BUILDING AP P LI CATI O},1 TTPTI R ESTDENTIAL PLfASE AllS!'Ei AtL qlEsTlotis AppLlc^stE tO youn pRoJEcI r'Praject R;sponsibluty', ..1/ 0 tb' )]2-- pERMrr ?Et lttt -bq APPLICATION Numbct (offl(e u56 ) APPLICANT'.5 ilAI'lE i DEVEI-oPfR I PRoJECT ADDRESS io -sUirDIVISf0i{i t DATE I( I LLC-flloNE Ir: + CTIY; la _ . BLoCK #: zrP | 6qtz. Lo'f tl: ZZ PttoNE.ll: '182-7 ?PNOPERTY OUNTR'S I.]AJ'lE : OWNER'5 ADDRES5: coNIRAcIon: T7., tl ol aoontsS: tl9 EI.IAIL ADDRES5; PnOltCT CoNTACT PERS0Nl [-J enrrrHousr .----- sr PBOPERTY USE / OCCUPANCY: DESCRIPTToN ol: l!ronl(: ATT 6ANA6E suNR00h q59 DET CAIIAGI POOL o6 TY:Lsr: Aqzrpi ZBqr( sT:.lUe zrp: 2E([r( LrcENsE it: I SS {l CITY;L,.lond Pltout tt: 181.1Ro6 RELOCATTON 5F sF 0 tHt'R:SF e (,J 'Jlu 6" U EX]STIN6 CONSTRT'CTION: NEI,J CONSTIIUCTION:ERFCT NEl,l RISIDENCE or.4DDITION TO EXISTINC RESIDENCE EnsE clll(( Al.tD Allsl,lElr UELoll /lLL T Af lfPly T0 voUR pRolEcT! C^ t\<r- DECK 5F ToTAL ITEATED 5Q rr: 1,131 ToTAL sQ FI UNDER noor t /2,(12 IoT L AREA s0 FT: TOTAI. PROJECT C05T(Lessrd) : $740 ll oF sToRrEs: 1,5 Is Any ELECTflICA!, PLUI01NG or l,lgCH,lNICAL l,brk Belng Done to the .ilccessory Structure? fl Ves I lo ff the project is a nelocatioh, is there a ilatural 6as 1.1 Is th(:r.: Electrical PoBer on thls Building? pVus filo ne on the current sltel E Ves' fl ruo ffiru,, norr,., I ourrrx Dlscl AIMER: I hsr6by c.rlJly tr.l r:l hbrmallon h hls appliaton ls conel and aI tdrt rdlt6omp,y rrl[l fi6 Stats Bulldlng Cods ard at ooersppllcabls Sraro aad ,o.aljar?s 611d odlo&1cos and rdoulaloni, Th€ NHC Oavabpm€nl 56 rvbls Cenrgr $,i11 be nolltsd o, Bny ch&Uos ln t\6 approvsd plans andsPo! Illcalbns or ch.ngs h.oll6cbrol contacbr hbrmrlon, , r'NOTEi Any llbrk P6rformad WrO |116Atpropdatg Poffdti refl bs h WIaIon onha NC Sla ct{NER/CoNTBACT0n:'fiEs) +:*|++:*,r +* ++**++r+****+*++* *(itl lil'] * * I5 IHE PROPEIITY LOCATID IN A FLOODPTAIN) EXI5TIN6 IIIPERVIOUS AREA; - sQ FI ,,lJ.t 6.0 16 BUo C6do Fnd S{racl b f h€s uo To aEOo.OO.,. /UJ l,^-516I]4TUNE: ***,+ ***+ +*+*+ *++j+ + + +* * f *l YEs Ld No .;;;;J--,-,*;;-* TOTAI. ACNES DISIURBEO, O,O1 I.IEI{ II4PIRVTOUS AREA;3165 so rr EXIST IAND DISTUflBII,IG PERI.IITI E Yfs I,JATER: rurr I cosrururw sysrEH .E pRrvATr wrlr. f] cENrnAr t,lftr .5EI,JER:CFPUA tl c[NTnAL SEPTTC l] nntVlrr srtrrc ! co,qflul,ll]y sysTE,! loDroval: Citv; L), L ^\ DATE BFEr2ft- *.+ sEp.qRAIE pE llTS f,EQUTRED FoR H-ECL !lEC]t, prBG, 6 S EQUrpr PR€FAB5 & JUSERTS .r+ pAyr4EMr ETH0D: ficnsr flcfircr (pAyABrE. ro nrcl pAlrrnrcan rxenrss f,] c/ws; fl olscovER*t,t,f,r**+,tjf*:t++;l*+*++++*;!*****;r*****+*.+++*+*+*:l+*t****+*+*++**++*+++++++++n+++*++*+*+*+** zorr: ,-pl{ orrrcrn: (foi offICE llJ6 o l SETBACKS: F: Y) .. , I P,lvtsaD oAfE a4/\lrz l1J ru: 5.5'nr: * e:;J1l IWComrneot: i-ls],t-FLOOO: prn T FtEt $ ?tDNe $: 18l.Z8o$ ! aLtrnarrolr' I ne ruovlrror'r '-[ cENFRAL REpArns 5F {.l,nn 21t ' ,, I sronntr srED _-.sF H'* 4,-3, & APPLICANT'S NAME: DEVELOPER: s. 1 NEW HANOVER COUNTY BUILDING APPLICATION IYPE: COMMERCIAL PERMIT 1.6 -LLz APPLICATION Number (offic€ us€) PLEASE ANSWER ATL QUESTIONS APPTICABLE TO YOUR PROJECT "Project Responsibility" S. T. Wooten Cororat ion DATEi 7/75/2a76 Wooten Corpora E ion PHONE #: 9ta t62 a32s OCCUPANT/BUSINESS NAI'IE: s. r. wooren Corporarion PROPERTY OWNER, S NAI'IE : OWNER,, S ADDRESS: p. o. S. T. Wooten Corporat ion PHONE #: 919 - 218 2834 Box 2,10 8CITY: wilson CoNTRACTOR: s. T. Irooten cor LICENSE #: 283s ADDRESS: p. o. Box 2,108CITY: wi - sonST: NC ZIP: 2?8ea Eli,lAI L ADDRESS: Butch Lawrer, butschosrwcorp. comPHONE *: 919 218-2834 PROIECT CONTACT PERSON: Bobby Butlock, bobby. bul lockasrwcorp - comPHONE #: 252 29a 7s44 (Check A11 lhat Apply) EXIST CONSTRUCTION:ALTERATION R ENOVATIONGENERAL REPAIRS RE LOCATION l, Relocation, is there a Natural Gas Line on the Current Site? nYes ilro IS BLDG SPRINKLERED? Iv". f]No NEW CONSTRUCTION:ERECT NEW STRUCTUREFAST TRACKSHELLUPFITADD TO EXIST STRUCTURE ACCESSORY STRUCTURE: -J rJ .\-tt e If UPFIT - The Shell Permit #: IF Yes, what was the Previous Occupancy Type? ARCH DESIGN PROFESSIONAL: ENGR DESIGN PROFESSIOTIAL: NC Development Enqineers Is E1ect Power on this Building I Yes fl ruo PH: ****,, rs rHrs a CHANGE oF occupANcy usE? EyEs!n \\J-tfI NC REG #: PH:919,803-8704 NC REG #: t9a2t - DESCRIPTION OF WORK: consEruct fouodation for 2 30oT silos & scales next to existinq asphalt silos \,I Z DISCLAIMER: I hereby certify thal all informaiion in lhis application is correct and all work will comply with the Slale Building Code and all other applicable State and local laws and ordinances and requlations. The NHC Develoomenl Services Center will be notified of anv cnanoes in the aoDroved Dlans and soecrficatrons or cranqe rn conlraclor or contractor r-nformatron. 'NOTE Any Work Performed w/O lhe Appropriate Permiis willb'e in Violalron of the\lC Stale Bldg Codeand Subiectio Fines Up To $500.00"' ls food or beverages prepared or served in this structure? EYes T No ls The Property Located ln The Floodplain? ! ves I No OWNEFYCONTRACTOR: n s sIGNATURE: R S Lawter'Jr'(Butch) Lawter,JI (Oualii6r) (Pdnt N6ho) conbin Asbestos or not. You are requircd to call the Natonal Embslon S'tendards br Hazadous Air Pollutants (NESHAP) at (91 9)707-5950 at lesst 1 0 days p.ior to the dernolilion ol any iacility or building. S€€ Asb€stos Web Site: htlpj vlw.epi.state.nc.us/epi/ssbestos/ahmp.htrnl TOTAL PROJECT COST: s127, o5o flzoNrNc usE CLASS f]coMMUNrrY SYSTEM WATER: ECFPUA fl coMMUNrry SYSTEM ulWELL CENTRAL SEPTIC I1I PRIVATE SEPTICSEWER: E CFPUA (FOR OFFTCE USE ONLY) IFICATION: r 2 PAYMENT IVETHOD: Icnsn I CHECK (PAYABLE TO NHC) IAMERTCAN EXPRESS I rvrCnrrsn IOrSCOVen *'SEPARATE PERIVITS REQUIRED FOR ELECT IVECH PLBG, GAS EOUIP, PREFABS & NSERTS *' ZONE: OFFICER:SETBACKS: F:- LH:- RH:- B: Approval:_ City:_ DATE:_ FLOOD: __ _ BFE+2ft= loD - -?'M\aaJa^- N PERMITfEE: $ &-' Slo; PROIECT ADDRESS: :10 SurEon -,ake :loadCfTY: wi tminqron ZIP : )s\ a2 ST: I!_ zIP:!f!j3- Y What is the New Occupancy Type? BUILDING HEIGHT: s:los -;: ' # OF UNITS: TOTAL AREA SQ FT :2-925_ SO FT PER FLR:z_!21_ # OF STORIES: NA - slab TOTAL SQ FT UNDER ROOF: o #OF STRUCTURES: _r .r* z =iro" #OFFLOORS: ra - srar ACRES DISTURBED: 0 EXST LAND DtsTURBtNG PERMTT?nYES ElNo NEW IMPERVIOUS AREA: o SQFT EXISTINGIMPERVIOUSAREA:2?7.43s SQFT pRopERwusE: lorrtce lnesrnunlrur lueRcnrurLe Ieouc !ner lcor.roo orHER:Aspharr pranr REVISED DATE 4/11/12 i- Comment AUU - -) >--) rPeZ15-3'.4LNEl.iJ HANOVER COUNTY BUILDING PERIIII APPLICATION IYPEi COIIMfRCIA L PLEA5! rn5tafr Att Qlt5T:Qt5 l9pr.ICIIIE r0 yqrn pio)t(] "P.oJect Responslbrlity'' Tribrrle Consruclion. ::a AP P'. IC AT IOX Nufibea (orfl(. U!€) oar::12..l6.15)t!LICAI:r 5 ryA'aE. CONIRA(-'A T D:VE TOPER i achliee Ventures LLC UA OCCUPAI'II/BUSINESS NA'1E iSlock Atilrircfils PROPERTY OI{NER'S NAAEI PCACI]ITEq \ICI 1UTCS LLC ol.rNERrs aDcR€ss 1C S. Cardinal Drive t':loNE l: 910'251'5030 .-' flc , . c:rY: Wilminqlof --- LICENSE t, -99901 - crTY; Wllminqlon PHo E {: 9'10.25 i.5030 c:- r \ oriz:P | 28401 iructior Ati. .ti 1 vc!: NC :;, 26103 :r,lll i tssi I , Jr,- -pro*e rr 910-251-503C PliolJE jl I J Exrsr c'Nsrnucrro r ! atr:nai:orr [! *.ilffi;li*t 'fr':'.'ilr^. nrparrs '-.l R:LocArrox I Rotoca on, is rhere a Naru€lGas Lins on lhe;,"rrsi:or tr:"ir]'lo s g-oo soiii<ren:rr Ivos []rro NEll coNSrRUCrIONr f] enecr Her srRUcruRE I rasr rracx ! sntr.l ] ucrrr f rcc ro Exrsl srRUcruR€ pRorrcT r:uTACr PrssoN: Eliar: {aiser ataE550tY -<r Rr -- . If UPF:- - Ihe Shell P.-.rit f: I5 E1e<t Poxer on this .luil.ding i:'l YcJ fl *O .!r.. .\ IFts a (HAtit6E .. o(cuper{cy ,5Er f rt: _- n9 ,.... Ir yps, rh.. las !rr previous occupa..v Typea OliCe^VarehoUSe,fiit j.s lq. Np! O((ri,ii.y Type>','u I i:,-, r prr, 910-793.3433 {c RFG ':atcH Dt51:\ PrcritsroL t: c n Harlis Archi"'.1 rIe rN6R 0tsr6N pRorEsslo)taL: DES(RIPrI.'r oF r,1o8(: Rehnb bliJ:Jiri {ol Mulli-Family unitg- -{!11':r 1) t6 tood orbsvorseos prop6r6d o. ssned in lhisst.o:{urts? EYas mNo b 'f hs Prcp8rly Lc,ci,lad ln'IhB Floodplsin? n Yes sirn r! llrD E:i'" "0 coda ali: olLcrha. uro .jr!a sl,le: '-1, (' ',r b,rr.,^tklr.1.r_- -'c!r'.:\rr cJC,nur- owtiEP"CONTRACiCR:-Brian Kaisor .1L--:> 400 iiurLDrNG r i:::}rr 20 SIGNATURE r*{- o*:tr.r Dtr.rr!,! i: "be!ro!,d, !r3l rqF,r srrkrl.{s r^, o be sulr-i:,.::5ii rihs:;rtslpn lorn (Dri'ls'::all wh.lher:rr r, !!orl,rlrltrJrrrro!rdla MhhArt c.,n oryo{o.i,}rrrodlo=rrn1r"n-.r,E,nb.ron9r?,2l.lo..!!ri3.!5al.Pi{r*t 1\r!ir,,.1(1,ir:7.6!5131 u5.t l0dlr F&r '. tho doorolibn ol.^y,ddlity o, hr lrrh! sc€rlbttbaY/ea sJrt hlllr,rvw cpr sldG.rc lgtploslr5.s/ohmp llnl roreu pnolrcr co:;- sEt0 TCTAL ARE SQ '- TCTAL SQ Fr riNfrrn noor: j!,) ]t_-. AOH.'S D:sI.lRoF, N/A sa rr PEn FLR: 12,540 , OF S'I i UCTURES: 1 LxS r LAND DrSTUlErlrc cenu r frvus I NO NFw [.lp:F...roils ARFA: SO FT EXISTING IMPEAVIOUS AREA: FRcFla] u-q:. I lci.rrcE llREsrAURANr l EqcANntE I EDUC ;! e,r -]cottoo \yArEa lIcFor]A s-,.,,ER. .'.-: . .- tA PAYI/f lrT Mf-f i-11 [:lcAsH EcHrcK (PAYABLE ro NHci [lue ctc$t exrnrss f]tlc/i/lsA f otscovEn ]lSOMMUNITYSYSTETI : IWELL! OEiITRAL SEPT a i - ,l.itvATE S=PTIC lzCNlNG U:: :LAS:^rF CATION: f ]]iJMMUI.] :.i SYSTEM ,,' J r.)l ina8,t'r:r'Gns!0!r,.rrn'^ir\ Irr ,, 'j z0ti AppIOYA rlE:l 1t(:-- -.. aE usEONLY}r: X un:_js! rbAUK$:nx: I g:4-l-erE*ztI N P:ritllT FEE: $.- _ Lii FLOOD: __ -Commerl DATE z-i .'.i. (ffi,I I PHI NC RE6 T: , oF uf;1:s: 10 # OF STORIES: 2 I Or rt.OOaS: _-I- /a11 tt .- /,,, !, "," (ffi, COI{u- a>-l Peztus5qL NEI,{ HANOVER COUNTY BUILDING PERMIT APPLICATION rTPf ; COI'4I1ERCIAL PLEASE AXS!/[R ALL QUESIIoNS APPLICA0I,E IO YqJR PRoIECT "Project ResponslbIIlty" APPLICAIION Number (orflce U5o) oATE:j41!l!-APPLICANT'S NAI4E ITribute Construclion, lnc. DEVELoPER: Peachlree Ventures LLC pRolEcr ADDREss: 210 Greenfield Skost crrYr Wiiminqt0n 0ccuPaNr/Busr,rEss NAI.{E : Block Apa(menls PROPERTY OWNER,S N,tt.|E:Peachtree Ventures LLC otlNER's aDDREss: 10 S. Catdinal DrivecrrY: Wilminqton coNTRAcToR: Tribute conskuctioulgt LrcENsE #r 60001 aoDREss: 10 S. Cardinal DrivecrTY: Wilmington Er,rArL AoDREss : bkaiser(Okibuteconstruction.com PRO]ECT CONTACT PER5ON: BI|AN KA|SEI PHoNE *r 910-251-5030 ztP | 2U01 PHoNe *: 910-251-5030 sr: NC zrp: 28403 ST: NC ZIP: 28403 prorr *: 910-251-5030 Pnorue r: 910'599-8130 *rr+* rs THrS A CHApGE or occrrpa1cy usrr IVtS [il6 ***** rF Yes, Hhat eas the Previous occupancy lype? oflicg/lvafehousahat is the New occupancy Typ If UPFIT lhc Shell Pcrm'it f;Is Elect Power on this Building E Yes E tO er MultiFami PH PH 910-793-3433 uc nrc r: 4290ARCH DEsIGN PROFESSIoNALi ENGR DISIGN PROTESSIONAL: DESCRIPTION OF WORK: NC REG f: Rehab buildino for Multi-Family units (Phase 1) 16lood or boverages propar€d or served in lhis stluaure? [Yos ffiNo 18 Tho Propsdy Located ln The Floodplain?f] ves ffi No DISCLAI#ER: ' hErcby cerUly thal 6ll lnlomolion I,l end lo(allaws and urJlnanc€s and rooulalluns. Tho or chsnos in cuntroc.ur or contrallor ii'ormslion. "' Sublccllo F ncs Urr To5500.00"' rhh spplhsrion Is clrecr a1(l allwork willcomply \ailh rhe Slale Bui NHC Dsvoloom0nl Sorvlcos Contor wrl uo nolrhod ol anv chan0esi NOTE: A'.y Work Pe/o'r.ed WO lhe fupropda(e Pernits |+ill60 ln n lhe aDorovsd Dl€n6 und suerilfrcallLns violallon ol lleNc slal6 BUg Cods snLl lourr.t) (filr Xor*) cooEh Aabolbo or nol You .m roqslrsd to call ths Natbn6l Emh{lon Stsrd.dr lor h.zrdous ,rlr Pollutrnl6 (NESHAP) at (919)707-5950 at lgarl l0 d.y6 prior lo tho domolhlonot6nytsdl(yorbundh0.SeeAlt€sto6WebSllarnlprlrlr.epr.sl6le.ncuyepl/asb€stos/ahmp.ntml ldlng Code snd allolher applicsbl€ slaie OWNER/CONTRACTOR:Brian Kaiser SIGNATURE: ) ToTAL PRoJECT COsr: $800,400 gurr-ornc nEronr: 20' f OF UNITS; 10 TOTAL AREA SQ FT :20,010 TOTAL SQ FT t,NDEn ROOF: 20,010 ACRES DISTURBED:N/AEXST IAND DISTUREING PERMIT? E YES I NO NEW IMPERVIOUS AREA:SQ FT EXISTING IMPERVIOUS AREA: pRopERryusE: lorrrce f]nesreunnrur luencerurLr !eouc ffiaer f]coNDO OTHER: SQ FT WATER: SEWER; #CFPUA CFPUA El CoMMUNIIY SYSTEIi!-. fIWELL EZoNING USE cLASSlFlcATloN; ECENTRAL SEPTIC LIPRIVATE SEPTIC f]COMMUNITY SYSTEM PAYMENT METHOD: ICASX ICXECK (PAYABLE TO NHC) EAMERICAN EXPRESS EMCNISA I OtSCOVen SFPAHAIE PERIVIIS REQUIRFO FQR EI ECT,ITIECH, PI8C, GAS IQUIII. PREFAES & INSENTS "' (FOR OFFICE USE ONLY) SETBACKS: F:_LH:_ RHr_ B: REVISED DATE 1UI1l12 ZONE: OFFICER: Apploval:- C Commont PERM|T FEE: DATE:_ FLOOD: _-- BFE+m:__ AVN s ((heck Al hat lpply) EXrST CONSTRUCTTON: E ALTERATTOru ffi RrruOVlrrON ! Crlennt- REPATRS E RELOCATTON tt Rotocarton, is rhere a NatL'at Gas Lrne on tle dirent site? E]""iE ruo ls B-DG sPR'iiKLEReo? ffi ves flrvo NEu CONsTRUcrrotJ' ! rnrcr NEh, srRucruRE ! rasr rnacx fl sHrr-r- ! uerrr ! aoo ro Exrsr srRUcruRE ACCESSORY sTRUCTURE: Cothran Harris Architecture NI'{ SO FI PER FLR: 12.540 #OF STORIES: 2 # oF srRUcruREE;T- * or rlooRs: -2- Qctb))9 ft? -/04NEW HANOVER COUNTY BUILDING PERMIT 1920S APPLrcArr@t rvPE: RESTDENTTAL PLEASE AIISIIER ALL QUESTIOI.{S APPLICABLE TO YOUR PRO]ECT "Project Responsibilit/ CITY: wilmington BLOCK #: APPLICATION Number (office use) DATE: t/Lt/1-5 PHONE S: 91o -3so.a'|44 ZIP.. 284]-2 LOT #: 1 PHONE #: 910.350.1744 T No Yes I No YES!NO REVISE0 0ATE 94111/12 APPLICANT'S llAIqE: Bill Clark Homes of wilmington LLC DEVELOPER: 8j.11 Clark Homes of wilmington LLC PROIECT ADORESS: 462L sikes Dr. SUBDIYISION: BerreMeade PROPERTY OhINER'S l,lAllE: Bill clark Hoftes of wilmington LLC oI{NER'S ADDRESS: 12? Racine Dr. suire 201 CITY: wilmington CONTRACTOR: Bill clark Homes of witminsron LLC LICENSE #: 34s86 ADDRESS: 12? Racine Dr. suite 201 CITY: wllmingtonsT: ryc' zIP: 28403 EIIAIL ADDRESS: rgill@Bi llclarkhomes . com PHOiIE #: sL0.3so.L744 PROIECT CO{TACT PERSoN: Richard cit},/Bi11 clark Homes of wilmington PHONE #: 910.3s0.1?44 ExrsTrNG co{sTRUcTroN: ! alrrnnrroru ! neNovarrou ! crNrnrl Reerrns ! RELocATToN NEt{ CONSTRUCTION: E ERECT NE[.J RESTDENCE o" ! aOOtttOrtr TO EXTSTTNG RESTDENCE I.*PLEASE CHECK AND ANSI{ER BELOI,I ALL THAT APPLY TO YO.'R PROJECT: I arr eruee q (& ! surnoor.r ! eR e eruousr SF SF 5F DE CK f] oer cnnecr ! eoor SF dtL SFPORCH SF I sronnce snro SF SFSF OTHER: Patio:120 TOTAL HEATED SQFTIIf,OS TOTAL SQ FT UNDER ROOF A2A, TOTAL AREA SQ FT:35tI 1 ToTAL PRolEcT CoST(ressro0 : $\\i,53O * oF SToRIES: z Is Any ELECTRICAL, PLUI,IBING or litECHAl,lICAL Work geing Done to the Accessony Stnucture? E Yes If the project is a ReLocation, is there a Natunal Gas Line on the Current Site? ! Is there Electrical Power on this Building? PRoPERTY USE / OCCUPANCY: I SrruCLe reUrrV 5Q FT SQ FT Yes!No I ouer-ex I rownHouse DESCRIPTION 0F WORK: New coflst.ruction of single famity home. OISCLAIMEFt lhereby cerlify hat allinbrmalion in lhis applicaton is conecl and all work will comply wih rle Slale Building Code and alloher applicable Srare and local laws and ordinances and reOulatjons The NHC Development Services CenEr willbe notfied ofany changes in fie approved phns anr change in conlracl,rror conlractor informarion. "'NOTE: Any Work Performed w/O he Appropriale Penn its will be in Violation of the NC SlaE Adg Up To $500.00"' OWNER/CONTRACTOR: Richard Gitt/BcH of wirmingron SIGNATURE: ** * *,*,i,* * **,* * * ** * * * * * * * ** * * ** * * I * * *,1* * * * + * * * + * * * * * * * * * * ** *** * * * * * *+* + * * * + * * * ** * * *,t,t,t * * rs rHE pRopERTy LocATED rN A FLooDpLArrir I-l yes!NO EXISTING IMPERVIOT'S AREA: O NEW IMPERVIOT,S AREA: 3808 TOTAL ACRES DISTURBED: .27 EXIST LAND DISTURBING PERfiIT: r.nren, I creua f] co[MuNrry svsrem ! pRrvArE wELL ! cenrml well sEuER: El crnua f] CENTRAL sEprrc ! enrvare serrrc ! co$MuNrry sysrEM *** SEPARATE PERI;IITS REQTJIRED 'OR TLECT, I4ECH, P186, GAS EqJIP, PREFABS & INSERIS *** payirE T ETHoD: ! cAsn I orecK ( PAYABLE ro r,rnc; ! atenrca ExpREss E rcryrsl ! orscovrn ***:t *** )* )t:** * + *:t :t * *:i:t * *:t:t:i*:t* * + +:t + * *** ****,t,t** *** **:l:*:*,t * )* * * *:f * ,i :r :r ,t :| :t :t:t:t * *** **** ** ** *** * +:t ZONE: OF FICE R: Approval : ___,_ City:DATE: (roR oFFrcE ust onLY) SETBACKS: F: FLOOD: LH:RH N B BF E+2ft= [a3- sT: N!, zIP: 28403 re ffio,rutl zou 2cta.r1 //t - /rtf APPLICAT]ON Number (offlce Use) DATE: !/ lt/ i6 Pllot{E *i 910.:so. 174.r 719.- 2aa1) LOT *; r PHONE #: 91c..190.17t,1 5 : N"C lf P: 28441 ST: NC ziP | 2alor PH0NIE *: gio.:so . r:,rl PHffIE fl: 9r.l.3so.:?4,i NEI^I HANOVER COUNTY BUILDING PERMIT APPLICATION IYPE; RESI DENTIAL PLEiSE ANSUIER ATL QUE-(-]OIiS APPTICABLE IO YOUR PRO]ECI "ProJect Respons ibll lty' APPLfCA{T'5 M}tE: tsilI clark 'rones c i1r.1ngEo1 LLc DEVEL0PER: EiIt ctark ro1.: of 6iir.ingtol LLc PRoIECT ADDRESS: 4621 sj.kcs Dr. CfTY: wilmlnsloi SUBDMSIo : Fell -uead€BLoC{ t; pROpERfY O/!]NER'S NAIIE: Bilt Clark liomEE of wilni.ngron LLC otlNER's ADORESS: rl / xactfle ur. sr::e 2U L CITY: l4ltmrllgLon CONTRACTOR r tsi1l clark sones of wilminglon l,LC LICENsE *t 34s85 AmRESS: 127 Racl:e Dr. suire 2c1 CITY: ililmingEon EttAIL ADDRESS: rqi t l(iBr 1:c1a:k|_.- r{;.con PROIECT CoNTACT PERSoI'I: Rrchard Giil/sill Clar). iiones of wilmi:1qton f surunoor,r SF EXrSTrnG CO{STRUCTTON: f ATTERATTON ! nenOVrrrON f Cenrnal nrtNnS I RELocATToN NEhr CoNSTRUCrrorl, f, ttecr EN RESTDEt,tCE o" I aOOtrrOn TO EXTSTTNG RESTDENCE IEASE CHECK AI{D ANSI.]ER EELOUI ALL THAT APPLY TO YOUR PRO]ECT: ATr GARAcE tl ( 3 sF *I l:- crnnce sr E poncn 'l '','' 'L SF GREENHOUS ESF POO L D ECK SF5F SF STORAGE SIIILT 5. oTHE R: !'-ic: l,r TOTAT HEAIED SQ FT:1JC5 IOIAL SQ FI UNDER ROOF:1iiJ-a, TOTAL AREA SQ FT: }9TT' TOIAL PRorEcT coST rr.css r.or) : $ 1,1] 5il * OF SToRrEs: 2 Is Any ELECTRICAL, PLUTIBr G or I'IECHAIIICAL Hork Being Do.e to the AccEssory Structure? E Yes If the pnoject is a Relocatlon, is there a Natural 6as Line on the Current Site? ! ves I Ho Is there Electrical Power on this 3uildin8?f-ly"s lENo PROPER]Y USE / OCCUPA CY:SIN6LE FAI'1ILY DUPLEX I roul,rnousr oESCRIpTIo{ii 0F WOR(: lteq ccns!::ucr:on of single fanily i--.he I No rch3n9e n contrac.dr.i ,ts Up 10 !50o_0r'- !.. * i * * r t r. + i r ,. r,a e* YE5 NO d/r!o,dnancesandrEguE0onsTheNhCDevek:-eniS-"-:r-i(jenErwi,tbenoifiedrt6n con14lol inbmado.. "'NOiE A.y\'r-.! p.r.l;::t W/O r|c Aprroprior n.o,lswi b.in OI.INER/CONTRACToR : Ricbard Grtr,/BCH of wilminsccn IS THE PROPERTY LOCATEO IN A FLocDi!AiNI YES €XISTI\G IMPERVIOT'S AREA: . N EI.I IIIPERVIoUS AREA: ]808 sQ'r 5Q FI iTI xo TOTAL ACRES DISTURBED! .2? EXIST LAND OI5TURBIN6 PERIiIiT: lihT i R 5:r.-: crpue [l co$;uuNrry svsrru ! pRrvATE r.rELL f ctHrRal r,lrrr cilul f] cExrRAt sEprrc fl pnrvnrr senrrc I commuNrTy sysiEir --..,:': -:- rlrrl ..- EL---, !. pAy!!!Nr ilrriooi ]casx .-- cxrcx (payaBLE To lrl€) f orentcax excness ! rcTvrsa (ijr ilt i,. / '- t(l , Pl.r " _ irr( I _ .,. DISCOVIR r *t r *r: t**** tt 1l * rt*r r.* r rr rr r1r iFon orrra! u9r o[y) rlvjsic DArE €!/11/r: ZONE: ) OFFIT.I: I .,,, s:TtsAcKs: F: . LH: RF: B: Approval: City; DATE: FL@O: .. BFE+2ft= r ll ffi NEW rvED jAil 12 20S 2olb:l30 tb- /oi APPLlCA'T]CN Numbei. DAI I PHONE #: !1 HANOVER COUNTY BUILDING PERMIT APPL|CATIOII IYPE; RESI DENT IAL PIEAS' A}I<LFE ALL QUTSIIONS APPLI(A8TE TO YOUi 'J{C]ECT "Project Responsi.bility'' . -' 6ARAGF APPLICANT'S NAnf : - lt i id!)- rir..:! or !.r r t-.::.rt,jr LLa OEVELOPER: !:11 rr..'---: cf riit11::-- - l,:-:. PRoIECT ADDRESS: r:r:! , ,.. . ,: (lTY: :.,.nr:.: ):l SUS0IVISIO : E.i].t1,..n BLoC( S: PROPERTY o{.INER'S tlAi'E: -.ii Il aia:i. ;i-- 'l :{rli::1:::r :!: OtlNtR'S AODRESS; rr- ! -r)e D:. sr-.-e :i: CITY: !.iL^r,r'r;_-cn CoNTRACTOR: Brll (rliIk H',,.s of l,rllr' ::a:":r i,LC LICENSE fr: 'j,rs86 AODRESS: :2'l :1-::Ie Dr. sui-,e 20: CITY: liilrin,lcrn E|'!AI L A0DRE55: -:i l:.1: r 1^1 -.--h.- . s...- - PROIFaT CONTACT PERSON: .r.l-ri 3:ll !ili a:a!; :3-o-- .i n': )T::r.i:oi !.16 /21).t ZfP: :8i l l4LOT f: PIIONE *: ?:: 5I : l'a 5T PHO",]E f : PHONE S: Nc ZIP; 261?ti i1c l5c.lf{.i 9:C.l;l _'r',i; I o S!00 0C' EXTSTING CONsTRUCTTON: [_-] ALTERATION 1__.1 Rrruovnrloru f nrnrnal nrearns j] RELocArroN NEI,J CONSTRUCT:CN:ERECT NE[,J RESrD€NCE o. IlOOrrrOn TO EXISTiNG RESTDET.TCE ..PLEASE CI]ECK AIJO AXShER E€LOH ALL THAT A|IFLY TO YOUR PROJECI: AlT GARAGF 45c SF SUNROO}I 5F GRFENHOUSE SF 5F SF fl eoo L f orcx SF poRcH 1-- 0/ r 10 st .- ]AGE !' .. OTHE R: l'. - 1. :5i SF roTAL HEATED SQ Fl: :lrr TOTAL SQ FT UNDER ROOF: -rr..: ToTAL AREA 5Q Fl: r ToTAL PROIECT COSTiL,.l<.roo: $ '-zt.trc S OF STORIES: r ,r,'tor: I5 Any ELECTAICAL, pLUflgING or IICHAI{ICAL l.,,ork geinS Done to the A.(..in.y Structr,.r)ves ! lto If the project is r Re.location, i.5 there a ilatural. cas Line on the Cu.rent Site? fJYes Tl llo Is there Electrlcal PoHer on this Buildingll-lves [!j no pRopERTy usE / occupANcy; p srruclt ralrrlv f ounttx DESCRIPTI0iI OF I'J0R(: :-.w :c: ':'.1.-!:c:. .: .-;:" ":e f.- -1\ lOI.JNHOL.a ,i i,l:.ILe$andr€lulatons. IheNtlC O.vohr.: 4nl Ser,;ar aerw*ilbenol,iedol.nychang€ein r-.' lppovo ..^ra.bi.fir':1.n"'NOTEAnyWordrt,r.":.rw/O!.lcAir"r:rrFI!--T.swittbeinV)otalonot,r.r\Car'rF OhINE R/CONTRACToR: ,r::::::.1 lill./3cll cf ii:jlnrr --: rrL SIGNATURE: IS THE PROPERTY LO{ATED IN A TLOODPLAIN? EXISIIiIG IIIPERVIOI,S AREA: TJ 5Q FT NEI., ]IIPERVIOUS AREA: ]439 SQ I,t YEs E *o TOTAL ACRES DISTURBED: .:, EXIST LAND DISTURBING PERAllT I crlrnal we rr n colututini'svsrem YES IliJo WAITR: E CFPUA SEI,JER I Z CFPUA n coylru,rr;y svs.;n I l pRivart r,tELL ! ceurml sEpTra D pRrvATE sEpTrc pavriaNT,iErHoo a/\sH [.*.cr< 1onvn"ls ro u<1 ] r*srrcAN Exrn.sg J ral"rro Eorsaor,o ( 0R , .rL U5t 0{ll) Sf ':3ACKS: F: ).- tavlSao DAIE enl i 1/ 12 ZollE: t- Approval oFFIc!R: L[- City:'w RH: \ Er:+2ft= ll Dti F LCOD: IH 7tt ,' NEW HANOVER COUNTY BUILDING PERMIT APPLICATION TYPE: R ESIDENTIAL IVED JAN 1p Z0lO prEAsE aNshrER aLL QursrroNs appLrcABLE ro youR pRolEcr "Project Res pons ibility" i12'/o{ ffi APPLICATION Number (Office Use) APPLICANT'S l,lAltlE: B1fI Cfark Homes of Wilmington LLC DEVELoPER: Bill Clark Homes of Wilmington LLC PROIECT ADDRESS: 1218 Matteo Dr. SUBDIVISI0N: . BelleMeade PROPERTY 0}{NER'S tlAfi'lE: Bill Clark Homes of wilminston oldNER'S ADDRESS: 127 Racine Dr. suite 201 CoiITRACTOR: Bill Clark Homes of wilmington LLC ADDRESS: 127 Racine Dr. sulte 2ol. EIiIAIL ADDRESS: rgill@Billclarkhomes. com PROIECT CONTACT PERSON: Richard ci11/Bi11 clark CITY: LLC I,liImingEon BLOCK #: PHON E PHON E DAIEt t/a/2016 *i 91o.35o.1744 ZIP i 28472 LOT #: .36 *: 910.3s0 - 1744 CITY: wilmington LICENSE #: 34s86 CITY: wilmingion Homes of wilmington ST: NC ZIP: 28403 5T: NC ZIP: 28403 #'. 910.350.L744 *: 910.350.1744 PHONE PHON E ATT GARAGE 450 SUNROOM GREENHOUS E EXISTING IMPERVIOUS AREA: NE I PERVIOUS AREA: SFDET GARAGE 5F ! eoor SFDECK SFPORCH 110,/ 110 SF STORAGE SHED SF OTHER: Patio 1s4 5F YesNo ,*,t***x***x******** YES NO SF TOTAL HEATED SQ FT:230a TOTAL SQ FT UNDER ROOF: 2e74 TOTAL AREA SQ FT: :rza TOTAL PROIECT COST lress ro9 : $ tzt,zza # OF STORIES: r w/uon Is Any ELECTRfCAL, PLUMBII{G or IIIECHANICAL tjork Being Done to the Accessory Structure? If the pnoject is a Retocation, is there a Natural Gas Line on the Current Site? ! VesI No Is there Electrical Power on this Building? l-l Yes I No PROPERTY USE / OCCUPANCY:SINGLE FAIYI LY DUP LEX ! rowruHousr DESCRIPTION OF WORK: New construction of slng1e fam11y home DISCLAIMER: lhereby certity hal all inbrmalion in tlis applicalion is conectand all work will comply wih he State Buildang Code and alloher applicable Siae and locallaws and ordinances and regulations. The NHC Developmenl SeNices CenEr will be notfled of any changes in fre approved pla conlracior inlormaton. "'NOTE: Any Work Performed W/O tre ApprcpriaE Perm ils will be in Violation of the NC Stae Adg ge To $500.00"' OiIrNER/CONTRACTOR: nrchard Gl11/BCH of wilminsron SIGNATURE: ********x*it+**,a,**r.,t*,t,*,t,t****r***+++++*+********)t,t++++,**,*,t,*,t**x**,*,* IS THE PROPERTY LOCATED IN A FLOODPLAIN?YES I NO 0 3439 SQ FT SQ FT TOTAL ACRES DISTURBED: .27 EXIST LAND DISTURBING PER IT: WATER:CF PUACOMI.IUNITY SYSTEI'1PRIVATE WELL CENTRAL WELL SEWER: I cFpuA E CENTRAL sEprrc ! enrvare seerrc COMMUNITY SYSTEM *** SEPARATE PER'IITS REqJIRED FOR ELECT, I,IECH, PLBG , GAs EqJIP, PREFABS & INSERTS *** PAYI{ENT METHOD:CASH Ecrecr (eAvABLE ro NHc) nA ERTcAN ExpREss rrclvIsa DISCOVER,t,*,t*****:*i*ii**x)k*)i,t**,*,i,r,**x*+,*,t,**+:tjt*,*,*)*+:trt,*,*,*)t*rt)t)t,*,**+**,t,t,**+:*,t,*,*,*++:*,*,t,t*+:t,**,t++jixx**+jljk (FOR OFFICE UsE ONLY) REVISED DAIE O4l11/12 ZONE: Approval: -) N T I DATE : SETBACKS: F FLOOD: LH:RH: BFE+ E/ zft4 -)^5;{ EXTSTTNG CONSTRUCTTON: ! nrreRarrOru ! neruOVnrrOru ! Crrurnnl REPATRS E RELOCATTON NEr,{ CONSTRUCTTON: E ERECT NEH RESTDENCE o" ! aOOttrOru TO EXISTTNG RESTDENCE **PLEASE CHECK AND ANSWER BELOW ALL THAT APPLY TO YOUR PROJECT: SF OF FICE R : City: RECEIVED JAN 12 2016 NEW HANOVER COUNTY BUILDING PERMIT APPLI carlott rYPE: RESIDENTIAL PLEASE AIISIIER ALL QIJESTIOIIS APPLICABLE TO YOIJR PRO]ECT "Project Responsibiliqf 2oru131 It, -tob APPLICATI()rl l&mbe r (Office Use) DArE: 'ltlItvAPPLICANT'S NAiIE: stevens Buildino companv T/A steven6 Fine Homes DEVELOPER:Navao Devel,t PRO]ECT ADDRESS:CITY sUBDMSI0l,l:e(ee PROPERW O${ER'S MltE: stevens Buildino comDarv O{NER'S ADORESS: s710 oleandei Di BLoCK f: _ LOT #: PTONE *: PIONE #: sLo -7s4-a6s9 ztP IE 11233.92_ ) ST : !q ZIP : -234!i_ ST: g ZIP:233!l PIO E #: 9l o -7 94.a6s9 PTONE #:9Lo-332-8s1s err ll\ ivF sui te 2OOCITY: wilminqcon COi{TRACT0R: stevens Buildinq comDanv ADDRESS: s71o oleander Drive Srri te 2OO LfCEllsE f: 31626 CITY: wilminqron EiIAIL AIDRESS: sn i chol son@sr evensf i nehomes - com PRO]ECT COT{TACT PERSOT,I:staci Nicholson EXTSTTNG CONSTRUCTTON: I alrrnarrOU ! nrmVnrrOr ! errenal nrearns fl RELocATToN EW CONSTRUCTION:ERECT l{E}r RESTDENCE o" ! AOOTTTOH TO EXrSTritG RESTDEI{CE ATT GARAGE oo sF ! sunnoom -sF ! cne eucrre _ sF I oer crnacr ! eoor- _ sr ! oecr SF PORCH 00 SF ! sronncr SHED _ sF SF OTHER:SF TOTAL HEATED SQ FT:1t01 TOTAL PROIECT COST 1r-ess ra1 : $\20 .00f OF STORIES:nA Is Any ELECTRICAL, PLt IEII{G or IECHAT{ICAL t,ork Eeing Done to the Accessory Structure? El Yes I5 THE PROPERW LOCATED II{ A FLOODPLAIN?YES T I{O ExIsTIl{G IiIPERvIOt S AREA: A5q0 SQ FT TOTAL ACRES DISTURBED: 1/3 irEH rroERvrous lutee @q et EXIST LAND DISTURBIT.IG PER IT: Ives @rrc rorAL sQ Fr UNDER **r, 11'11 rorAr AREA sq dno If the project is a Relocation, is there a Natural Gas,rline on the curnent Site? [ves flffo rs thene Electrical Power on this Building? l-lv"t fllro E PROPERW USE / OCCUPANCY:srirGLE FAMTLv ! ourr-ex ! rowunouse DESCRIPTION OF WORK:Ner,, Resi d.nti a] Construction DISCLAIMER- lhereby cenit hal all lnbrmatbn in fiis applicarioo is correct and allworkwill clmplywih fie State Building Code and alloher applicable $aE and tocat taws and odinances and regulations. The NHC Developrnent SeMces Centr willbe notifi€d ofany changes in he 4prov€(, plans andor charEe in coflt_acbr or contaclor inbmatbn. "llOTE: Any Work PerfonrEd w/O he AppopiaE Permilswillbe an Vbb[bn ofthe NC SrEE Bldgines Up To S500.0C" 0UI{ER/C0I{TRACTOR : craiq srevens SIGNATURE : **,*,*,**,* *,**)r ** ** ******* ** * * *(IlTl Nil"]** )i++* )i)r*)r *:i+ ++ ji+ ++++ +++ +++**+*+ ++,r*,i,t*****)r ** (FOR OFFICE USE OI'ITY) REYISED DATE O4l11l12 SETBACKS: F:_ LH:_ RH:_ B:_ *** 5EPARATE PERI'lITs REQ{JIRED FOR ELECT, I,IECH, PLBG, GA5 EqJIP, PREFABS & INSERTS *** PAYIIEMT iTETHOD: E CASH tr CHECK (PAYABLE IO IIHC)AIITERICAI{ EXPRESS E r.rclvrsa E DISCOVER *+++ +*,1++*)i *)r)r* )r***** )* **:i)i:i)**)i **:* **,** )* )*,t*,* ** )*,t * * **:it )r:t )r )r )r**+++++ +++ ri+ ri+ ++ +:i:i + it +:i:t* * +** * rt zoNE: _ oF FICER: Approval:_ City:_ DATE:_ FL00D: _ BFE+2ft= AVN Conrne nt :PERfiIIT FEE: ijl .*'TPLEASE CHECK AIID AI{SWER BELOJ ALL TH/TT APPLY TO YOIJR PRO'ECT: !'TATER: I creun ! colt'ruNrry svsrru ! pRrvATE WELL ! crurnal uerr sEr'rER: EI creua f] CENTRAL sEprrc ! enrvarr seerrc ! corvrMuNrry sysrEM ( ).tt )ZIRECEtvE!r JAr 12 2013 NEW HANOVER COUNTY BUILDING PERMTT APPLIC,TIN TYPF: REST DENT IAL PLEISE AII5IIEfi ALL QUE5TIOIIS APPLICAELE TO YOUi P8O]ECT ?roje(t Res pons ibi.l i.qd ib toto "& EE APPLICATION ltunber DEVEL0PER | \-avar PIONE $: q:c-rt.r-s;l-o _ PRO]ECI ADORESS; . 'i-I SUSOMsIOI: fl1ri:f:ck - fhf ir'it n, CITY: ui:q:r,--;i BLO(K S: PROPFRTY OI.}IER'S N!,va ii. Fi,irdina a.n..-r O,it.:i'5 Ai-i:.: 'r : t, " tr s.:::! :CITY: irilmir .. r:1 COaTTRACToR: sE€..'n:r Bui l.:: au c::-.anv LICETEE #: 1.,6 2 6 AIX)RFSS: irlc ot 6ander o!:ye CfTYI rl rm , .,. au,1IL ADORESST '- s,,. . ....rs: -- PRC]E5 CO{TACT PERSOi: sr i1-' Nich.)lr-. LOT S: PK)NE f: ST: jg_ ZIP;Je4o3 st: Nc l:P: ?a..r STORAGT 5HED5f SF YesL4 No plsnE *: PTONE S: EXrST rri6 CoI{S-rRUC l' l0 :A: - ' RATIONRtNoVrrrlN I elrirll arnares ! RELoci-:ol TIEH CON5TRIJC-iCN:ERECT NE!,] RESIDEIICE o.ADCITION TO EXISII}J6 RFSIOEI,ICE ..PLEA5E CHECX AltD AfJSitEn BEIOW ALL T]|AT Apply TO YOUR PROIECT: .: ' GARAGE OEi GARAG:SF poec* ? sr I sunnoou -sF I eoou _ sr I crcr _ sr SF If the f,'.'eat is a Relo(.1tio., is ther€ a Is there Ele.t.ic.l Po\,rer on th'-s EuildlnB? OTHTR: r.'. Gas/Line o'1 the CLr.ent Site? ves ffi to ,:PtiflHoJSE SF ll i_,. PnOPERTY IJSE I OCCtJPhllCl-:a:'.. : FA I Y DUP i- EX T0r,lfii la .,5 : DESCRIPTICtr! OF I}IORX; OlSCl.A!,€* nr€by c.njt.t!r !i ,lt na,bF n flis apgliatt$ a c6r..r r,,., Jr wiwit cornpry en i€ Slare &r$dho Cod. a{ ar on€r..,ir:" }€ SEE ara tocat taws "aj.Rra.!.raidreqlLrron\:xoNHCa!,,.,rrrenrS.N..saerp:srbcrc:!e:otanycnruesniroorp@€dptss&69ecit6ar6nsorcneg€'...-r6cbfo.(irt rr., hbmstbn. '-NOMi, r,..-r nr.lor-.d WiO le A,E:.rnnro Pt, . l|qll D€ n VbE[b. ot u|e NC SL?r lbg'.." r)p r0l5@.0cr- otft E R,/CONTRACTOR:5IG{ATURE : (trlnr qrn.. I5 THE PROPERTY LOCATEO IN A FLfiDPLAT ? Exrsrr{G rHpERVrou, orro. '.:Y i n rr N€t{ IIpERVIO{JS 41g6, ,i' - 5p rr r ilo TOTAL ACRES OISTURBED: EXIST L$D DISTUREIN6 PERfiIT YES YE5 I,IAT E R :CF PUA I comrulrw svsrrrn fj pRrvarr wELL I r:nreaL wErL 5EHER; U crpuA J CEITRAL sEprlc f] enrvlrr sterlc I co!,.rulrT] sysTEM .,' SEPAFATE PF8$ITS PfqJIRTD rOP ELECTJ qECH' PLBG, 6A5 EQUIP, PREFAES E INSERTS ".pAyrE"' iErHoo: D .o.* D cr*< (pAv^&E ro **1 [ *.ir* .;".;, - E;;z;r;i "- E orr.or.",.......:,-...... ir,r!rr.r,**rrrrr ZONE: \l( Arr-ova]:_ City:_ DATE: . fLOOO: (ror oFrl:r usE a{ry) xr!I5!o DATE O!/1r/r.i SETEaCKS: F: i, ; t-H: 5 RH: .), B: i., --, It{Ur-nv (-z? { EFE}2+. CCorYr:e nt: \u\. lU PERI{IT FLt 6{ APPLICA|TT'S llAflE: @r_____._._- DATE: ;r,r .'.', TOTAL HEATED SQ TT: I.I. TOTAL SQ FT (IIDER RMF: ' '-' TOTAL AREA SQ FT: TOTAL PROJECT COST ruass rot ; I rzc ooo * OF STORIES: 1\ Is Any EIECTRICAL, PLtIlBILG or TECHATIICAL Lork Beint oone to the A(ceslony Structu^el f,l V"s E] lo RECEIVED JAN 12 2016 2ol6)32_ NEhI HAM)VER COIJNTY BUILDING PERMIT APPLICATI I TYPE: RESIDENTIAL PLEASE ANSWCR ALL QIJESTIONS APPI.ICABLE TO YO{'R PRO]ECT 'ProJect Responsibility" /b107 APPLICATIOiI ttumber (offtce Use) Stnuu finultorno lh ilttorrs 0u,t4rnq C0,n9611 DATE: i tl tbAPPLICAI.IT'S MIIE : DEVELOPER:? PROJECT AIDR SUBDIVISIO : JT l BLOCK CITY: LICEl'lsE *: CITY:uJilm LEX ! rouuxousr PK)NE *:0 zl LOT *: ploNE *: $@lrtl.qbql sr:'N0 zipiT34o, ACCOUT,TT #:11e srtNL zrp.t eglo'tt Plo E *: 1q4-$h1q PK) E *: ?rA-lA57 ESS: t\ PROPERTY O{NER,S Mi4E: o*t*" or*455, 91t0 ,,0n? uitiiillInto ( COT'ITRACTOR:t\5 ur/ltflf4 0 ATDRESS:1t0 0 EIIIATL ADDRESS: , 0t PRO]ECT COT,ITACT PERSON:Xo PRoPERW USE / OCCUPAI'ICY: d SINGLE FAMILY loho EXTSTTilG CONSTRUCTTON: f] ntreUrrOU I neUOVnrrOr !CrNrnar nrearns ! RELocATToN NEW COI{STRUCTTOil, fr eneCr NE}t RESTDENCE o" E mOrrrOr rO EXTSTTT{G REsrDEr{CE **PLEASE CHEC( _-J I rl Arr GARAGE alst{ER b0 BELO{ ALL THAT APPLY TO YO'R PRO]ECT: sF ! orr ernace st El ,o*c, ldV se If the project is a Relocation, is there a Natural Gas, Line on the cunnent site? ! ves Is there Electrical Power on this Building? [v.r ftno dno AND I sulnoom -sF E poor - sF ! sromee sneo SF ! cnerruuouse _ sF I orcr sF oTHER: tf0n oft 5F ToTAL HEATED sqn: ?,5A0 ToTAL sQ FT UI{DER awT:1,Ai'O ToTAL AREA ,Q,.,,9,?&O TOTAL PROIECT COST tre+s rat I $no,o0of OF STORI ES:A Is Any ELECTRICAL, PLIfiBII{G or IECHAIfCAL tJork Being Done to the Accessony Stnucture? E YesT4 No 6 DISCLAIMER lhereby cedjry fd all inbmatbn in this epplicaton is corecl and allworkwi[ complywitl he Stale Buibhg Code and a[ oher applicable SiaE and tocat tau/s and ordinances and regulatbns. The NHC Developmenl Services CsnErwillbe noltfed ofanychanges in he eproved plans and conlracbr intormalion. '-NOTE: Any Work Perfomed w/O he ApprcpiaE Permits will be in Violation oflhe NC SlaEEldg or change in contracbr or Fines up To $5O0.0o.' OWNER/CONTRACTOR:(6'5 t'10 SIGNATURE : ,*,* {.*,****,*1.* * * * +,1.1.+ + t*:t:1.* * *(Prlnt Nare)***:* )** * * * ** *)* * )*:k:*,* )* *)* Ncul tr,l,e IS THE PROPERTY LOCATED IN A FL@DPLAIN? Fl vrs i/i* r( *i()i*)** *** )t iro TOTAL ACRES DISTURBED: ,i )t *** *****,**,* * )*,*,k ,* x EXISTIIiIG IiIPERVIOUS AREA:1lg'(5Q FT SQ FT ls NEw rrlPERvrous AREAT i l91 EXIST LAM) DISTURBIiIG PERfiIT: I-I YES NO IdATER: SEWER: q fr creua ! coi4r4uNrry svsrrm ! pRrvATE wELL I crrrRal wrlr creua ! cENTRAL sEprrc ! enrvare seerrc ! coMMUNrw sysrEM **1. SEPARATE PERIIIITS REqUIRED FOR ELECT, IIECH, .PL8G, GAS EQUIP, PREFABS & INSERTS *}* pAytlElr rErHoo: ! case ficnecx (PAYABLE ro nncI EBrLL accdJr,tr E nclwsa I orscown )r,* '** ****:t+*:t**,t *)i)* * **:i +:t:i+,i*****,t,***)i *+)t:f:i++,t:i+)t *,t,t,*,**** ***** + +,* rt *,i ,l,t *,* * )*+*:i:t+ +,t,t+**,*,*,t* (FoR OFFTCE UsE ority) RE\rtsrD DArE O4l11l12 ZONE: _ OF FICER:SETBACKS: F: LH: RH: B: Approval:_ City:_ DATE:_ FLoOD: _ BFE+2ft= AVtI fr 11 Al oerrrra(0 t\[0 Conment :PERMIT FEE: crw: DESCRIPTIOI{ OF HORK: CPflJA lnv N lotu-7tz APPLICAIT'S IIAT.IE: DEVELOPER: PRO]ECT ADOR ESS: SUSDIVISIoT: PROPERTY OhNER'S llAfiE: OT{ER,5 ADORESS: 0 n' 6[i\A(r5, LLC T{EW HAITOVER Cq'NTY BUILDING PERIIIIT APPLICATIOII TYPE.. RESIDE TIAL PI.EASE A}ISX€R ALL qJESTIO}{S APPLICAALE TO YOI'R PRO]ECT "Project Responstbtlity" \w r{\a- CITY: a BLOCX #: '1-'1 #APP L I CATIOti l{mben (Office use) DATE: PTICNE *: ZIP I LOT f: ? 5 COiITRACTO ADDRESS: PHC'{E *: ST lto o7 /-goa?,WWsoCITY: LICENSE *: 4 CITY: \N ilrniAqn$ /, Com 'I Lrt )q Accor*{T *:,tA* ZOiIE: _ OF FICER: t s,yefr&l/ pwrc tt__&,3271 P}O E *: SF Et'tATL ADDRESS: Vlnl u pRolEcr ctx{rAcr r..so, J Fra r",rl0n \\ \l rtr rq1u4 ExrsTrG colisTRucTroli: f| alreurrol ! *rslrron I GEI{ERAL REpArRs I neloclrror r{Et{ coiETRUCTIoll . {r*rr, NEx RESTDEI(E or [ ruDl11or To EXISTIiE RESIDENCE STORAGE SHED5F I areruro.rsr - sF f] oecr 5F ofHER: AZ1-SF rorAl HEATED sa ctz 40cl.l TOTAL SQ FT U DER ROOF: faz< rorAl AREA sqer, 55o{ TOTAL PROI ECT COST lr-u"' rar : i oA* OF STORIES: A fs Any ELECTRICAI-, PLIFIEI G or iTECHAUCAL tdork Being Done to the Accesso ry Structure? [ Yes No If the project is a Relocation, is there a Natural 6asine on the Current Site? I ves No fs there Electrical Porrer on this Building?.fiYes No dPROPERW t,sE / OCCUPAICY: SIIIGLE FAI4ILY fl oueLrx !TOtINIIOUSE DESCRIPTIO'{ OF hIORl(: DlgCLAll/Eft I horoby c8nit t!616n hbflna@n ir hls Opkalofl !i conecr and al wofi wil c:o npty yrih tr€ Sta!6 tuitdhg Cod€S'taE ald bcal taws and ordinances 6lld rEgulalbns The NHC De\iebpr,rEnt Servbes CenE( win b€ noti€d ol any chEtgos h fie appaoled pbn cont,rlor inbrmaton. '"NOTE: Any Work P€rfomed w/0 tle Appropriae Fbmls u,lt b€ h Vbbrirn of dta NC Stat To 350O.0Oit 0t{{ER/CONTRACTOR t SIO'IATURE ..ptt{se cxecx AiD arsxER SELot{ aLL IHAT appLy ro yolrR p*orEcr: flor, ,^^oe, boa t ! oer eauce - sF I surnoor _sf ! nooli..__-.=_-_-_1__. sr rS THE P EXISTI'G NEH A FlrroDP LArr{ ? f so Fr 7V5T- q c-, PORCH {ta ***{, * * * **** * *** ** ** *** **** *(Ilill,lS}*,. !*r.*)r,I,*)*,*,r**,*** ROPERTY LOCATED I f]YES t{o ,i ,t +,t rt,l,t * *t,.,r *+rt*,t,t IiPERVIOT'5 AREA:TOTAL ACRES DISTURBED: IlitPOUS AREA: ExrsT LAII) DrsTURBrr{G pennrr: J--l ves MTER:CFPUA COI'}TUNITY SYSTEM rr uelr- [CENTRAL I,IE L L SEriER: ! creua fl CE TRAL sEpTIc pRrvATE sEprrc fl cow"r-wrw svsreu SEPARATE PEn,IITS I EDFOn ELECT, r'tEcl{, pLBG, GAS EQUIp, PR€FABS & IiEERTS *** PAY ET{T NETHOD: n casx( PAYABLE IO M{c) D BILL ACCOUI{T f] nczvrsr f] orscoven,*)i*,rrtt,tt,*'r*rit*,tt*r*+:t,l:**:la+*)tat,l*:t :| ,q :l 't 'l,t t t t:t a rt *:t t *:t + )t aa*t at:t t:l rt t + *** t t,t * t*:r:t,t,lt trt*tr,t* t,t (FOR OffrCE UsE O[y) REVTsED DAT! O4l11/12 SETMCKS: F:_ LH:_ RH:_ B:_ and Appnoval:_ City:_ DATE:_ F!qD: _ co'rent: A v ={ BFE+2ft= Jr*rrr r.., ,l;rt.q