FEBRUARY 22 2016 BUILDING APPSJolb_ 9s:
NErt HANovER couNTy BUTLDTNG pEntlrrpF,T h..1 rl,aappLrcAfrott rr"E: co{t4ERCrAL r \- L_ ,.{ (.- 1 I
pr-EAsr A*srfiR at! QuEsrro s apprlc lLG ro yom pnollcr lffior
"ProJGct R.sponriblltqf t{ur$.r
APPLTCATT's t{Aru://rD a rt/n u-t
-l---
----
(offlcc Ur.)
DATE:DEVELOPEN:
PRO]ECT AOORESS:
occuPA T/BUSTXESS il lrE :
PioPEIW Odt{Ei" t4ttE 3
OT{I{ER' S ADDRESS:
coi[RAcToR I
ADORESS:
og D
o 2to
h
pltot{E f
t€4
o ,t
o/ tf L
Lo"
Dn
uc CIWI
crw:
ZIPi 2 t>y'oja
#:
ST:JkZItt 28Ya"
In
il
PHOI{E
wlll
LICETSE T:
CIW!
(Ch.ct All lhrt &ply)
gr
Plor{E t:
PIIONE *, :!1!o zz, - 069 J
Sbte
0
..t/C ZIDl 2e?4{7
q/o - 271_o6t3
ETIA]IL AODBESS : I
PROJECT CoI{TACT PTiSON{!
EXIST CO{srnUCflOr : fl ar.nurror I REI(,VATION GENERAL nrrarns fi REtocArro{
ls BLDG SPQ;[615R9p2 [ves fit'to
It Rolocation, is lhere a trNslursl Gss Une on the Cunent Site?E Yes EHo
NET' COI'ISTRUCTIOI:tr EREcr rttEw sTRucTUiE I rasr rucr I SHETL uPr17 [ ADD To Exrsr snucnnEACCESSORY STRUCruRE:tr
If UPFTT The Shcll Permit *:Is Ehct Polr.F on thls Building fi ves tr NO.r... IS r 15 a ou GE OF OCqn|I{cY usE?I vts [t rc .....fF Yer, ret rns th!Prcvloua occuprncy TyDe? -Ih.t ls thc ilan Occupancy f)oe?
ARCH DESIGII PROFESSIOMI:
_r,lcREG*:ENGT DE'TG PTOFESSIOM!:
-
Ptl:
DESCRIPTIOTI OF I,'ORK:cloq* {,,klk-tt Coo /r,-
__,r_ I,lc REG # :
/b/
b bod or bovcneGs Frp.rrd orsGrved h $b srwtrra? Eyes [m t n"P]opdry t&d ln TI|G Hoodphh? E yes E NoDlSCLAltlERr I heBby catt lhat sll lnlbrmsrjoh tn
End local lah6 8m ordin8lqs gnd lloulstlons, TtE
or crEnqe in @rffactor 9r aon|raclor lhfonnatlon. ."
S!,bjedlo FlrEs Up Io S5m.m"
$,ill wilh the Srd.Cod€ andb€
ACRES DISTURBED:-BGT l-At{D DISTURBTNG pgytTl flves flroNEW IMPERVIOUS AREA:_ SOFT E(STTNG IMPERVIOUS A&A:
--_SOFT
of titc !nd
r*Ethar tha or tdt rE r/ts fqrd brFte)r07{06o n 10 dry! prlor to tta
OF UI{]TS:
If, STORIES:
OF FLooRS:
RMSED DAIE (rt 1112
PRoPERTYUSE: fPrrce a RESTAUMNT fluenmunr_e leorrc flAPr Emnoo OTHER
3'AP; E SBUI E E$IYtTIffi-E pE]R\ffisEmc trBf'lifi ff V3ffi FEAno]t
(FOR OFFICE usE ONtY)
. SEPAFA]E PERTiITS REOUIRED FOR ELECT. UECH, Pt!G, GAS EO('P. PiEFABS r NSEFIB h,o**u flnovrsl fiorscwen,aaalhia+raa...ffi.ii.ra.fr_n
ZONE:-OF|ICER:-SETMCKS:F:_LH: RH!_B:Appoval: City: DATEL-;_ FLooD: __
-.BFE+2lt=Commenl:
A
PERMIT FEE: $0
_ ......---
l(ocl<q, /.d /^,/7-
ta..rr4
<-::__\
Qr ltv-5tZ
NEI.J HANOVER COUNTY BUILDING PENffrrT-4-7 h..' IlrlAPPLICArIOII rYPg: COHERCIAL ' I \- L- I\* (.1 i
PIIISE Alrslrtt alr OUE5TIoIS Ar?rtA8lE rO yo!.r ptollcr lppLfClflA
"P.or.ct Rcrponribllltt/, r{u blr
APPLICA{T,s llAffI
OEYTIOPER:
zorue:-(frorrrcen:
At/tD L rt/a qa
CITY:
PHO a fi
Ploa{E t:
IDtI:
(off1<! ui.)
Zl?t 2 !y'o ?
DATE:
PRO: ECT ADDRESS:
oCOJFATTT/BU5!|{ESS MIE: F t€,e I o ttrt 5,1
Pi0PERW O{ ER'S t/.t {E ! 1
J
EXIST Col{s nucrrol'; I alrrurron !((ht(t Al rh.t rrrl v)
t{ Rolocstion, i5 there 6 N8lural Gss Line on lhe Cun€nl SiG? Ey
RETO./ATIOII tr Eruo ts
GEHERAL R rplrRs l?t
ELDG SFRrN
-
r"i:
-- PH:
ST
pHOllE #:
PtoflE t:1/p ?71 , 069 3
IE tocrt-Iotl
rc-eneor I vx f,uo! oo ro Extsr srr{JcrurG
IJC REG #:{.- *.n
rEr,u consrRucrrs{r I rnrcr rrw srRUcluRE f] rlsr rucx I sxrr.r ! wr11
ACCESSORY STRUCTURI:
If UPTIT rhe Shcll Pernit f:Is El.ct pouer on thls Buildtng..... IS IHIS I GII'JGE OF ocoPAxcy usrr I ws [lro ,.-.IF Y!5, tirt rat th! Prtvl.our Occuptnay T)?!?mat is th. tJ(ry Oc.upa,lcy TypllATol DISTG}J PROFESSIO&t:
EX6f, D[SI@{ P8oFt55IONA| I - r,tc RE6 a:
5 Lo"
orfiER',s ADOTESS:o D,.
DESCRIPT]OiI OF hDR(:clourt Lrklk '/, Coo/t-
ACRES DISTURBED:
CITY:srjii@:
:!9 zrpt ?cqr7
4to - zzt -oZ trj
E Yes Dno
I
--
SO FT
--
--
b/
b tood or bovtraCl"r Flp.red s 5a.vod h tN6 aeudtre? Eyes tr No b Tha prop.It, torrt€d In TIl€Foodplsh? E yes
s:Hiffi *#* 3H *J**-{$&:w#iffi#msfig#J$ P''EY#T sfr #'sor ii'orh't o,' "
E ,,lo
Code $c S-,!E
h":iliy o( !ffh! lr! iut toa 01!jmr-595r n i..5 10 &yr Fiy !o Ur
oF uNrs:..--W STORIES:
TF FLOORS:
NEW IMPERVIOUS AREA s.1!'r EXISTING TMPERVIOUS A&A:
PROPERTY USE: I)OFFCE a RESTAUMIT fiuenclrnr.e D eotrc filrr [66pps
WATER:trtx)
CFPUA E @MMUHMY SYSTEM
CENTRA SEPTTC E PRMAIE SEPTC E
EwElr
rTY SYSIEI!SEWER CFPUA EzoNrNG USEqjqSlFtO{
COHUUN
E(SI UND DTSTURBING pERMrn LJ YEs lJ No
OIHER
" sPrtalE P€Fr.ns REoUTRED FOF E C'I, VEg{ pl3c. G s Eoup . PAETABS I rirsBt .-
PAtirEt.Ir METHOD:tr CASH ECHEq( pAyABtE To NHc) EAri(ER rcAfi UPRESS EMCJ'V|SA E orscovrn
(FOR OFTICE UsE oxl-
S ETBACKS I F€\.SEDUII {4vl:
BFE+m=
N
ADolDrral:FLOOD:
ERMII FEE: S 00
6o
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE; RESIDENTIAL
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibility"
* NO PLA^/ S +zf)tt"-t<oB
PEtlL"-3r11
APPLICATION
Number
(office us€ )
o^rE: zf tl llb
ffi
APPLICANT'S NAME:
DEVELOPER: 1 :
Todd P L ccharczyk
PRO]ECT ADDRESS: @
SUBDMSION: Lardfall
CITY: 'rr I r, r L.Ir.,: l zIP | 2A,;at
PROPERTY OWNER'S NAIIIE: James aid A.,ii:ea Jchnstorl
OITNER'S ADDRESS: 1255 sreat oaks Dri.re
CONTRACTOR: irngPosl Desi.Jr i rl.n3LrLr.:tion
ADDRESS: 4122 r{rarket St. Suite 203
BLOCK f: 5 Lor *: 1lL
ST: f!_ ZIP: 284n:
PHONE #: 9l0-61b 5858
CITY: l!'r lnr nEt..
LICENSE *: 52!n1
CITY: !.1:ln:ngtoo sT: I!_ ZIP: 3gl
EI',IAIL ADDRESS: ki!q!csLloddqgr a r!r com PHONE #:9ro-616-111:
PROIECT CONTACT PERSON: ll-ci P i o c i-.,r r:. z 'r k PHONE S: :iil 5i;, 11-.1
EXISTING CONSTRTICTION :A LTERATION a/RENovATToN ! orrrnar nrcarns ! RELocATToN
NEW CONSTRUCTTOT: ! rneCr NEW RESTDENCE o" fl nOorrrOt TO EXTSTTNG RESTDENCE
**PLEASE CHECK AND ANSWER BELOH ALL THAT APPLY TO YOUR PROJECT:
Arr GARAGE
-
sF ! oer cannce _ sF
suNRooM _sF ! coor _ sr SF
SF6R E ENHOUS E 5F DECK
* * * * * * * * ** * * * **,k,* ** **,k * * * * *,** ** * ** * * * * * * *,t* )** * * *,r * * * *
PORCH _ SF
STORAGE SHED
TOTAL HEATED SQ FT:
-
TOTAL SQ FT UNDER ROOF:
-
TOTAL AREA Sq TT' -l I'I
ToTAL PROIECT CoST lress roj ; $ oob,, lDo'"o S OF STORIES: 2
Ts Any ELECTRICAL, PLUI,IISING o. TIECHANICAL Wo.k Being Done to the Accessory Stnucture? [ V"t I lo
If the project is a Relocation, is thene a Natural Gas Line on the Cunrent Site? [ Ves [ ruo
1s there Electnical Powen on this BuilJing?I ves [ ruo
PROPERTY USE ,/ OCCUPANCY:srNcLE FAMTLY ! ouelrx ! rowruuouse
DESCRIPTION OF WORK: lo--a- ki.1-chen r:encva:ion; Re-do plumbing in powder Rm. New cabine:s and washer
a.d dryer Lronnelrtion jn mrdroom. Ne.r yanities in tw.r 2nd fiocr pathrooms
and ordinances and €g{rlalions. The NHC D€velopmen rS€ rces CenEr willbe nor,lied o, any chanOes in he apprcved phnsand specilicalons orchange n contacbror
conracror inbrrnadon ""NOTE:Anywork Pe ormed W/O lhe Appropnale Pemits willbe inViolaton ofthe NC Siale I bject to F nes l.Jp To $500
(P.int Name)** * * * * * * * ** * * ** * * ** *,* * )** ** * * * *,*)t * * *
IS THE PROPERTY LOCATED IN A FLOODPLAIN? N YES
EXISTING IIIPERVIOUS AREA:
-SQ
FT
NEV'i IMPERVIOUS AREA:
-SQ
FT
TOTAL ACRES DISTURBED:
EXIST LAND DISTURBING PERMIT: I-I YES T-l NO
I NO
WA TER Mg CFPUA Colvli\4uNITY SYSTEI'4 PRIVATE l.^lE L L CENTRAL l^lE L L
SEWER:cFpuA D CENTRAL SEPTTC ! eRrvnrr seeruc COMI4UNITY SYSTEI"I
*'* SEpARATE prRfiIIs REQUIRED €oR ELECT, mEcH, pLBG, 6As EqUIP, PREFASS & INSERTS ***
,orrrn, ,rtr,oo]- E .ui, f] cxecr (PAYABLE ro NHc) AfiERrcAt{ ExPREss U "l'rsa n orsco"*
******,t***+*+****+**r(*)*****,f*****+*****+,t****'t+'f+*)*)i*****)****'*****)t'<)i*****'(*+*****r**)***r*
(FOR OFFICE UsE ONLY) REVISEO DAIE O4l11l12
li-l!. _ ^EEr.Ee. SETBACKS: F:- LH:- RH:- B:-
Approval:- CitY:- DATE:- FLOOD:BFE+2ft= _
N
Comment :
PERMIT FEE: $4ltt.o
PHONE #: 91|-616-11r:l
SF OTHE R:
OWNER/CONTRACTOR: iced Pioc:larcu iK SI6NATURE:
)otb'lto{)
F lic Pt-,:ri: +
NEW HANOVER COUNTY BUILDING PERHIT
APPLICATION TYPE: R ESIDENTTAL
PLEA5E Arlslrtt aLL QuE5Ilcll5 APpLICABLf '. YoUR PRirla'T
"Pnoj e.t Re s pons ibi1i.ty"
PL. i iL )q.t
APPLICAi]OI]
l{umber
oatr, rf tt l\bAPPLICAXT'5 NAITE
OEVELOPE R: .PHO\E S
PRotta: A00REss:
SUSDI\ ] i ION: : .
LICEI1SE *:
Cl IY: i :,-:
LOT S:
ST: _ ::;-r: .
BLOC( ':
PROPER]Y G{NER'S NAflE:
OI.IiJER'S ADDR E55: :,CIfY:
coh -.iACT0R:
A00RE5S: I .r.. r.: ,:r, r-:
EI4AI L ADDRT SS:PHOI{E $:
PHONE S:PROJECI CONTACT PERSOL:
NEr.l coNsTFU(rION: ! enrCr ll€w RESTDENCE o" f AoottlOlt TO €XrSr:N6 RtSIOET.JCE
..PLEASE CHEC( Allo A SHER BELfi AtL THAT APPLY T0 YOUR pROIECTi
AT'I 6ARA6E
-
5F
SUNROOT1 SF
EXISTIN6 COt{STRI'CiIO
! carrmrouse _ sF _lc:.c"-
-l alittar:or,r R ( NOVATION ] ccrenar- necrrns f Ra L 0ci.- . )r!
! oer canacr sr I eonor
-
sF
pcoL : f0RA6E Sfai
SF OTHER
SF
SF
TOTAL 9EATED 5Q FT; _--- TOTAL SQ FT UNDER ROOF : -- TOTAL AREA 5Q TT: I i I i
# OF SIORIES
I5 A1y ELtaTRicAL, P!U|19IN6 or lltlctlANr(AL iror( B.inB f,one to the A.rerrc.y (r.j'L..ol I V.a f Uo
:f the projcct i5 a Relocation) is the.e a Naturar Gas line on the current Sitel f] Yes
a lr
ToTAL PROIECT COST.*'.ar : $ l'.u','.i;.;
Is the.e Electrical Pou,er on this 8uilJ:n8?Yei NO
5IN6L E TAMILY DUPiEX I iowruxousrPROPtrr / US€ / occuPAlicY:
oEscF::;IoN 0F r.roR(:
SIGNATURE:
ir.!.: tr.r i
ooD
€XISrI|{G IiIPERVIO{JS AREA:
--
SQ FI
NEl,,l IIIPERVToUS AREA:
-
5q FT
,,]ATER:
SEIiER:L1 CFPUA L CENTRAL ST:'iIC
crnul ! tomuri;-y s"r.rtt tr:lirvATE l^ELL
[] nnrvrrr srerlc I
IS THE PNOPTRTY LOCATED IN A FLOOOPLA]N YE
raYr.lEr,lr ":- a::CAS q f,crrc* leotoe,e ro r"c1 f uratcat exoaess
'ryra
IOTAL ACRES OISTURSEO:
EXIST LAND DIs'I1 R8IN6 PECIT] I:YE5 i- no
Pe.ana
01{1251f'?,
t1clvIsA Drs(0vtR
zolt, ft|Q or.tcrn (, F TSACKS: F:.,: - ni-
. !rL..trr _ _
pERl,r: i: l: : 5
, .. :1
Approval :.- CitY:-- 0ATE:
.*s.
".-0l u c
.lCon-ent
+
CITY; ., : I _ Z:P: __-_r_
5T: r'. ZIP: !i'
01,'IiiER/CONTRACT0R: -, ,- -...:
\.".
./i-\..\) \
L\'
APPLICATION TyPE j RESIDENTIAL
PLEASE ANSWER ALL QUESTIONs APPL]CAALE TO YOUR PRO]ECT
"Project Responsibitity"
W. tt-t 5+
2otb't{2L
APPLICATION
Number
(Offtce Use)
REcEIvED tr' fr[ mt6 o*ovER couNTy BUTLDTN. pERMrr
m
APPLICANT'S NAME: ocean Blue pool and SDas of NC
DEVELOPER:Ocean Blue Poofs and S as ot NC PHONE #: e1o7ee 3022
PROJECT ADDRESS:
SUBDIVISI0NT
1401 EasEbourne Dr CITY: wilmirlqr-zIP : JSj))_
BLOCK #:LOT f:
PROPERTY Ol,lNER'S NAI'IE: J.rson Four.ier PHONE f: 636-399-7816
ST: NC ZIP: 2 841rOIdNER) S ADDRESS:1401 Eas cbourne Dr CITY:wilminoton
CONTRACTOR: Kevin Dunne LICENSE $: 7r760
ADORESS: 30 covil avenue CITY:Wi lminqt.on 5Ti NC ZIP: 28401
EIi,!AIL ADDRESS:l sandspas@yahoo , cont PHONE *: e1 't99 22
PROIECT CoNTACT PERSON: Pauline Dunne/Rvan romb PHONE *: 970'7993a22
EXIsTING CONSTRUCTION:ALTERATToN ! nrmvarror.r I ertrnlr nrearns I RELocATrol,l
NEW CONSTRUCTION, ! rneCr NEhl RESIDENCE o" I loulrrolt To EXISTING RESIDENCE
**.PLEASE CHECI( AND ANSWER BELOH ALL THAT APPLY TO YOUR PRO]ECT:
[nrr cnnaer _ sF ! oer canacr _ sF
suN R00t4 SF P00L:55
I cnernnouse _ sF I orcr
PoRCH _ SF
STORAGE SHED
-
641
SF SF
SFS F OTHE R:
ToTAL HEATED SQ FT: _ ToTAL sQ FT UNDER RooF: _ TOTAL AREA SQ FT: _
ToTAL PRoIECT CoSTlressroq ': $ +z,zzg # 0F STORIES:
Is Any ELECTRICAL, PLUflBING or HECHANICAL l.]ork Being Done to the Accessory Stnucture? [ Ves I ffo
If the project is a Relocation, is thene a Natural Gas Line on the Curnent Site? [Ves [ ruo
Is there Electnical Power on this Building?
PROPERTY USE / OCCUP/rNCY: I SrruCre rlnrrV
ves I lto
DUPLEX TOI^INHOUSE
In qround swimri nq pool with 547 sq.fE of concreLe deckinq/oool code main
I
DESCRIPTIOI'I OF WORK:
drains/poo1 code door alarms/poo1 code wooden privacy fence
aM ordinances and tegllalions- The NHC Developmenl S€ruices C€nler wll b€ nol,fied olany chgnges in lhe approv€d phns a.d speciiications or chanoe in contracbr or
contactrr inrormaton. "'NoTE: Any work Performed wo the Appropriab Permits willbe in violalion ofrhe Nc srars Bhg code and subjecr to Fines up Io $500.0q.'
OWN E R/CONIRACTOR: n61i.,,. p,.,.,.SIGNATURE:
(PrinL Nale)
r ***,t** )kx*x r**+,i *** * * + +++* ++** *r.+ +*+*,i.r.,i*i.,t'+* x, {.r. +i<** )t* r( * **)tr(** ***** *** * ***,i*)t* )t**+ )t+*x **
IS THE PROPERTY LOCATED IN A FLOODPLAIN?
EXISTING II4PERVIOUS AREA: 2922 SQ FT
IIE!^J ITTPERVIOUS AREA: 3559 SQ FT
NO
TOTAL ACRES DISTURBED:
* r.* * ,r,i * **** **** ***r( *** * * ** r*** * ** ** ** * * * *:k* * * *** ******'f '* ****:** rt**** **** * ** *:* t'* * *:* '* * *:*:* * *
YE5
EXrST LAND DTSTURBTNG PERMTT: E VrS l--'1 UO
(ron orrrcE rrsr orLy) REVISCo oATE 04111112
SETBACKS: F:_ LH:_ RH:_ g:-ZONE: OFFICER:
Approval:-City:- DATE:- FLOOD:
-
BFE+2ft=
-
AVN
COffiICNt: PERMIT FEE: $
I
7r,@
DATEi 02/ 15 /tG
ArEn: I creur I coMr',ruNrry svsrer,r f] PRrvArE EtL fl ctrrRrl wrll
sEwER: El crrun I CENTRAL sEprrc ! enrvnrr srerrc ! coMIuNrrY sYsrEM
'** SEPA8A'TE PERI,IITS R€QUIRED FOR ELECT,
',IECH,
PL8G, GAS EqUIP, PREFABS & INSERTS **"
pAyrilENr flETHOD: u casn E c'rrcx (PAYABLE ro urc; I arenrcm *eness E nc/vrsr E orscoven
c^1 02- 17- 16; 05 | 24P[4;
?€7 tb-q811
Tott-isLl
APPLICATTON
Number
(offl<c ur€)
Lo')
i9193090627
E oer GARAce sr fl noncr
-sF
EI poor-
-.---_
sr ! sroaaae sHED
-
sF
! oecx _ sr OTHER:5t
RECEIVED FEB 18 20fi
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPEr RESIDENTIAL
PIEASE AIISXER ALI OIJESTTOIIIS APPIICASIE M YO1JA PSOJEqT
dProject Responslbtltty"
AppLICANr'S IUA'IE i charlie Lewie/ F5, L.L,C. dba RdmJack OAfEr 2/t1/2076
DEVELOPER: ES, L.T,.C. dba FanJack PHONE *:9121
PROIECT ADDRESS: 790E BanYan TraiI crw:w:Ini:1qton UP i 2847\
SUBDMSION: Avona]section I P]\RrD: R03719-o 4-47-000 BLOCK f: _ l-0T #: lll_
PROPERTY oUltlER' S NAI{E: Thonras Moser PHoNE *: 91c-508-289e
Ot'iNERrS ADDRESS: ?906 Banyan rrair CITY;WiImi.ng!on sT: S- zIP :2!.3L1-
COT{TRACTOR: Fs? L.L.C. dba namJack LfCEiJSE S: s3r?8
ADDRESS: 4f22 Eennetc Menorlal Roa.l suite 364 CITY:Durharn ST: Nc ZIP: 27?05
EI|AIL ADDRESS: charLieoxanl ackusB. com PHoNE #;919-309-9727
EXISTING CON5TRUCTION: E ALTERATTON I nenOVarrOr GENERAL REPATRS fl atlocarroru
r,lEN CONSrRUcrroN; E rnrcr NEl.l RESIDENCE o" I lOOtttOr,r rO ExrsrrNc RESIDENCE
..PLEASE CHEC!( A O AIIsI{ER BELOI{ ALL IHAT APPLY TO YOUR PRO]ECI:
flarr eenaor
--
sF
! sulnoon
-sF
! eneruxousr
-
sr
TOTAL TIEATED SQ FT:
-
TOTAL SQ FT UNDER ROOF:
-
TOTAL AREA SQ FT:
-
TOTAL PROTEET C05Tn"":ro0 : $ .14 * 0F SToRTES:
Ir Any ELEC'RICaL, PLUiTaING or IIECHAIICAL Hork Eein8 Done to the Accetsory Structune? [ Yes
If the project is a Relocation, is there a Natunal 6as Llne on the cunrent Site? EYes I No
Is there Electri(al Powen on this Buildlng?I Yes flruo
PROPERTY USE ,/ OCCUPAT\,CY:5TNGLE FAl,,trLY I OUrlex I roultwouse
Df6CRTPTION OF WORK|insrall heflcaf ple!to stE-bilize fouDdation
OECIi^IMEft thftbyc€ntt hEt 6t lnbmslon l. hl5 6pprrcll6n E corsd anC Clrcrk wlll.ornp ywlt ilE SEl. E{lldlng Cod€ 'ld dloh6r aPPkrbb Stlb ond hctllnw-
End onfln rn.6. rC rlollatlonE. Tho NH C Osv6lopm€ol S€rvlcsE C.nEr wlll be noullsd ol any €ha g.t h !16 ap?Dvtd phnt !.1d s9oclEruons or chsgs ln Eont Ect) r or
ionracbr lflhmsdon. '-NOTE: Ary work Perlom*d W/O $e Appopr nb Pamlti wllb! ln Vlohlion otlns NC StBb sldg nd es Up To 3F00.00"'
or,rNER/ coNTRACT0R :Chalfle Lewls SI6'IATURE:
*,r*i, r*,r ****,r,.** ,**** *** *r***(IirlT*Illli***.....*. *,.rr.. f+*+**,, 'r(** ***** **** t** ***{i t*****++l+
rs rHE pRopERw LocarED rtt a rlmopurlr E vEs E Ho
I No
EXISTING IMPERVIOUS AREA:
-SQ
Fr
NEw IIIPERVIOUS AREA !
-SQ
FT
ToTAL ACRES DISTURBEDT
-
Exrgr LAND DTSTURBING renUrr:-fl ves I no
rurER; ! crpul E coMtluNrrY svsrru ! PRTVATE HELL I crrurnt uell
srweR; ! CFPUA E CENTRAL sEPTrc I cnrvare sEPTrc E coMl'luNrrY sYsrEN
rt+SEPAiATEPER}IITSREQIJIREDFoRELECTIlrEcti,PLBG,GnSEQUIP)PBEFABS&INSERTS*4
paynENT iIETHOD: EcnsH E orscx (FAYaBLE To urcl fluenrun exrnrss LJ lclvrsl l-J orscOven
*********.l|++}*..*.r*.+*l*++*1*****'fi******'1.*{l*'lr***{*,14*'x******ll*lt****+*+*+.*+a*++*t)il;l'***
(foB orFr(E usE oxLY) alvrSEo 9ArE o!/11/rl
zoNE:
-oFFICERT
SETBACKS: Fi- LH: RH:- Br-
Approval:- CitY:- DATE:-- FLooD:
-
A
Comment:
N
PER TT Fgg:
-7(,(9
PRoJECT CoiITACT PERSOiI: steve calrand:rno PHol.lE #: ?l!:109-9r2?
BFE+2ft= _
(
o-s
I,e)J.--r
ilfcrrveoFEtsot2016fL
p ot6-t93b
r3c.l -6.
1,.Y
$s
Sb
c+
\
a,(F
=srdr+ab
b
d.<()
#
NEW HANOVER COUNTY BUILDING PERI4TT
aPPLICAT|1N rYPs: COMME RCTAL
Pl aa5E AtuSlrte aLr, QU€STloXS APTLIC,TBLI ri YoUR Pno.I i i
"Project Responsibility"
ApPLICAI{I'S t,,Al'4E: Hi.rh:s:1d R1:.:1r.r c1r!ar'i OATE:
OEVELOPER: PToIIIE *:
PRoIECT ADORESS: t410 l.t:1r t,,r s!
g,
,.o
,!tj
lU- jr?
APPLICATION
Number
(Office use)
CITY: htr
oCCUPAI{I/EUSINESS NAIIE: i::r:,lrei.i.
PROPERTY OUNER,S IJAI.!E: :.I.: iic:d,::-]-
OI,JNER'5 AOoRESS: f i?? ir!..y rr !yo>-r :i.r)r:1
CoNTRACTOR: :ii:r : .:..1 rc.l ::, c3r:-:i!-\'
ADDRESS: 4t-r. a,',-' credl r r--i
E,IIAIL AD0RE55l :id::.,r- .r I r.n.-^a:.-
LICENSE i:
CITY: r.r jt..:rii :
CITY i l.lyrr:c !.':: r:ST: .i(: ZIP:29rsi
5T: :, zlP i ,6j, -
PHOIIE *: it ir :1,i.
i(h:-r 1lj trr: r:: lr l
EXIST CONSTRUCTION:ALTE RATION R ENOVA] iON 6ENERAL SEPAIRS R ELOCATION
l{ Relocation- 6 lhere a NaturalGas Line on the Curreot Si:e,I E^o IS BL{)G S,iIINKI iJR{ I,'?
If UPFIT - The She1l Permit f:Is Elect Power on this Buildin8 Ye5
I'I.T ;S THIS A CHANGE OF OCCUPAXCY UsE)YES I
S IF Ye9, what was the previous Accllpan.y lype?lftat is the Ner Oc(upancy Type?
No
N€H CoNSTRUCTIoN I ERECT NEW STRUCTURE FAST TRACK SHELL UPFIT ADO TO EXIST STRLiaiL'RE
ACCESSORY 5TRUCTI,]RE
r NC
ARCH OESICN PROEESSIONAT:
EN6R OESTGN PROFESSIO AL:
PH:C RE6 r:
I,IC RFG I:
DESCRIFTIoN 0F HORK: Re lt-.-l lixrsl :rt.r Iruild:::.
ls lood or bevcrages prepared or served h t,|is stnJctrr€? flYes No ls The Prop€rty Located ln The Floodplain? E Yes !NoI
ioL..,r'.*'.0-01 J,,d e--urr,o,,: -. N'lL - ,',,re-rSc., c.{."-alN i"c'a,Jrc'rdr,, ",'ru.r,o rJLlu',i'J,',L,li, "\_ \!u'. l)'n, .,. ,Ip|, ne,'e.'r ls ".''clJr,' \(s tl.lL: (u,r," 'S!!r..r t., ^^! !D c ,'
OWNEFYCONTRACTOR lr. - -'r:i SIGNATURE:
iolrllad' (Pdd $d)
c!.r!rn aibsto. or not- You lro r.qulr6d ro clll rtb l.latonai Emllsao sEn.b.d! to. Hazrdo(E Ak Pollur,nt (l€sHAPl ar (919)707-5950 ar !s.3t l0 @y5 Pjo. ro lh€
dolrDltloo ol dry bclily or buildhC. soe ,6bo$os WsO Slto: htlpJ^ew opl ctdo.nc us/olussb{slo9ohmp nt mt
TOTAL PROJECT COST: 59:, IC! . ],] BUILDING HEIGHT: 2i' # OF UNITS
TOTAL AREA SQ FT SQ FT PER FLR:# OF STORIES
TOTAL SO FT UNDER ROOF:
-
, OF STRUCTURES: I , OF FLOORS
ACRES DISTURBED fr /;\Exsr LAND DrsruRBno eenurr f ves I NO
NEW IMPEEVIOUS AREA:SO FT EXISTING IMPERVIOUS AREA:
(FOR OiFr:E USE
SETBACKS:
Approval:- C BF
SO FT
pRopERryusE: noFFtcE flnesraunerr fiuenmrrtr-e !eouc f] eer f]mnoo orHe*
WA]'ER:
SEWER:
CFPUA
CFPUA
Tl coMMUNn-Y SYSTEM Tl WELL [f ZONING USE CLASSIFICATION:
-,-"-
frcerurneL seertc n P-RMATE sEPrlc flcoMMUNrrY sYsrEM
PAYMEN-r METHOD: ICa.SH [CnrCX (PAYABIE rO NHC) fielteRtcAN exrne ss I racvvtsa [-l orscovEn
zoNe' R6 orrtcrn;
oNLY)
f: \P rx: r..rEnx:Nl'68:-0.ir4E'*t=
Commsnt
E FLOOD
n PERMIT FEE: $/o
ZIP:;!Ei! l
PHONE f:
PRoIECT CoNTACT PERSoN: ctrnsi) ,:Il i,,: r'.n PBONE Sr Llj_-].j,a .]:5r
RECEIVED FEB O12O1O
APPLICANT'S NAME: Hiqhland Roofinq company
io.
4r
NEId HANOVER COUNTY BUILDING PERMIT
APPLICATI0N rYPEr COMMERCIAL
PLEASE ANSI,.JER ALL QUEsTIONs APPLICABLE TO YOUR PRO]ECT
"Project Responsibility"
tU 3tl
Po lb- lr sc
APPLICATION
Number
(Offic€ use )
OEVE LOPER :PHONE #:
DATE: 1/28/tc
PROIECT ADDRESS: 4,110 Marker sL
OCCUPANT/BUSINESS NAME : clri rrends
lf Relocation. is there a Natural Gas Line on the Current Site?Yes
NEI^l CONSTRUCTION:ERECT NEW STRUCTURE FAST TRACK SHELL UPFIT
ACCESSORY STRUCTURE:
CITY: Wi lminlrron
PROPERTY OWNER'S NAI'IE: cl,r H PHONE *:
OWNER'5 ADDRESSi 4'122 Hwy. 1? Bypass SouEh CITY: MyrEle Beach
CoNTRACTOR: rjiqhland Rooflnq coinpany LICENSE #:
ADDRESS: 4r10 Deer Creek L-ne CITY: wi lminqLon
E!1AI L ADDRESS : chas elhi qhla:r.lr.c. f i iqccr,pa:r-.r
ST: sc ZIP: 2e588
910 798 0155
910 798 0155
ST: NC ZIP: 2B4o j
PHONE #:
PHONE #:PROIECT CONTACT PERSON: chase williamson
(check AIt That Apply)
EXIST CONSTRUCTION:ALTERATION R ENOVATION GENERAL REPAIRS RE LOCATION
No IS BLDG SPRINKLERED?f]v"" Ino
ADD TO EXIST STRUCTURE
If UPFIT - The Shell Permlt #Is Elect Power on this Building T YeS E r,,ro
NC REG #
PH NC REG #
ARCH DESIGN PROFESSIONAL:
EN6R DESIGN PROFESSIONAL:
DESCRIPTION 0F I.^IORK: Re Roof ixistins Buildinq
DISCLAIMERt I hereby cerlit that all informalion rn this application is correct and ail work will comply with the Slate Building Code and all olher applrcab e Slale
and local aws dnd ord nancea and reoulations. Ihe NHC Develoomell Servrces Cenler wll be nolified oi any chanqes in lhe approved plans and speoficalrors
or cnanqe.n ( onrractor or conraclor i"nlormalion. "'NOTE Any Wo4( Perlomed WO l1e Appropnate per mrts wll 6e rn Vrolailon ol lhe NC Slale Eldg Code ard
Subtectlo Fines Up To $500.00"'
OWNERyCONTRACTOR: ct,"se will iamson SIGNATURE:
(Ou6li6*) (Pti.l N6m6)
Note: D€molitoo notillcetions & asb€9os romovsl pemlt appllc€lions sre to be submhled uslng ths apdlc€tion form (DHHS-3768) whelhsr the faclllty or bullding was I'cund lo
contaan Asbestos or not. You are requk6d to c€ll rh6 Narional Emlsslon slsndards ior Hszsrdous Air Pollulants (NESHAP) 3t (919)707-5950 3t lsan 10 days p.ior io the
demolltlon of any fucillty or buildang. Se€ Asbeslos Web Sile: hltp/wwwepi.slste.nc,uyepi/asb€slos,/ahmp.mml
TOTAL PROJECT COST: Seo, ooo. oo
TOTAL SQ FT UNDER ROOF # OF STRUCTURES: r # OF FLOO RS: r
ACRES DISTURBED N/A Exsr LAND DrsruRatNc peR[4trr [_l ves NO
NEW IMPERVIOUS AREA:SQ FT EXISTING IMPERVIOUS AREA:SQ FTN/a
pRopERry usE; EoFFlcE lnesreumnr ffiuenceHrtrr f]eouc lenr lcouoo orneR,
flzoNrNG usE clAsslFlcATloN:WATER: IICFPUA
SEWER: ICFPUA
COMMUNITYSYSTEM TIWELL
cENTRAL sEPlc fl e-nvlrr seertc EcoMMUNrry SYSTEM
ZONE: OFFICER
(FOR OFFICE USE ONLY)
SETBACKS: F:-LH:- RH:- B:
REVISEO OATE /VM2
BFE+m=
I00
Approval:- City:- DATE:- FLOOO' - o ----l N
I
Commentt PERMIT FEE: $
ZLP i 28ta)
***'r* rs THrs A SHANGE oF occupANcy user Ives Ero --.--
IF Yes, lrhat ulas the Previous Occupancy Type? _ t.lhat is the New occupancy Type? _
PH:
ls food or beverages prepared or served in this struaure? flve. I No ls Th" Property Located ln The Floodplain? ! ves [ ruo
BUILDING HEIGHT: 2q- # OF UNITS:
TOTAL AREA SQ FT : .1ZI.q0- SQ FT PER FLR:
-
# OF STORIES:
pAywtENT METH6D: flcasn lcuecx leevnaLE ro NHc) flauentcnu ExPRESS pucnrtse f]otscovrn
tl-"-r?
RECEIVEDFi3OI?l]T
APILICAI{I ' 5 NAI{[: !:i:l:: ,r:
DEVELOPEN:
.Jo/b'(fJb
APPLICA'I,]N
Nufiber
i.ri
1i
NEt{ HANOVER COUNTY BUILDING PERI4IT
APPLICATION rYPf: Cot'tltlERCf AL
Pl€45E an:"r. AL, QUESrt0!5 aP?LI(rBLr r. YoUr( prOI
"Proje<t Respon5ibility"
PROIECT AODRESS: .r,1r-i r: ,:, s!CITYr ^:::nI ZIP:.'rr.r.
oCCUPANT/EUS INESS NA":: , t:.e:.a:
PROPi i.Y ol.]irr'5 iJAHE : i r,. i:-
CON-- ,CToR | :i :.. r :r: i-
ADDRESS: .i!r-
LICENS E fl:
PI-ENE *:.,: rii^ :1
pROIECT C0llTLC-i PliiSON: rt r-,!,:]1,, .n
ExIST CONSiRUaT.io:'l:I alr:narron i]R ENoV.iT ]ON lLl
ir Helocat,on rrlh{nDrNalu3l(iaslrneonr' (_r . .r'': j'No lS 8t.lxj 1rJ
I nrrocarrct'r
?lNKt r ir, t-_.? L_j yes l!o
NEhl CONSTRUCTT0 : ]:nrCr r.:rl.J STRUCTURE !rasr rnlcr I srrr.u f]unr;rI mo ro Exrsr srRucrJRr
ACCESSORY STRLC'URE:
If UPFIr - Tne Shell P.^.1it *: Is E1e(t Power or this BuildinB ii Ycs I nO
IF Yes, $hdt ras the Prevrous O((upancy Type?l.ihat is the New O.crrp;r,(y Type?
PuARCH OESIGI! PROF' 5s]ONAL:
EN6R OES]'I. PRCFESSIOIiAT:
NC E{6 e
IJ( AFG !
ls focd or bevefa;es :..F::-eC :. i.n.',.J in this +.:::.]-:? F Yes E Nc ls The Propecv Lo..lt4 r',,,Pr.-'il:'-'lv"t'!-1"
olsctAiMER r'eii.ri ' r'!rr::i ' rru.'ts rrr: L,,'r1,:
r"atr:i,:rs n.!,rl1. rfd,,),:r rror,\ -' f. r'ri-,, )r!.n.rSnv,,\ie.rn a:h. . rrnl.r
or drnn\r L.jorta.Lo, rr.1,rl rilJ,,r.ln '-N:- !!oii l)-'rr, .. ,. '/1f'J rler'e ','r' ,lr \-__ ri ,,/., ^.s !t r.
DFSCRII'lllll OF ',,JORK: . '':-' :
OWNERCONTRACTOR: -i ,SIGNATURE
TOIALPROJECT COST S9],i.N -.,.
TOTAL SO FT UNDER ROOF:f OF STRUClURES
ACRES DiS ' 'I i EXST LAND DIST',-RBING PERf,llr? ,] YEs E NO
NE\ry IMF='/IOUS A,r'i r: .SO i.r EXISTING IM?ERVIOUS AREA:
pRopERry usE: a-loFFtcE [nes'nunerr NTECCANTTLE ]EOUC [Anr ImlrOO OrriEa
Lortlad iP..rrrF3,
€flr6ll' arDesros o.
'ror,
Yo !16 r€qursd to c.tluE Har@r! Enrssp.r S6.a5.ds tr rla.z.do6 Atr Pdrullirs (NESFA') al1919l?ct.5950 !r lsn !0odls 9.,0r lo rhs
donrohon ol3.ry hcllhy or blildhlt see A3!+rr.3 \ ,t! slloi hxrJre eoi sl3:0 t lsrrFL'atts srdr3th9 +hl
{ OF UN ; :.: _..
f OF STCRIESi_
f OF FLCORS: _ _
I
WATER '"']CFPUA
SEWER: :l CFF'UA
flcoMMUNr'rY sYSrE4 I]WEIL EzcNlNG usE cl sslFlcATloN:
:- - CENTII L SEPTIC I I,RIVATF SEFTIC ] COMMUNITV SYSTEM
pAyMENr |,{,,'HOD: f,CASn ]CH:Cr (nAYABLE r3 NHC) f euenCel rxenrss McMsA I] DISCOVER
zoNE, i(6 orrrcEn
(roF ::_ :c lJ3c or{
S:-: \CKSI F:
L,
AE LH: r.{F RH:N1rA B:Niir)
E+2Ir-Apprcval: Ci \r Ei
Comment
ly:-FLOOD
FS
ol.]NER')S AooRESS: r'rr,r i:!.., :',f!t. ::.,::r. CITY| !i[L:,i i, .__--_ ST: i!- ZIP: i::i::_
PHOI,OE *:
PI€NE ,: ,r r'" ::,,.
TOTAL AREA SO FT : : i. :::
-
SQ l-T PER FLR:
-
EUILIJING HEIGHT. :.T
-
r'JEI,{ HAM)VER COUNTY BUILDING PEEETST
appLrcaf io ri?.: RESIIE:r-TIAL litgBil-E ,.lfiqE
PL€45! PAt'f' C,.EAT!Y E A,O5I.'Ei ALL qUf5TIOI!5'.prcject Res poos ibi i j.ty"
2.s tb- l91t
tb-qb3
APPL!C}1'T9I
t&flrber
APPLI'A.i'T'5 HAHE:
oEVELOPER,
Aer s- i u-r
io+fl6s Uss)
D,r.riE : 2 -q'lt
PIF r $:PFO]ECT ADDRESS:
suBDtvisl0$:
PBOPERTY Olf{Ei'5 zuA',IE :B-.^r (>eJ.*l
\
IOI'TRACfOR :
A'DRT55;
CTTY:
Btoci( #:
!_ff..'.-__
t$Cjrz rp :a.rLlal
LOT {t;
6
tUf l aOOnfSS t
FRO:IECT CfNTACT PEftSO'9: Lt
ri,lsTAt- t_ i,Eh, t4oBrLE
'JOtlE
OESCEIPfTOI oF l,J0fik:S',
PTIf'NE f:
.'TY:l:.T : \l<1i11!' I, tGcld!
iI(EilSE ,: atq l^ACCOI TT tCriv: I ,aLrnd '-: Nc-,l: ae.fsI
I,ltoirE ii:
Pttur,iE ii: lcESja_6!3
((HEC'( ALt ?HAT APPLY)
f]]i nrrocerro* oF usED imarlE HorylE
Eq
DlECLrrlER: I h.6by €d{y or1 .r tntomuon ,n thrs Eppt*sraon E co.r6t rho .il tro.t 6n c.y.E y wnh ll/o st ro &itr,lo co,i€ a.rd 6I oiiof apl)a..b,s srla€ lndrJrl! qrlirB.{rs ard ,o$ffons. Th€ r,fic DovsLomdl s&,lic€s cBfldt ys te l|olirdl {d ary dlatg6 in ,s sgov€( phlts arld spsaifcd.rrs o.drrrgE ,n cffi'Bah: .'co.{raclor r o.Frarn _-NoT!i .cny war psrfo.rhcd wo tfie Ar{Ytp.iat ParmrE !.rll D4 ,n \rrobtbn o/ !h€lJC Slrk SldO oodc an t Sut 6.r b Firzs UD l, S5O0_f}0."
SIGNATURE :dLr\Ac^or,lruER/c0r{rRA6rn* Li nda,- *e.r\ i -^q---Ii,* ^*) -*._-.-
irr J.1.+** il+.i-*r.t ; j.,:i+i:*, r*+ir+* t*lf a.iril+rrytg*r<ir:*vrj
rs IHE pRop€RTy LocaTEp rr{ A FLo(ppLArN? i..: ves it'no?RopERTy t sgloccupApay: ffnssroe Ncr ,/ orHEE?
HUD Lnarr, !!\.rC.- t_t,t Sf,"q<o mANUFAcluFLr
YEAR f.iA{)L: Acrlb r,rDrH: _.\U _
it8{::t+r,..,)a,tnx+1r*++a't *{:;!n* t +,(+* ri.,r *:n *:r *,i,., r+ ..
C-!a.SFRIAI f,
coLos:
c_ 6a sa. ")qNC_Tq r..LEHS f'rj: -1 1
;(.TdL i,t.to:lS:t Ct3; rr--sr,rr:, g+qggf
#t#:l: H*'":vesffno -.- sr'
-OTAL ACIIES D:s?URBED:
ttuR8rcA E zor{E:
DEC(, YEs SF nonCH; ,fl.
2 I] : sro(E ,ErE
lJAIER
SE}JER
f, creur f] co,amlrrrv svsre r.r
CFPUA I crrurnal ;;nr:c
zotrE : ._-- oFFICER:Approv6l: aitv
SETBAC(s: F:_ LH: RH: B:
/-AT€ I{E L L
IVAI E SEPTIC
( f0{ oirlat t6f ca{!r.j
NfPAL IIELI
cot,srLhtl rY svJTEl4
i-__! --
'1 SEprajir; rEF;.riir nEgul.aED rir: ii:aa. HEaE. FLac_ !:4g €0ur-, rr.Erass & irisEprs .-.
pAvHE !r 4Er,*)D: l] casr i r cxr* (pa\ADLE To i*rc) illsri"r- accann r1n*rsacaro f, vrsa!**+***t****r:c i r; * ** t!.r ++ +*+ +* ++**_* * a** * i +a +1+ E* **i- + *:i*i: ra*r:* + yr: * i,:** + *4rr*{_!*****x**:!i**+2
t.ifxflrert PEB IT f[E; $3o o
#AE
$tl.c. :=* -\l.e-
ffi
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE; RESIDENTIAL
PLEASE AI,ISWER ATL QUESTIOI{S APPIICABLE TO YOUR PRO]ECT
"Project Responsibility',
Jo/b- lflro
l(t)'lb?
APPLICATION
Number
(office Use)
APPLICANT'S t,AfiE:
DEVELOPER:PHONE #r
PRO]ECT ADDRESS:
SUBOIVISION:
(-CITYi
BLOCK *
ZTP
LOT #:
PHoNE s:3b58ZZlL
sr : NC zrP : 28q, I
sr,Mzrp,284 ll
PROPERTY Om'lER'S NAI'1E :
OWNER'S ADDRESS:
CONTRACTOR;
.} ADDRESS:
CITY:
LICENSE *:
CITY;
PHONE S:
PERSON:PHoNE *: J\t"-5KZ-2112
EXTSTTNG CON5TRUCTION: I nr-rrnlrrOr [l RENOVATION fl crrrnnl neerrns I RE LOCATION
NEW CONSTRUCTTON: ! enrCr NEW RESTDENCE o" f] mOrrtOu To ExrsTrNG RESIDENCE
'i PLEASE C}IECK AND ANSWER BELOW ALL THAT APPLY TO YOUR PRO]ECT:
! arr ernrce
-
sF ! orr clnncr sr ! eonor
-.
sF
I sunnoom _ sF f] noor- _ sr f] sronace SHED _ sF
! cnrrruHousr _ sF I orcx SF OTHER:5F
TOTAL HEATED SQ FT:
-
TOTAT 5Q FT UNDER ROoF:
-
ToTAt AREA se TT. /1/i()6
TOTAL PROIECT CoST rr""" rorr : $ 26r Cnrr # oF sToRrES: I
Is Any ELECTRICAL, PLUIIBING or !4ECHAI{ICAL l^lork Being Done to the Accessory Structure? ! Ves ! ruo
If the project is a Relocation, is thene a Natunal 6as Line on the Current Site? [ ves f] to
Is thene Electrical Power on this Building? [[v". [ ruo
pRopERry usE / occupANcy' fi srruele rnurrv ! ounrrx ! TowNHousE
DESCRIPTION OF WORK:IC
DISCLAIMERi lhereb plicsrion is conect 6nd all work wilt compty wib ihe srare Buitding code and a[ oher appticabte srare and tocat taws
and ordinances and rcgulalions. The NHC Development Services Center willbe nori,ied of any ch6n0es in the appro plans a.d speciiicatio.s o
EI'IAIL ADDRESS:
PRO]ECT CONTACT
conrraclcr inbrmahon "1{OTE AnyWork Performed Wq teAppiopriab Permilswittbe inViotarior o{lhe NC SlaE
oriNER/coNrRAcro*, srta^ {nroh} srci,rAruRE:
\14
)
rs rHE pRopERry LocATED rN r rlooorurrl fl ves E ro
TOTAL ACRES DISTURBED:
EXIST LAND DISTURBING PERIi.!IT: f] YES fI ruo
HATEn: ! creua I coMMUNrry svsrrm ffi pRrvArE WELL ! crrurnal wrlr
sEwER: ! creur I CENTRAL sEprrc El enrvnrr seerrc f] coMMUNrry sysTErvl
**{ SEPARATE PERI,1ITs REQUIRED FOR ELECT, TCHJ PLBG' GAS Eq.JIP, PREIABS & INSE
payrirENr METHoD: ! cnst I cteCK (pAyaBt-E ro uc1 [ arerra^ **or.r, I r,,c7vrSa
sUpTo$
)*,*,*,* *r *,* * *,r *,* )**:** ***** **** *tllTl *i{"}** )* *** )*x** * *rt **** ** !**,*,* )r *,F ,t,* * * **** * * )*,*** * ** *,**
EXISTII'16 II'IPERVIOUS AREA: _5Q FT
NEH rIPERVIoUS AREA: _SQ FT
ZONE:
Approval:_ City:_ DATE:_ FLOOD: _ _
AV
Comment:
RIS il"
DISCOVER
*r** * *,t * )h****:*** )**r** r* r.* r**)***,**)* t,* )* r**+)t*)i)t* *r*+)t )ht )t *)*+*,t,t*)t )k** r* r* )* ***+* *** )*,*)** **** * r*,i* **+* + r
(foR oaFr€E usc oNLY)RE!'ISED DATE 64l11/12
OFFICER SETBACKS: F:_ LH:_ RH:_ B:_
DATE :
-
.J
_ BFE+2ft= _
Jr*rr, ,rr' tlA 0