MARCH 31 2017 BUILD APPSj,'5 (ro Enrrl ,Ct ,Optu,A
NEh, HAN.VER couNry BUTLDTNG ,r*rf ''1' H**ApplIcatro,, rvpf : C(DIERCIAL
pltas! axsbrR o.r Qu.srrotrs appu(llr,G To your pm)to mr.r,--:rror
A?PLTCAIT'S NA}I[:
DEVELOPER:
PiO]ECT ADDiESS:
ocqrPA[r/3USl[E5S [A,lE :
PiOPEiTY (}tltlEi'g tOnC ! \
ot{ EB', S ADoBESS: C
OOXTRACTOR:
"Project Rcsponsibiliqf
CTIY:
CITY:
C
uabcr
(Offlc. t.)
DATE: !IY\3
ztP: €11(, i
PloilE 13cl\L 3[il^\tI
P}€flE ':
PlofiE t:
Plot{E r:
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SI: N(IIP:
SI: \rre zre: Ji3r{
i
(
ADOiESS :
EiAtL ADDRESS:c,.eC,r'u
PRO]ECT CONTACT PERSOII:
Exrsr cot{srruclrot: I rlrrnrrron n rrrff;!#j
lf Rabcation, is tpre s NaturalG8s Lin€ on the Cuner s e? E
flEN coflsrRucrtq{: ft rnrcr rrw srnucnnr I rrcr
ACCESSOnY STtUCrutE:
If UPFrT - The sicll Perrit s:
..... rs THIS Aff Ycsr rhat Es tlrt F?{nlour (kcuprr(y
Ator 0EsI6 PlOFElStO{At:
ETIG DISIG PTOTESSIOIIAI.:
TOTAL PROJECT EUII.DIi{G HEIGHT:
SO FT PER FLR:TOTAL AREA SO
TOTAT SO FT UNDER ROOF:
-
# OF STRUCTURES:
lh t rg9ly)
. Egnrmr nrrur I ntrccanorYcs lJ ],to ts BLDG SPRN&EReor I ves s m
rrrcr ! sxrr.t I UPrn I aDD ,o Exrsr srn cnnr
().1 qz-5 (
--
Is E1ect Poutr on this Suildtng (l ves El,ooofct or occuPl cY l.6E?Etnt [tm .,...
T!?r I lalhat ls th. fcy Occupamy TyDel
pi{
PH
'
-___
Ut RIG {: _. ___ C RE6 r:
i*
t 0F uN[s:
, G STORIES:I 0f FLOORTSACRESDISTURBED: DGTrANDDtsTURBtNGptnurnEhts ExqNEW IMPERVIOUS AREA:_SQ FT B(ST|NG tMpERvtous AEaj * -- c _- :_
pRopEFTyusE: EpTFEE Elnesnuurr f]uencannrr Eeouc Errr EOxoo orxer
WATER:
SEWER:
EB EE]
CFPUA
CFPUA
OOMiIUNITY SYSIEM
c€rrIRArsEPnc E EwELt ElzoNtNG lrsE qlestFtcarroN.
PRNATE sEFnc Ecotrt uNrrY systEts
- SEPARA]E PERMTTS REOUIRED TOF ErECr. },ECH. PI.8G. GAS EOUIP. PREFABS I INSER]!.-
pAYltE}tr METHoD: ficasx flcxeCx leav$u rO Hxcl f]auenrcAN EpREss EIMcjvBA Iorscown
roR omcf u8E oNtY)RII'SED DAIE 441&ZONE:-OFFICER:-SETBACKTS:F: LH:-RH:-B
Appmval:-. CritY:-DATE: FLOOD:
-
BFE+2ft=
t{comment: PERMTT FEE: $HZ
DESCRIPTION OF IOR(:
b lllr Propcrry Locr.d n ne nooo6r,f flycs I xo
er.[.'l
)d?Mt1.wNEW HANOVER COUNTY BUILDING PERII,IIT
APPLIGATIaN TYPE: Cofttl4ERCIAL
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YUJR PROJECT
"Project Responslbillty'
APPLTCANT,S NAflE: \C Ster,)
DEVE LOPER:PHONE #:
PRO]ECT ADORESS:"59 a)
CITY:
LICENS #1!et3
CITY:
ZtP t 2 !'1,'l
PHONE *:
sr:Llll zrP: ZtiZ-?l
sr: -[,zrr:
-
PHO E T:
PHONE f:ibq-qt 9-ttzz
CITY:
occUPANT/BUsINEss tlAr.lE: T- lt\ob.k 5 'tl 5rt lo9?D
Cruu..a5 IcPROPERTY OT'INER,5 tIA}tE :
Ol,lt{ER'S AOORESS: 35b ,{ \
\lr.r
#
CONTRACTOR:
ADDRESS:Sc r5
EiiIAI L ADDRESS:
PRO]ECT CONTACT PERSON:(
Exrsr co srRucrrori: I ALrERArroil E -rJiT;lSi 'Et!Il*o,- neearns fl RELocArro \ /
tf Retocdon, is there a Naturat cas Line on the Eirent s,t"z E v"?Fno ts BLDG spntru-xreneoz E v* St"
r{Et{ cor{srRucrroN r ! enrcr ilEhr srRucruRE ! rasr ruc( ! sxrr-r- ! uerrr ! mo ro Exrsr srRUcruRE
ACCESSORY STRUCTURE:
V,O
IF Yes, what was the previous Occupancy Type?
'r**' rs rHrs A ctrar{GE oF (rcupaNcy usrr fives f]m .*.**
Is Elect Por.rer on this Building E Yes
ARCH DESIGN PROFESSIOiAL:
EiIGR DESIGI{ PROFESsIOIUTL:
PH:
PH:
NC REG *:
NC REG #:
og1q70-6447;I
DEscRrprroN oF woRK: Cc\\cal- oc. €:is-}i*r \.*r ', cJl dub.^c"[ on ffir;0J , atrl 7"v' a*p
ts food or boverasos on** . * * *;;;rE ;F b rhe pop€rty Located rn n
"
nooourtnz E ""Jy *"
\P
(A!3liic)
Note: Domolilion ncticatorE E asb6ios rglloval psmit applicatons ar6 to b6 sub.natted using lhe spplicalion loIm (DH
Building Code and all other applic6ble State
Dlans and aoedflcalrons
Nc stare Bldg code and
cooEln Arb€.tc s not. Yolr are mqrr€d to cdl th€ ilato.Bl Emlrslon Slandads fo. lbzrdqrs Air Pollulanls (NESHAP) 3t
denbli0on of Erry fecillty or building. Soo AsbBloG Wob Slt6: http //www epl.stale nc lsieprasbestos/ah.np hlm
at le6st 10 clays fior lo the
ToTAL PROJECT COSi: ZG 8c 'L\ O BUILDING HEIGHT:# OF UNITS:
TOTAL AREA SQ FT :5 SQ FT PER FLR:
TOTAL SQ FT UNDER ROOF:#OF STRUCTURES: Y # OF STORIES:
# OF FLOORS:
ACRES DISTURBED:EXST IAND DISTURSI{C penirrrl r-'l NO
NEW IMPERVIOUS AREA:SO FT EXISTING IMPERVIOUS AREA
pRopERTYUsE: florrtce Enesraunnnr [uencnr'rnle [eouc nepr D@NDO OTHER:(
th€ tacilily or building wae found to
SQ FT
REVISED DATE 4/11/12
*, SEPARATE PERMITS REOUIRED FOR ELECI, MECH PLBG, GAS EOUIP, PREFABS & INSERTS "'
n..........r....
(FOR OFFTCE USE ONLY)
ZONE:OFFICER:SETBACKS: F:-LH:- RH:- B:
Approval: City:-DATE: FLOODT-;---
N
BFE+2fi=
pAyMENr METHoD: flctsn flcxecx lenvneLE To NHc) flllvten16eN exeneSs I ucrusn I otscoven
Comment PERMIT FEE: $
G/'l
trr
APPLICATIOT'I
l{umber
(office Use)
oare: 7'Z!' ' )1
If UPFIT - The Shell Permit #:
tlhat ls the NeH Occupancy Type? _
WATER: EICFPUA fl COMMUNrY SYSTEM EWELL _flZONlNG USE CLAsslFlcAnON:
-
sEwER: E- CFPUI I CeNrnnr- sEmc E P-R|VATE SEPTIC f] COMMUNITY S'I6TEM
)o)T AqnwNEhI HANOVER COUNTY BUILDING PERMIT
APPLICATION IyPEi C0filtilERCIAL
PLEASE ANSTIER ALL QUESIIONS APPLICABLE TO YOUR PROJECT..project Responsibility',
twr/
PHONE Sr
PHONE *:
PHOiIE #:
APPLICATIO
I{ufiber
(offi.e Use)
oarc: Z-29- 11
zre'@
APPLICATIT'S iIAI'IE:
DEVELOPER:
PRO]ECT AODRESS:225 9 $CITY:
OCCUPAI{T/8uSINES5 ttAIilE: T- l\ob..l( 6.fl StJ lo ,10
PROPERTY ot'rl,lER,S ilAriE :
ot{ ER's aDDRESS: 3630
Cl Lln ,\\c
CITY:Ax
x
COl,lTRAcToR:
ADDRESS:5o d (
EIitAIL ADDRESS:
PROJECT COITACT PERSOiI; -Dqso,r'
LICENS #119tr
CIry:
sr;N( zrp: ZtZ"?J
sr:_Ntzrp: _
exow * 74:449 (-5ay>-
Exrsr coNsrRucrroN: E alrERArror n rrrJifiliii 'ii^8'*il*r- neparns fl RELocArroirrrReroca on,isrherea nat 'rcasrineontn"-c*,"ri;;; tr""?Eitil-'dffiiloki*i'u'.i'Jiij"* Sr"
r{Er,J coNsrRucrroir: fl rnecr E}r srRUcruRE I rasr rnac( ! srrlr- f] ucrrr fl aoo ro ,rrri ,.*r.rr*,
ACCESSOiY STRUCIURE:
rs Elect power on this Building f] ves V*ocuPAflcY usE? fivrs I r,ro '"**.
If UPFII - The SheII permit ti
,.rl, 15 THIS A
IF Yes, hrhat was the prevlous Ocaupancy Typel _ Ihat ls the i/eu Occupancy Type?
CHANGE OT OC
ARCH DESIGT{ PROFESSIOMI.:
ETIGR DESIGI{ PROFESSIOML;
T P
DESCRIPTIoN oF WoRK: CDTI lrl
h t@d or be\,€ragos Fepar€d or 6on6d h ttts slructurE?Yes
PH:
PH:
Nc RE6 r: oL1qZ?
Nc REG r: -0T3i471
o-l
I inlormati
ls The Prop€rty
2r:O a.
fEdlly or boild0tg wos fclrd to
l€alt 10 (bys Fioa to h€
SO FT
Located ln nre Ftooddarn? E vesp ruo
Stale Euilding Code 6nd s olherappticsbte Srst€
",f,i$?1,S':3#ti',iglj'is,?['EE?8Sg"J,i
0 b-rl srGNAruRE:-/{ V<*+(o!.r!tr)
Nolo: Domolltoo notifcatb.ts & ssbBto€ r.noval p€I|nt appllcafiom aro to be EubrnilEd using dl6 aprllcsdoll torm (DHHS{[ta) vFoul€r tl€
(NESHAP) st (S131107-5950 srconlain Asbaa!6 or not You ars l€qut€d to csl th€I'ladomt Emtsston slendsds for He:,ldo(B Ar polsranB
d€ndilioo ol ary bd[t, or bulld|m. s.6 Asb.rc lt bb s|l6: hflpJ^nvw spt stsrs.nc.us/opyasb€sro€/ah.hp ht n
TOTAL PRoJECT CosT: 26 .o0 BUILDING HEIGHT # OF UNITS:
TOTAL AREA SQ FT o5 SQFTPERFLR: \f OF STORIES;
# OF FLOORS:TOTAL SO FT UNDER ROOF *Of STnUCTURES: \s
ACRES DISTURBED:EXST |-AND DtSTURBtNC peRirrr l-l NO
NEW IMPERVIOUS AREA:SOFT EXISTING IMPERVIOUS AREA
pRopERTy usE: floFFtcE Enrsraunarr lueRcnrnle Erouc n epr flcoNoo OTHER:
WATER: EICFPUA ECOMMUNITYSYSIEM [IWELL _flzoNtNc UsE CLASS|F|CATIoN: _SEWER: [] CFPUA I:ICENIRAL SEPTIC E PRMATE SEPnC E COMMUNITY SYSTEM
...SIPASATEP[RMI]SPEQUIIIEDIOA'LECII'ECHPLAG.GAS€QI]IPP'tEFAESSINSERiS"'
PAYMENT METHoD: flcnsn I cnecx leavrsr-E To NHc) flellenrcet o<rness I ucrusn floscoven
(FOR OFFICE t SE OI{LY) RE1/tsED D^rE,cll/I2
ZONE:_OFFICER:SETBACKS: F:_LH:_ RH:_ B:
Approval:_ Clty:-DATE: FLOOD:
-- -
BFE+2fl=AVN
Comment PERMIT FEE:s
APPLICANT'S t,IA E :
DEVELOPER:
6re.,..| rrJ'. r
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE; COMMERCIAL
PLEASE ANSIiJER ALL QUESTIONS APPLICABTE T0 YOUR PROIECT
"Project Responsibility"
Lt ,.r.c^ €?\, p,.i,L(- (--
!ot+ sq{5
APPLICATION
Number
(office use)
i
PHONE #:
,/'\a
a
PRO]ECT ADDRESS:F e-o*)-f s,C.zIP: Z89C \
PROPERTY OI,JNER'S i,IAME :?UJ 3{d
OI{NERJ S ADDRESS:3
ce L-
CITY:
LICENSE f:
CITY:
'\^-{ i
PHoNE s: lt" e 12.?cYf
sT :441 zrP: 2_F-+.) (
o.
Yes
NEt'' CONSTRUCTTON: E ERECT tet SrnUCrUnr !FAST TRACK
ACCESSORY STRUCTURE:
ACCOUNT #:
ST:IP:
PHoNE #: j 1O Lr >7
PHONE *:
L REPAIRS RELOCATION
IS BLDG SPRINKLERED?fiv"" firo
SHELL UPFIT ADD TO EXIST SIRUCTURE
PRO]ECT CONTACT PERSON:
. lr-lf )
ExrsT coNsTRUcTroN: n ALTERATTO' 6 *rrJifrffi
lf Relocalion. is there a Natural Gas Line on the Current Site? Ll
apply )
GENE RA
El*o
If UPFIT - The Shell Permit #:Is Elect Power on this Building E Yes E ,O
***** rs rHrs A cHAr{GE oF occupaNcy ustt flvts ffiNo *****
IF Yes, uhat rras the Previous Occupancy Type? _ l{hat is the er, Occupancy Type?
ARCH DESIGN PRoFESSIOiTAL i
ENGR DESIGN PROFESSIOML:
€^PHt 1/o-gt z'&'?{llc nrc *,
.PH NC REG #:
DESCRIPTION OF h'ORK: N r\,..--.--9€$,r.-t) - O-LA f_
ls food or beverages p epo,su (r s€rved in ffiis *irarife? [ ves ffi to ls The Propeny Located In The Floodflain? [ ves fr uo
DISCIAIMER: I hereby certfy lhal allrnformalron in
and locallaws and ordinances and reoulatrcns. The
or chanoe in conlraclor or contraclor iilormalion, "'
SubJedlo Frnes lJp To $500.00"'
this applicalon is correct and all work will comply with lhe Stale 8u
NHC Development Services Cenler w l be notified ol anv chanoesNOTE' Any Work Perlormed WO lhe Appropnale Pemits will 6e in
in the approved plan
Violalion of the NC
ilding Code and allother applicable SEtesands
Slate Code
OWNEF/CONTRACTOR:
(ousffer)
r---{- y-)y SIGNATUR
cl€Erolhlon ol any fadllty or buildlng. SAAsbeslo6 Web Stlc:
rorALPRoJEcrco* $ggd -
hnpr/www,epl,state.nc.urepuasbostos/ahmp.hlrnl
BUILDING HEIGHT: # OF UNITS:
WATER:
SEWER:
EECFPUA
CFPUA
T=lcoMMUNrry SYSTEM n WELL ElzoNlNG usE ctAsslFlcATloN:
ficeNrnelseelc f]P-RtvArEsEPTlc flcoMMUNlwSYSTEM
Noter Demolllion mtfcations & asbestos r€anov6l permll appllcslions are io be submltlod uslno th€ appllc€tion (DHHS-3768) wherher th€ lecility or buildng was
conialn Asbe3tos or not You are r€quired to c€ll the Na{onal Emi!:slon Stardrrds lor H6zardous Ar Pollutanrs (ESBAP) at (9'19)707-5950 ar loasr 10 days Fior to fie
TOTAL AREA SO FT # OF STORIES:_
# OF FLOORS:
-
TOTAL SQ FT UNDER ROOF:
-
# OF STRUCTURES
ACRES DISTURBED Exsr LANo DrsruRBrNG pERMrr? E yEs E No
NEW IMPERVIOUS AREA:-SQ FT EXISTING IMPERVIOUS AREA:
pRopERryusE: EoFFlcE Enesnumm fluencmtrtLE leouc [mr f]corloo OTHER:
SO FI
-' SEPARATE PERMITS REQUIRED FOR ELECT. MECH, PLBG, GAS EOUIP. PREFABS I INSERTS "'
pAyMENT METH9D: f]casx lcneCx leevral€ ro NHc) fletu accourr EMc/VlsA I otscoven
(FOR OFFICE USE ONLn FEvlsED DATE telr'12
ZONE:OFFICER:SETBACKS: F:-LH:-RH:B:
Approval:- CitY:- DATE:FLOOD:
-
35E+2fr
N
Comment PERMIT FEE:lnr
DATE: Sl-t )z-o,1'----'---7------
CTTY:
OCCUPANT/BUSINES5 }.IAitE :
CONTRACTOR:
ADDRESS:
EITIAIL ADDRESS:
tr
SO FT PER FLR: _
'.,&,
ck ch,w cff,rA Aot? )'tLtJlJ#
APPLICATION
Number
(Office Use)
NEtl| HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE: COMMERCIAL
PLEASE ANSU]ER ALL QUESTIONS APPLIIABLE TO YOUR PRO]ECT
"Project Respons j.biIity"
APPLICANI'S NAME: .i, t DATE :
DEVELOPER: ..a PHONE #: ': -'-- .: :aaa
PROIECT ADDRESS: 6i6 s. .otlece !.c
PROPERTY OWNER'S NAME: ::rluth C'rlleqe F..ad, LLC
CITY: wr lmrnqt on
OCCUPANT/BUSINESS NAflE: Grr,s, Leldeishrp A.adeny of Wr Lmington
PHONE f:
OWNER'S ADDRESS: t4 -rt pembr.ok,- Jones !r ST: \a ZIP:2ts.r:i5
CONTRACTOR: 'Jh t. r n.l LIC ENSE #: . r: s.l ACCOUNT #:
ADDRESS: p.c. Box 44.11 CITY: wi I mt noron ST: NC ZIP: :8,1 0 6
EMAIL ADDRESS: u.PHONE #:91a-rir3-668d
PROIECT CONTACT PERSON: '-::-c r.,l PHoNE f:9ir-:I1-I8-it
(check AIl That Apply)
EXIST CONSTRUCTION:ALTERATION RENOVATION GENERAL REPAIRS RELOCATION
lf Relocation, is there a Natural Gas Line on the Current Site?tr ves flno IS BLDG SPRINKLERED?I v".I No
NEt^l CoNSTRUCTION:ERECT NEW STRUCTURE FAST TRACK SHELL UPF IT ADD TO EXIST STRUCTURE
ACCESSORY STRUCTURE:
CITY: wrlrnrngton
If UPFIT - The Shell Penmit #:
IF Yes, what was the Previous Occupancy Type?
ARCH DESIGN PROFESSIOi,IAL: Ja\. De.I,eSeIe
'"**i,'* rs THIS A CHANGE OF OCCUeANCv USE? EvES T NO +* ***
Is Elect Power on this Building Yes Eruo
What is the New Occupancy Type?
ENGR DESIGN PROFESSIOTIAL:
PHi 350-0115 NC REG #: -t,t - l
NC RE6 #:
DESCRIPTION 0F WORK: ie:.sraft dr 'h,al l cei I inq tiles
a
carpet and re-open existing corridor
ls food or beverages prepared or served in this structure? [Yes No ls The Property Locsted ln The Ftoodptain? [ ves T No
DISCLAIMER: I hereby certjfy thal all information in lhis application is correcl and all work will comply wilh the Stale Building Code and all other applicable State
and lo(al laws and ordirances and reoulalions The NHC Develoomenl Services Center will be nolrfied ol anv chanoes in lhe aooroved olans and soecrlicationsor change rn (onlractor or contraclor inlormalion. "'NOTE: Any Wo.k Pelormed w/O the Appropnale Permils will b'e in Vrolatron ol lhe NC Stale Bldg Code andSubjecrlo Fines Up To $500 00"'
(Ousmer) (PdntName)
contaln Asb€stos or not. You are requh€d lo call the Nalional Embsioo Standards for Hazardous AIr Pollutanb (NESHAP) al (919)707-5950 at leasl 10 days prior to the
dornolilion of any facility or building. See Asbestos Web Siter ht$:/ xww.epi.state.nc.us/epi/asbe6to€/ahmp.htnl
OWNER/CONTRACTOR: ::, -SIGNATURE:
EXST LAND DISTURBING PERMIT? T-] YES EI NO
SO FT EXISTING IMPERVIOUS AREA:
TOTAL SQ FT UNDER ROOF: I:,:r'15 #OF STRUCTURES: l
ACRES DISTURBED: I,/ A
NEW IMPERVIOUS AREA: ii ,,A
WATER: ZCFPUA
SEWER: i7l CFPUA
ff coMMUNrrY SYSTEM EWELLf] CENTPAL SEPTIC LI PRIVATE SEPTIC
SQ FT
PROPERTY USE: [OrrrCe RESTAURANT MERCANTILE EDUC APT CONDO OTHER: rtoraqe
flzoNrNG usE cLASSrFrcATroN
COMMUNITY SYSTEI\4
PAYMENT I\4ETHOD ficnsrl ficnecx leeveaLE ro NHc) fiaru nccourur !MCA/|SA E DTSCOVER
". SEPARATE PERI\,{ITS REOUIRED FOR ELECT. I\IECH. PLBG, GAS EOUIP, PREFABS & INSERTS "'
(FOR OFFICE USE ONLY) REV|SED DATE 4/11/12
SETBACKS: F:-LH:- RH:- B:ZONE:_OFFICER:
Approval:_ city:- DATE:- FLOOD:
-- -BFE+2ft=-
I
Comment
N
PERMIT FEE: $io-u----
ZIP: :8,1 r
PH:
TOTAL PROJECT COST: -, - BUILDING HEIGHT: -
TOTAL AREA SQ FT : ,: SQ FT PER FLR:
-
# OF UNITS: -
# OF STORIES: r
#OF FLOORS: I
NE[^J HANOVER COUNTY BUILDING PERmfT
ADLOO1 APPLICATION TYPE: RESIDENTIAL
PLEASE ANSI,{ER ALL QUESTIONS APPLI(ABLE TO YOI'R PRO]ECT
"Project Responslbl1ity"
H&H CONSTRUCTOR'S OF EAYETTEVILLE LLC
PROIECT ADDRESS: 1oo4 Adam6 Landi Dri.ve CITY: liI LMINGToN
BLoCK #: 1o 04
,D)+ 71,/
APPLICATION
Number
(office use)
APPLICANTJS N/IIVIE:
DEVELOPER:PHONE #:
ZIP | 2s412
SUBDIVISTON: Adams Landinq
PROPERTY OI4INER,S NAME: H&H CONSTRUCTORS OT PAYETTEVII,LE, LLC
ONNER'S ADDRESS: 8209 Market streea suite c CITY: wi lminqLon ST: NC ZIP: 2 8411
CONTRACTOR: H&H CONSTRUCTORS OF FAYETTEVILLE, ttc
ADDRESS: 8209 Market streeL, suite C
LIcENSE #: 7,r 1s I
CITY: wILMINGTON 5T: NC ZIP: 2 8411
PHONE *: 910 -219-148s
pROIECT CONTACT PERSON: JJ Brennius PHONE #: 91o 219 1485
EXISTING CONSTRUCTION:ALTERATION R ENOVATION GENERAL REPAIRS RE LOCATION
NEI^J CONSTRUCTION:M ERECT NEI^] RESIDENCE OT ADDITION TO EXISTING RESIDENCE
**PLEASE CHECK AND ANSIIER BELohl ALL THAT APPLY T0 YoUR PROIE€T:
LoT *: oo1
ATT GARAGE 425 SF
SUNROOM SF
DET GARAGE
-
SF PoRCH 1e2 SF
STORAGE SHED SFP00L _ sF
DECK 5FGR E ENHOUS E SF
TOTAL HEATED SQ F'l i 2452
TOTAL PROI ECT COST tress t-oo : $a4o ,493
OTHE R:
TOTAL SQ FT UNDER RoOF: io6e TOTAL AREA SQ FT: 1e7e
S OF STORIES: 2
Is Any ELECTRICAL, PLUIiIBING on IiIECIIANICAL Work Being Done to the Accessony Structure?
If the project is a Relocation, is there a Natural Gas Line on the curnent site? [ves No
Yes I No
Is there Electrica] Power on this Building?
pRopERTy usE / occuPANcYr E] sruele rnmrrv
T ves fino
DUPLEX N TOWNHOUSE
DESCRIPTION OF hJORK:S]NGLE FAI'IILY DWELLING
and ordinances and rsgulatons. The NHC Dev€lopm€nt Services C.entsr willbe noijfred of any changes in 8)e appro\ied plans md specllicallons or chaoge ln contacirr or
conractirr info,m6ton. .,.NOTE: AnyWork Perlormod w/O he ApproprlaE P€rmils will be ln Vlolation of lhe NC SlaE Bldg Code and Subiecl to Flnes lJp To $500.00"'
OWNER/CONTRACTOR:,fJ Brenninq SIGNATURE:
* * * * r( * * * ,t + ,* ,r ,i ,i * ,r. * * * * * + * * * + {* * 'i * * * {. il)t,t*:**r.**+*,tt+,i**{(:t*t(i(**tr(*i(,t()*,4,***+**x,i(1**+*****+rt**+**
IS THE PROPERTY LOCATED IN A FLOODPLAIN? N YES T NO
EXISTING IMPERVIOUS AREA:SQ FT ToTAL ACRES DISTURBED: . rs
EXIST LAND DISTURB:NG PERMIT:T
[/,,ATER: Z CFPUA
sewrn: I creun
COMMUNITY SYSTEM
NEt,l IMPERVIOUS AREA: 2521 SQ FT YEs f-l No
(fOR OFFICE USE ONLY) REVISET} DATE O4l1U12
SETBACKS: F:- LH:- RH:- B:-
L-] CENTRAL SEPTIC I I PR
PRIVATE l^]E LL
IVATE SEPTIC
CENTRAL h,ELL AOUA <tl 4ntl
COMI'IUNITY SYSTEI'I AOUA Y I )." ,
*** SEPARATE PERI'4ITs REqJIREO FOR ELE'T, I4ECH, PL8G, GAS EqJIP, PREFABS & IIISERTS **T
pAy ENr r,1ErHoD: I cmn I cxrc( (PAYABLE ro NHc) E Al.tEircAN ExPREss fl r'rc/vrsr I orscorrn
iB *** * ** *,* )* r* )B'F:!:t *tx * +*i. + ++* t* * + *** i(:f * )i +,* *i. *,t** + * + +t ** * l.:1.,t ti:i(* )*t*,t** *'*:* * ** I *'. ***:l it* * 't'i'** r'*
ZoNE; _ 0F F ICE R:
Approval:- City:- DATE:- FLOOD:
-_
BFE+2ft=avt{
I
itu
I
I
DATEI 02/23/20t'7
PHoNE #: 910 - 219 - 1.18 s
EI4AIL ADDRESS: i uf icaf ferty@hhhomes . com/ JerryBrenninq@hhhomes . dom
SF
NEW HANOVER COUNTY BUILDING PERIYIIT
APPaCATIO t rYPf,; RESIDENTIAL
PLIASE ANSUJER ALL QUESTIONS APPLICABLE TO YUJR PRO]ECT
"Project Responsibillty"
APPLICANT's NAIiIE: NorLb State ?artners Consrructioa LLC
DEVELOPER:
PRoIECT AmRESS: 1016 srrikirq rs1 and Drjve CITY: 14l Lminqron
SUBDMSION: Aucunur ;{a1i BLOCK #:
C&NER'S AmRESS: 1015 srrikl:rq 16 land Drrve CITY:wi lminoton
LICETISE #: ?0046
ADDRESS: P. o. Box 3s9
A0)+-n1a,
tffi35
APPLICATIO$I
Number
(office Use)
DATEi 3/t't/2ot'7
PHONE #:
zIP : 29!9L
LOI s: 1s6
sT: JS_ zIP: 28480
Et',lAIL ADDRESS : of f j.ce@nolthsiatecustombuilders - corh PIO{iIE t: 910,200,e174
PROIECT COiITACT PERSoN: .j]'n r.risenan PlloilE f: 9aa - 442-is7 4
EXIsTIN6 CONSTRUCTION:ALIER,AIION RENOVATION GENERAL REPAIRS RE LOCATION
NE!,r CONSTRUCTTON: I rnrCr NE RESIDENCE o" I nOOtTrOr TO EXTSTTNG RESIDENCE
**PLEASE CHECI( AllD ANSI]ER EELOW ALL THAT APPLY TO YoUR PRoIECT:
CITY: wrighLsvalle tseach
sT: Iq zIP; 28403
SF
ATT GARAGE
suNRooM _ 5F
GREENHOUSE
DET GARAGE _ SF
Poot _ sF
SF
PoRcH l:!_ sF
STORAGE SHED SF
DECK SF OTHER:
TOTAL HEATED SQ FT: ra82
T0TAL PROIECT COST ress r-or) : $ eaqooo # 0F STORIES 3 2
15 Any ELECTRICAL, PLUII{8ING or |4ECSAI.IICAL Work Eelng Done to the Ac(essory Structure? ffi VeS fl lo
If the project i.s a Relocation, is there a Natural 6as Line on the Current Site? [ ves [ ruo
Is thene Electrical Power on this Building? llJv"t Ilro
PROPERTY USE ,/ OCCUPANCY:SINGLE FAMILY DUP LEX TOI^,NHOUSE
DESCRIPTION 0F WORK: consrucE s14qle aanily Resj.dence
DISCIAIMER: lhereby cerrit hal all inbrmation in his applicadon h corect and all work w llcomply wih he Slal€ Building Cod6 and all otler appl le Stats and
and ord inances and rogule tions The N H C Dewlopmea I Se rvic€s Cen lE, will be notfied of aiiy changes in he appoved plan s and
conracbr inbmarion. "'NoTE AnyWork Perromed w/0 he Appropria? Permirs willbe i|l Viohuon otlhe NC SIEE Eldg Cod6 0c"'
Ol,,NER/CONTRACTOR: ;im wi seman SIGNATURE :
IS THE PROPERTY LOCATED TN A FLOODPLAIN?YES I NO
EXISTING II4PERVIOUS AREA: <racre SQ FT TOTAL ACRES DISTURBED: . rac.e
ItlEl,,l ItilPERVIflrs aREA: slqgga- 5Q FT ExIsT LAttlo DISTURBING PERMIT: rf YEs m [o
r,rATER: u] cFpuA n comyuNrrY sYsrEl4 n PRrvArE WELL I crrurRnr urll
sEr,rER: m CFPUA E cENTRAL sEPTrc I cnrvarr sEprrc f] cot'tfiuNrry sYsrEM
},* SEPAIIATE PERIiIITS REQUIRED FOR ELECT, IilECH, PL8G, GAS EQUIP, PREFABS & I}ISERTS ***
pAyrrtENT ETHoDT Icos* f]crrcx (PAYABLE ro Ntr) n Ar.rERrcAtl ExpREss D aczt rto ff orsco,t.
* * x(:t *,*:* *,*** i(*,** **** ** * ***,i,** !*,* **)* * * )*,t **)*+ r**r** * '*+ t'l:t)a*r()i* 't:* * * ** 'l'**** ':i 'l' +)r'f *'l' *t'i* +'**" )r*** )k*
(aoR orFrcE llsE oNLY) REVTSEO OArl 04/11/12
ZONE:
Approval:
F:- LH:- RH:- B:-
: BFE+2ft
t;
Cornnent:
OFFICER
cit v:DATE:
SETBACKS:
FLOOD
PERMIT FEE: ${t-,t+c
PROPERW O|^INER'5 NAUE: Michael. and Robbie pooie PHoNE f:
CONTRACTOR: Norih stat.e Partners consLrucclon, Ltc
TOTAL SQ FT UNDER ROOF: 4::-. TOTAL AREA SQ FT: a82?
AP PLICA'{IT' S M}1[I
DEVELOPER:
PROJECT ADDN
SUBDIWSIONT
NEId HANOVER COUNTY BUIIDING PERMII
CIry:
BLoC( *
aot+- 27rtS
AppEcllTro[
l&r6en
(Offl3. U.c)
pRoPErry olniER,s Ml{El
O{.INER'S ADDRISS:
CONIftACTOB,
AODNESS:
EMTL ADDRESS:
moJECf Co[fA€I PEflsO r
CITY:
IICEN5E }:
CITY:tA
DATE:
Plio E s,
:, , LoT tr
.-sF
5F
ptm[,E
ACCOIINT S:
ZIP
PHOI\IE
'I!nwtE *:qWAgzfrAL
* h4'qbAlqD
sr| Nlzr?l4.&48
E0srriE cofisTrucEoN. n ALTFnATToN I nanvenor I e ae ul nepuu. E RElOcArro],
EU C0t6TStETI0iti ffrucr lrfll R[srDEi,cE or E aoorrrfut m EGsTJlXi RESIDE{CE
.tpLEAsr cHtc( {to ats fu !E[oH I,L TR r AppLy lo ydJR pioJtcr:
flarr emear t]*.Q sr
I suuroo.r _gFI onrauu-tsE _ sr
ff orr cmme .- sr ! noncu ,137 tf] pool-- sr ' I sromae slro
florcx
ToT L HEATED Sq n, Atlf TOIAL SO FT UNDET YOTAL AREA SQ FT:<Q*4
rorAl PnolEcr cosrroi,r , s ,Q5&r)# oF sronrEs: A,
PROPERIY IlsE / OCCUPA{CYI LY Iul*a :Iron*wse
DESCNIPTION OF TOh(:
s t j,iqE i 7 12:i6Pll
ls AIIy ELECTRICT&, PLU,IBI c o|' ,{Ecl IICIL }r,o* ,.lirg Don to.tho A.c.6rory Structurof [Vet f] loIf the prcJect is a Reldcatlopl is there a Natural 6as Line on the Crirrent sf{re? EIG E N"
rs there ELectricat pqxen on thts Bulldtng! IlJyes f]uo ..
0IJNER/CoNInllcroR:SIGMTURE !
. rr. *.r r. +r' rr++r*rrr*t** rfiTllifl l*r*tt*l.l****t+*i}*}'**t*a**tt*tt****)rttlr*
rs rrE pftopERTy LocarED xrl l nooolrarur I vrs E[ wo "rb
EXISTTUG lltplnw0t6 ARE^! _S0 FI IOTAL.ACBES
'I5TURbEDTNEll lj{pEmrldjs ,REAi _sQ Fr E(r5T LAto DrsruiBr}lc rrotrr: ff ws I lr
MIER; I crpun I cdf{Jr,trT? sysrrm f] enrvrre HEr|n cE fiRAL HELL
sEr,lER: I crrue I clinru srp,r"rc E pRruArE sprrc f] co,r+}nly sYsTB.r
..! sE?utTE,PER[Ts BEq.'IIEO rm ELECT,
't€Cfl.
PLt9] sA:t EQUTP, PRIFI3S & rIEElTs '.rpAy,{rn }lErnoDr E qrsn E.nr.t (pAyaELt ro mr; f] arll cccrrr f,] rcTwsl ffo:sconntiriltata*r*rt*i,**a*ralt+t'ttltr:ttit*tr*ra;rit.titllat*tsatnt*t+i,ttar.taittt,talr*ar***ai*l
Cc>)
,aX
(tot otz<l u5! adaY)
siiEAcKsi F:
t€l?s., ol.ra o4lrtlu
zoive:oFtIcsn;
App,:oval i----fdL- cl
+( u:$-ffi:* a
FLo@r _
,+_
BFE+Lft
,i^r,.on4*-,=-./nlfor' rrr,'02-
*6nl gtttctulcs ft0.
adftnant
DATE
eily inssctio{r flqureo, 9l$2514tr0
APPtacfitd.t rypE; RESfDENIfAL
plElsE rM* lu. qJEsrIrDs ,,pLICtEtE TO lolri piol€cr
?roJect nesporE$fBq/
3tr
N\U
+#+
NEW HANOVER COUNTY BUITDING PERMIT
APPLI CAT I ON rYPE: RESIDENTIAL
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROJECT
"Proiect Responsibilitt/'
eo4 27v1
Application
Number
(office use)
APPLICANT'S NAMEI \
4l-/ta Zl?
3-t)- Lnt-lDate
PROJECT ADDRESS:
suBDtvtstoN:
b>.u,
(-
CITY Li,,1 ,u, A
L,,
\
1' S laire
tdt *;\
PHoNEtr: I rt - t:' 4'4: - 2/< 1.
Crfl li . t)tr t'tx i>,'
PROPERTY OWNER'S NAME:<-
OWNER'S ADDRESS: /l ztp: 2-t', I t
.1
CONTRACTOR BLDG LIC€NSE f
ADDRESS:I
EMAIT AODRESS:
PROJECT CONTACT PERSON
/CITY: L ST: lV!- ZIP 2e ,i/
PHONE:<) r ..'6,{dr'2//1
: *tuf.i s,YiEAi-*'PHONE: i, l'()z{ 6:.* l-l t, (.
n Greenhouse (SF)_! Deck (sF)
ls the proposed work changing the existing footprint? f] Yes I No
TOTAT5Q FT UNDERROOF {for propased work) Heale& ?)?d
E other (sF) (:,{,(i}.,'L?
fi- cra r
i L^ 2lt
fitr- IPhDsS
Unheated:
TOTAL PROJECT COST (Less Lot): S
lsthe proposedworkchangingthe numberof bedrooms? D yes N t'lo
ls any Electrical, Plumbing or Mechanlcal work being done to the Accessory Structure El.'fes fl No
lftheprojectisa Relocation, is therea Natural Gas Line on the current site? E yes El No
ls there ElectricalPower on this Building? BI Yes E t'lo
Property Use/ occupancy: E Single Family E DuplexE Townhouse
ion of Work:'t lt,<..a lYl o// .<'r I t
til ec LUI-/vy,nbin
ldws and ordinances and regulations. Tha NHC Development Services Center will be notified of anychanges in the approved plans and specmcations or change;n contmctor
information. a"NOTt: Any wo.kperfo without the appropriate permits will be in violation o, the NC State BldB Code and subject to fines up to 950O.0O...
Owner/Contractor:Signature:
'-(
"LicenseC QuoIiIier"j-r1'Y!P nt Nome:zii*):rv
ls the froperty located in a floodplain? E Yes trl No l
Existing lmpervious Area: _ 5q Ft TotalAcresDisturbed: tVd rt ::
New lmperyious Area:
-
sq Ft ExistinB land Disturbing Permit: E yes E ttto
WATER: P'CFPUA fl community system E Private well E central well E Aqua
SEWER: ID CFPUA D community system E Private septic E central septic n Aqua
zone:
-
officer:
--
setbacks (F)
-
(LH)
-
(RH)
-
(B)
-Approval:
-
city:
-
Date:
-
Flood: (A)
-
(V)
-
(N)
-
BFE+2ft=
-
y'.-___
Comment:
N A /4'l Lc/l /,v/ . H L
Permit Fee: S
?t'/ t,
ttl i I
EXISTING CONSTRUCIION; 6] Alteration E Reno\rdtion E General Repairs
NEW CONSTRUCTION: D Erect New Residence E Addition to Existing Residence ! Relocation
...PLEASE CHECI( AND AI{SWER BELOW ALL THAT APPLY TO YOUR PROJECT*'*
! AttGaraBe(SF)_ E Detcarage (SF) [ porch(SF)_
n Sunroom (SF)_ D poot (SF)_ D Storage Shed (SF)_
+5-
NEW HANOVER COUNTY BUILDING PERMIT
APPLICArIOI'I IYPE; RESIDENTIAL
PLEASE ANSHER ALL QUESTIONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibility"
! eoor- _ sr
20r+2?s3
APPLICATION
Numben
(office use)
APPLICANT'S NAIiIE:
DEVELOPER:
Haqood Homes
PIONE #:
PRO]ECT ADDRESS:1910 London Lane
SUBDIVISION: Laidta;1 BLOCK #:LOT #: l!__
PROPERW OI'INER'S I,A E:,foe 1 and Pat.sy Aiken PIONE #: 91a-2s6 6131
5T: NC zIP: 28403OI.INER, S ADDRESS:72oa cray Gables Ln CITY: wilminqton
C0NTRACTOR: Hasood Homes LICENSE *: 16868
ADDRESS: Po Box 116 9 CITY: wriqhtsvifl.e Beach sT: Ig_ zrP: 2g3gq
EIi,IAIL ADDRESS: ki rbytiaha dhomes . com PTPNE #: s1o -2s6 - a2s4
PRO]ECT CONTACT PERSON:Steve Moore PHONE #: e7a 212 '/a32
EXISTING CONSTRUCTION:ALTE RATION ! Rrlovlnoru [ ctntnnr nrenrRs ! RELocArroN
NEW CONSTRUCTTOU: I rneCr NE RESTDENCE o" ! aOOrrrOl TO EXTSTTNG RESTDENCE
*IPLEASE CHECK AT{D AI{SWER EELOW ALL THAT APPLY TO YOUR PRO]ECT:
ATT GARAGE 714 SF DET GARAGE 5F PoRCH j3!_ sF
STORAGE SHED
DATE: 3-23 77
SUNROOM 363 5F
! cnrrrunousr
-
sF DE CK SF OTHE R:
TOTAL HEATED SQ FT: :e:e TOTAL SQ FT UNDER ROOF: l!f:- TOTAL AREA 5Q FT: so32
DESCRIPTIoN 0F IJoRK:New Construct ion Sinqle Family Residence
SF
SF
DtscLAtMER I hereby certify hal alt nt rmation in tlas applicatron is correcl and ellwork willcomplywift he state Burlding
and ordinances and regutaiions. The NHC Oevelopmeni SeNices C.enErwillDe noijned ofany changes in lhe apprcved plan
contacbr inlormaton. ,-NOTET Any Work Performed wo lhe ApprcpriaE Permilswill be in violation oflhe NC slaE Bldg ro $50O.0r"
SIGNATURE :
LY) flEVTSED oATE O4l11/12
1Y r-n:# nH,Y a,*
BFE+
Code and allourer applicable StaE and local laws
s and specifications or change in conractcror
OWNER/CONT RACT0R: Haqood Homes, Inc
IS THE PROPERTY LOCATED IN I TIOOONUTUI I VTS E TTO
EXISTIiIG IMPERVIOLS AREA:
-SQ
FT TOTAL ACRES DISTURBED: 44
NEr.l It4pERvIoUs AREA: llgl-- sQ Fr Exlsr LAND DTsTURBTNG pennrT: ll'l vrs I r'n
(Print tlane)
:* )*,** **)* )**{r+ )* r( ,1.,t * * x, ,1. **l *x*+{a+**{.*+x*x.i( +,t ,* * )t )t *,1. * )* )t *)t*+:t)t* * +*,t r**r( )*,t,t* *,.,t * +* *)*t r. + *,* )* * * )t,t ,t +
HATER :CF PUA COIV]IVIUNITY SYSTEM PRIVATE I^]E LL CENTRAL l^lE L L
SEWER: fl CFPUA E CENTRAL SEPTIC
X* * SEPARATE PERI'IITS REqUIR
PAY EMT ETHoD: I cnsn [ orrcr
*{.:t*,*** r(it)** )*:i* '* * x'**:t*'} **d(+ + * 't:} +
! enrvnrr sEprrc E coMMUNrrY ttilfty insectron Requreo gtt]2od-fi ,
ED FOR ELECT, I'IECH, PL8G, GAs EqJIP, PREFABS & INSERTS *
(PAYABLE ro ttrc1 fl olenrcm exenrss Ll r'rc/vrsa l-l orscovsn
**:t*)t)*+)***:i)t***,t)t{(+)i****)*'l'***+:i)i*++ji*d(+:t**'}t:t*'t't++)*'t++**'*
ZONE
Appn
,?.Io oFFrcER: {lw .'^"t-'/,:il':}
N
Coflne nt: X /t4,,1,1/t/PERMIT FEE:7L
CITY: wrlmi nqLon ZIP: 28405
TOTAL PROJECT COST (ress ror) : $ ezosos # OF SToRIES:
Is Any ELECTRICAL, PLUl,lBIl,lG or ITECHANICAL l,lork Being Done to the Accessory Structure? [ V"s I fo
If the pnoject is a Relocation, is there a Natunal Gas Line on the Cunrent Site? [ ves I lo
rs there Electrical Power on this Building?[v"t [l lo
PRoPERTY USE / OCCUPAI\ICY: I Srrcrt rnmrlv ! ouelex f] rol,lNHousE
LT1 NEW HANOVER COUNW BUILDING PERMIT
APPLICATION |YPE : RESIDENflAI
PLEASE ANSWER AI.[ qUESTIONS APPLICABLE TO YOUR PROJECT
'Projesf R6ponsibllt/
)art Msy
Appli@tlon
Number
(ofiice urc)
/t'/
tt
AppLtCANT,s NAME: F.S., L.L.C. dba RamJack 621s 31222017
pRoJEcT ADDRES9: 3421 Bragg Orive g1n, Wilmington NC 71e. 28409
SUBDIVISI oN: Pine Valley PARID R06611{04-007-000 191 6; 707
owNER,s ADDRESS: 3421 Bragg Drive clTy: Wilmington NC y1p. 28409
G6NTRACToR: F.S., L.L.C. dba RamJack 9196 Ugsx56 s. 53778
1ggjg55; 4'122 Bennett Memorial Road suite 3O4
EMAI. ADDREss: charlie@ramiackusa.com pgg11g; 919-309-9727
pROJECT CONTACT pERSON: Chadia Lewis prOtr: 91$309-9727
ExEflt{G COI{STRUCflOI{: E Alteration E Renovation {General Regairs
NEW CONSIRUCIIOT{: E Erect New Residence E Addition to ExistinS Residence U Relocation
aar aaa
E Att Garage (5F)- E Det Garage (sF)- D Porch (sF)
D storage Shed (5F)_tr Sunroom (sF)_
E Greenhous€ (SF)
-
! Pool (SF)
tr Deck (SF)D orher {5F)
ls the proposed work changing the existing footprint? fl ves Edo
TOTAT SQ FT UNDER ROOI Uor proposed work) Heeted:
TOTAT PROJECT cosT (Less Lot): $5100
ls the proposed work changing the number of bedrooms? tr ves ffi'
ls any Electrical, Plumbing or Mechanical work being done to the Accessory St.ucture E Yes
lf the proiect is a Relocatlon, is there a Naturaj,,lsas Line on the current site? C Yes El4o
ls there €lectricat Power on this Bullding? ts'Yes tr l,lo
{*
Property Us€/ Occupancy: E Single Famlly D Duplex tr Townhouse
Descrlption of Work:install helical piers to stabilize foundation as desiqned by structural enqineer
DlSCLAlMEn: I her€by certifo that allthe informetion ih thrs appticataon b correct and ellwo* will comply wlth the St.te aulblnS Code and all other applicabl€ State and local
laws and ordinances and retulationa The NHc oevelopment services centerwifi be noufied oI any dl.n8.s in the app.ored plans and specificatlons orchanSe ln contractor
information. "'NOTE: Any work performed Yrithout the appmpriate permit5 will be in violatbn of the Nc up to S5(}0.0o"'
Owner/Contractn Chaliis Lewis Sa3It ture
"Licensed Quolifrer" Prlnt Nome
tsthe propertylocated ln afloodplaln? E Ycs E to
ExlstinS lmpewious Area:
-
Sq R Total Acres Disturbed:
l{ew lmpervious Area:Sq tt Exlstlng Land Olnu.blng P€rmlt O Yes E No
WATER: E CFPUA E communaty System E Private Well E Centralwell El aqua
SEWER: tr CFPUA E Community svstem E Private Septic E centralseptic E lqua
Zone:
-
Officer:
-
Sctbacks (Fl
-
ltH,
-
(RHl
-
(B)
-Approv.l:
--
clty:
-
Date:
-
Flood: lAl
-
(v)
-
(Nl
-
BFET2G
-Comment:Permit Fee: S Ss-
!
ffi
Wffi
pRopERTy owttER,s NAME: Rob€rt Jenski ptotr t: 910-799-1875
gTy; Durham g; NC 11p.27705
Unheated:
En'"r'frt\eCi ]?)otT-)1*
APPLICATION
Number
(office Use)
ON
*e NEW HANOVER COUNTY BUILDING PERMTT
aPPLICATIoN ryPEr COHMERCIAL
PLETSE ANS|{ER A!L QUESiIONS App!ICASLa TO VOUR PRCIECT
"Project Responsibility,,
i;i
APPLfCANT'5 NAI1E
DEVELOPER;
al::i:J:Il a.t::!DATE I C-1/23/2a.-.-
PHONE #:
PRorEcr ADoREss: .4t2. 5 Z a9r .tYv. .l-.., ' .-..ZIP|2ai:'_
0CCUPANI/BUSfNESS NAflE: ::.j'ria::r ::'js: a:l ;.::- :,:a!.1r;::
PROpERTY olrNER,S NAIiE: ]'-:.i::: .;::: rtia: a:.::::i:::.;
OI^INER'S ADDRESS: ; : :air! :i-- s
PIIONE #: 9'.a-- a2-a-.e 2
CONTRACTOR: ::.r:s i:ir .i:a:
cITY:;i.L:{::"cr}''5TI \: ZIP:::;':
ST: ., r ZIP: :6..: I l
LICENSE f: :,a:i
CITY: .'.:::.: r::::lADDRESS: r::6 :nS:r: :.r,/):a ial.l
EMAI L ADDRESS : : :a:a:r.::.)i:.:!3..i :i:::s;t: : a::: :. :l:PHONE #; '': a- j- -:;'t:
PROJECT CONTACT PERSON: ]-Tz !:::Z PHoNE #: a - ^ -:- --.- :.. -
( che< k ali rhat aooty)
EXIST CONSTRUCTION:ALTERATION R ENOVATION GENERAL REPAlRS RELOCATION
f Relocation, is there a Natural Gas Line on the Current Stte?tr Yes I No IS BLDG SPRINKLERED?I ves r No
NEI,J CONSTRUCTION:I enecr new sraucruae !FAST TRACK SHELL UPFIT ADD TO EXIST STRUCTURE
ACCESSORY STRUCTURE:
If UPFIT - The Shell Penmit #Is Elect Power on this Bui.lding I Yes ff *o
****. IS THIS A cltrANGEIF Yes, what was the Paevious Occupancy Type?
oF occuPANCy usrr I vrs I
|./hat is the New Occupan.y Type?
ARCH DESIGN PROFESSIONAL:
ENGR DESI6N PROFESSIOIi,AL:
PH NC REG #:
NC REG $:PT
DESCRIPT]ON OF I^IORK: ial:j !.:?t.i::!::):: -. ?.,f{r., \
ls food or beverages prepared or served in this stnraure? fives [ ruo
DISCLAIMER: I hereby cemty lhat all lnlormaton in rhrs applicar on is co.red end a[ worka-d rocarraws a.d o.d rances and .equiar ons. Tte \-ic Devetoo.re.r serurces center wo. c'dnge n conrractor or contraclor info.m.tion "'\OTE. A.! Work Peno.med W O lhesu5leci ro F'nes up To 5500.00'-
OWNEFYCONTRACTOR: P,::j .c:.Y
ls The Property Located ln The Floodptatn? E yes
.NC SI
will comply with the Slate Buildins Cod allolher applica le Staie
S-3768) whether tho or building was found 1o
at (919)707-5950
# OF UNITS
SIGNATURE(Ooa!td) (trlm NrE)
Not€: O€molitioo notjfcalions 8 asbencs r€rnovat permit appti=tjoos a.€ to be suomittod rlsino tD applicatjon brm {OHH
cootain Asb€slos or not Yo! are r€quired to call the Natiooat Emission Stardads for k:ardors Aj. po utants (NESHAP)
de olilion o, any hdlity or bi,ildin!. S€€ Asb6tos Wsb Silq hilpJlrww. spi.slats. nc. usJepi/asb€stotahmp.hhl
TOTAL PROJECT COST: s22,.:.
TOTAL AREA SQ FT : :: : ]
BUILDING HEIGHT
SQ FT PER FLR:
TOTAL SO FT UNDER ROOF
ACRES DISTURBED:EXSr LAND DrsruRBrNG pERN4rrr I ves I r'ro
NEW IMPERVIOUS AREA:SO FT EXISTING II.IPERVIOUS AREA:
PROPERTY USE:FFICE RESTAURANT lurncmrle lrouc [enr f]CONDO OTHER: r.rlr::
DzoNrNG usE CLASSTFTCATTON:
fl coMMUNTTY SYSTEM
WATER: EbFPUA
SEWER: El CFPUA
'"s
PAYMENT METHOD:
E COMMUNITYSYSTEM T-"IWELL
cENTRAL sEPTrc I e-nvere seerc
AV
a^--o^t
flcesx [cHecK (eAvABLE To NHc) flmrrnrcau EXeRESS fi ncnrrsn E orscoven
(FOR OFFICE USE ONL'REVISED OATErulln2
ZONE:OFFICER:SETBACKS: F:-LH:- RH:- B:
Approval:- City:-DATE:- FLOOD:
---
BFE+2ft=
I
# OF STORIES:_
# OF FLOORS:-# OF STRUCTURES:
J.**,r..., r-l-0D-
I
APPLICATION
Number
(office Use)
N NEW HANOVER COIJNTY BUILDING PERIIiIIT
APPLIcATIott rYPe: RESIDEI{TIAL
PLEASE ANSWER ALL QUESTIONS APPLICABLE IO YOUR PRO]ECT
"Project Responsibility"
APPLICANT,,S llAlrl€ : Coascal Home Corporation DATE: 3 L
DEVELOPER:PIONE *: e 10-200 3344
PROIECT ADDRESS: ?44 Tuscan way CITY: wilminqton ZIP:28411
SUBDMSION: Be1la sera BLOCK #:LOT *: 8
OWNER'S ADDRESS: 2030 Eastwood Road, ste 5 CITY: wilmlngton ST: NC ZIP: 28403
CONTRACTOR: coastal Home Corporation LICEi,ISE *: 76 s73
ADDRESS: 2o3o Eastwood Road Ste 5 CITY: wilninqton ST: I9_ ZIP: 28403
El'lAIL ADDRESS: dweldon@coastalhoneco. com PHONE f: e1o-2oo-3344
PRoIECT CONTACT PERSON: Dan weldon PK)NE f: 910-2oo 3144
EXrSTrr'rG CONSTRUCTTON: f| nrrenaTlOr ! nrHovnrror GENERAL REPAIRS RE LOCATION
NEW CONSTRUCTIOru: I eneCr I{EH RESIDENCE o" ! eOOrrrOt TO EXISTING RESTDENCE
{.*PLEASE CHECK AI{D AJ'ISI{ER BELO.I ALL Tll,tT APPLY TO YOIIR PROJECT:
I orr cauee sF E PoRcH rss sF
I oecx SF OTHER:SF
TOTAL HEATEO SQ TOTAL 5Q FT UNDER ROOF: 2e52 TOTAL AREA SQ FT: :z;s
TOTAL PROIECT COST tr."" roO : $ r:sooo f OF STORIES: 2
Is Any ELECTRfCAL, PLUllEIilc or ECIIAI{ICAL work Being Done to the Accessory structure? f] V"r I Ho
If the project is a Relocation, is there a Naturat Gas Line on the Current Site? fl Ves I to
Is there Electrical Power on this Building? flves l-l no
PROPERW USE / OCCUPAT{CY, I SrUClr FAMTLY E DUPLEX
DESCRIPTIO{ OF HOR(: New Home construction
TOWNHOUSE
L5-ooE
ATT GARAGE 470 SF
suNRooM _sF
GREENHOUSE SF
af:2fia
DISCLAIMER: I hereby cenify lhat all inbrmation in his applicaton is conect and allwork will
and ordinances and regulalbns. The NHC De!€lopmenl Services Cenler will be nolifed ofan
cofilaclrr inbrmai,on. '_NOTE:Any Work Perbrrned W/O he AppropraE Petmils wilr be in
complywith tle State BuiEing Code and allober applicable SlaE and locallaws
ychanges ln the approved plans and specifications orchange in contracttror
Violation ofrhe NC StaE Bldg Code and Subircl b Fines Up To $500.00"
5TGNATURE: l)c.^- \^) a,le--OWNER/CONTRACTOR: Dan weldon
IS THE PROPERTY LOCATED IiI A FLOODPLAII{?
EXISTII{G II'IPERVIOUS AREA:
-SQ
FT
NEI.I IMPERVIOUS AREA: 3276 SQ FT
YES a NO
TOTAL ACRES DISTURBED: ,25
I NO
(FOR OralCE USE ON[Y) RtvrsED DATE 04111112
SETBACKS: F:- LH: RH:- B:-
_ BFE+2ft
t{
PERMIT FEE: $
(P.lnt riame* *,t 't,t,1. * a.:a** )****,*,1*+ )t**,*,8)t* )+,|*:+ +*:t*] ** ** ** **** *** *{.** **)t* r.)t* )* )t* + + )*:r. {.:a r. *,* * )i * *)*)i* **)t* *)i*,r *r(E
EXIST LArD DISTURBTNG PERI4IT: E YES
WATER:cFpuA ! collr4uNrw sYsrEM E PRrvarE WELL ! crNrul well
sEr{ER: E CFPUA E CENTRAL SEPTTC ! enrvarr sEprrc E coMMUNrrY sYsrEM
* *r. SEPARATE PERI'I
PAYIiETT iETlOo: E a*,T
REQUIRED FOR ELECT, I4ECH, PL8G, GAS EQUIP, PREFAES & INSERTS
crrcx (plvmr-t m t*rc) f] arERrcAt{ ExPRGss f] tclrrso ! orscovtn
ITS
**)i )* ,t *,t ***,* *,t*,i *,t*)t )*X* *,t** )t,**+ *** **** +*,i* ***,* **)t )t+** )* )tx******* r.,1' * + '* **)** +*1'**** 'k***:**** r* )*
ZONE:OFFICER:
Approval:- CitY:- DATE:- FLoOD:
comment:
{r53-
A,ory- 2458
PROPERTY OI'INER'S MitE: coastal Home Corporation PIONE *: 9aa-2oo-3344
! eoor- _ sr ! sronace SHED _ sF
APPLICANT,S iAt'tE:
DEVELOPER:
Pel.r
NEW HANOVER COUNTY BUILDING PERMIT
APPL,UTION TYPE.. RESIDENTIAL
PLEASE ANSN]ER ALL QUE5TIONS APPLICAALE TO YOUR PRO]ECT
"Proj ect Responsibiliqr,-
Jon- ?_qb+
APPLICATION
Nrmber
(Otfice Us€)
oAT* 07-ln- / 2
Pt0{E #: q t0 - 7)-g ?oj'/PRO]ECT ADDRESS:
SUBDIVISIONT
lb CIW: Lv.t'lzu..ti>tt A/,L ZaP: > ?dto /
proNE *: 1ro - 4iS - 3 tq
sr:. _zIP | -Zk3o i
ACCOUNT #:
BLOCK #; LOT *: -
PROPERW O}]NER'S MTIE:
Or/'INER'S ADDRESS: /C / I q
C h,-z,L d s/CITY: /.r.',/">2- l/L
CONTRACTOR:
ADDRESS: 4
EIiTAf,L ADDRESS: f)I*c
1<r ti lt;q,n
t;h a LICEI6 E #:cfTy: i-,.; lr>_,ST: _ ZIP: _/q )t 7 a €Entn: t - co.z.-7 PHONE #:
PRO]ECT CONTACT PERSON:PHONE #:
EXrsTrr{G coNsTRUCl-roN: I alrenarroru p[.Reuovarrou I oeueu,l aeearas RELOCATION
NEh., CON5TRUCTIOTI. I ERICT NE!.I RESIDET,ICE O" ffIOOrrrW TO EXTSTING RESIDENCE
**PLEASE CHECK AI{D A SHTR BELOI{ ALL THAT APPLY TO YOT'R PRO]ECT:
ATT GARAGE _ sF ! orr olaaor sF fl poRcH _ sF
Pe*-. t '., //,'e,+5 qo-izt-xo5 |
SUNROOq
-
SF
GREENHOJSE _ sF
I pool_ sr I sronnee sHED _ sF
DECK 5F OTHER:
TOTAL SQ FT UNDER ROOF:32{TOTAL AREA SQ FT:t 3>fTOTAL HEATED SQ FT:
TOTAL PROIECT CoST lress Loe | $ J;,OO)# OF STORIES: I
Is Any ELECTRICAL, PLUHBING or i,IECHANICAL Wo.k Being Done to the Accessory Str ucture? ffi"" ff lfoIf the pnoject is a Relocation, is there a Natura] Gas Line on the Current site? f]Ves [fMoIs there Electnical Powen on this Building? p|{er f] l'io
PRoPERW USE / oCCUpANCy: [fSrrcle FAi.4]Ly n DUPLEX n TOt MTOUSE
DESCRIPTIoN oF NoR(: t?,, f- f O O 4d a:7:4n
0{o
q bed roor'',
DISCI.AIMER lherBOy c€nj, halall hbfiaton in tlis app[ca&o b coflEctand all\6rkvi[ complywih ]ro SEE &rildhg Codo sod all otlor sppli:abla SlsD and local la,{.
and ordinances 3,1d r€gubrons. Tho NHC Oewlopment S€rvic€€ CanEr will b6 notfud of sny cnanggs in i,lg sppro]/sd plsn6 aod +ocific€dons or cian96 in con!'&Dr or
cont-acEv inbnn€don, 'nNOTEr Any Woft P€rb.m6d w/O teAppoprl€b P*'rni6wnlb€ in Molalim of$€ NC Slab Adg O:d6 snd Subi6cr o Fin66l, To CsOO,OO"'
ONNER/CONTRACTOR:STG},IATURE :
++* +*****:r****,r******* ** * * *({i'Il }ii"J ** * * ** **** *++:} *+* ++** *** **++ +*:** *+:}* *+* **:i:} +**+ **+*:r.*
IS THE PROPERTY LOCATED IN A FLOODPLAIT{? T'] YES E rc
EXISTING IIIPERVIoUS AREA: _sQ FT ToTAL ACRES DTSTURBED:
NEW rJ'IPERVIOUS AREA r _ SQ FT B(IST LAIO DrSTt RBrr'lG pERl4rT: n yES r-l ilo
ffi
F
CFPUA f] corurururw sysrEM n pRrvArE uiELL
I:T SEPARATE PERXITS REqUIRED FOR EL€CTJ IIECH' PLEGJ GA' EqUIP' PREFAE5 & IISERTS :"
payr,lENr i,rErHoD: I crsri I Gre.K (PAYABLE ro Nxc) f] BxLL aaccuNr n r,lclvrsa I o:scwe"******* r*** * *** **r.*:i.**:t****** ** * ** ****+ *** * **:t **+ * i(** *** * ri*****ri(**** **:i(* *** ******** **+ ***
t?eter Ly-i / /ian t
I,IATER CENTRAL I,IE L L
SENER:cFpuA fl CENTRAL sEpTrc I enrvare sEprrc n covli4uNrry sysrEM
,^r. fL3 oFFrcER:
opp"ou}@-.:..y
a{e (foR oFFtcE usE onl
5
Y) - REVISED D,YE O4l11/12b o,-l nH,7 e,/5CKS: F:
FLOOD: .\a BFE+2?I=
t-^hLt\
DATE
0
N
PERfiTT FEE: $cornent:
ldea o€ fu-e A utck.rZ.
lltv lnsoection Recrrreq, 9l 0.2S4.mlt
SF
"fzzz-. ->2)-.--:,
Aot+- zqb+
tT=942#NEW HANOVER COUNTY BUILDING PERMIT
APPLI CATIO N TYP E ; RESIDE Nrnt
FLTAsT ANSW€N ALL QU€5IIOT{S APPIICASI€ TO YOUR PRO]ECT
"Proiect f, esponsibiliy
CITY
APPTICANT'S NAME:
PRO'ECT AODR
SUBDIVISIOII:
PROPERW OW ER'S
OWNER'S ADDRTSSI
LOT {:
Date.
ztP
rrcEi*Er: 33797
sT.as@
E:11,PHONE
ctw zt
),rcl at {4r,,hl<_co
ADDfi'SS:
EMAII.
PROJTCT CONTACI PERSON
EXISTING CONSTRUCTION: --:
NEW CONSTRUCTIONI
CITY:
t PHONE
fl Renovatioo . General Repairs
New Residen€e U Addatbn to ExistioB Re5idence U Relocation
Porch {SF}1s'
il Storage Shed (SF) _
n other {sF}
to fines up to 5500 00"'
&/Att GaraSe (sF)E Oet Garags {5F}
--[] Sunroom (sF)il Pool (sF)
3 Greenhouse (SF): Deck {SF)
15 the proposed vyork changing the existing tootprint? Il Yes [:] l,lo
TOTAL Sq FT UNDER ROOF Vor ptoposed work) Heated:3Y1 (o Unheated:
TOTAI PROJECT COST ll"ess Lot): 5
ls the propo5ed work changing the number of bedrooms? ff Ves E lo
ls any tlectrkal, Plumbint or Mechaok l work being done to lhe Arcessory Strusture E Ys C o
4tt
lf the proi€ct is a n€bcrtioo, is therga Natural Gas Line on the current site? 0 Ycc
ls there Electrical power on this Briliding? E Y.5 tl no/
Prop.fty l,rsr/ occup",r.y, Vslngb r"mllv E puphr tr To.wnhoti€Des$iptronorworr' Zafhqtvuf tl-f .i) 5i
Ilo
intorrn:tton. "'li.()TE: Any wo.t perlonrled th! .Ofrcpriata p.rrniB t,lll be in vidatirr ol the t{C St.te gldf Code
Owner/Cortractor:s Sigrature:
tIStLffR: I h€reby certity that .ll the info.mation in rh6 .pplicrtion a conlct aad .ll wo.i wif cornply with lhc State Suilding Code .nd .1, other .ppl(rue Srate and lo<al
'Licen .d Quolifiet'
ls the property located in a floodplain? fl
Existi[8 lmp€rvlous Area:
-
5q Ft
..2,?qt Sq Fr
Total Acret Dirturbed . f,f$
€.xlsting Land Disturbint Permh: f] Yes C No
? lloqe ,ra
,atd
ff"w^D Communitv System D Private well 0 Central Well E Aqla
0 Community System EI Private Septi€ 0 Cent al Septt E Aqua
zo,r€: _ Olficer:
-
Setbacfs (rl
-
(tH,
-
(RHl
-
t8l
-A!,prov3l: _ Oty; =- oatei
-
Floot ; (Al
-
(V,
-
(il}=- 8FE+2ft
--
Qt
Comment:Permit teei 5
$),1r2
lr,1
2
f t j 4
qr-.xq?-)?7t*
NEW HANOVER COUNW BUIIDING PERMIT
APPLICAI|ON TypE: RESTDH$flAI
PLEAST ANSWER ALI. QUESTIONS APPIICASLI TO YOUR PROJECI'proiest Respon5ibiliqf
CITY
{.J 7;
AotY Zqb&
++.9€A
Application
loffice ul€)
APPIICA T'5 NAME:1*nt('t
Dalei Ll
PROIECT AD
SUaOlVlSlON:
PROPTRTY OWNIR'S
OWNER'S ADDR[55:
L
LOT '
llP
*l(L
1
PHONT #
crw
.l
ztP
t,ttt'1
ADDRESS:
EMAII ADDR
PROJECI CONTACT Pf R5ON:
Att Garage (5F)
C Sunroom {SF)
C Greenhouse {SF)
CITY
ucENst f:
st: k ztp 27'HONE:'tr
. Unheated
o.on 41i: 5?s 717;
:18
I Storage Shed (5F)_
n Other (5F)
EXISn G COiErRUcnOl{i : : l),teration f Renovation il Generat Repairs
EW COflSIRUCIEI{: 0,.(/rect New Residence I Addition to Existing Residence lf Relo.ation
Is the proposed work changinS the existing footprint? Il
TOTAL Sq FT UI{DI*ROOF lJot propoted wort] tl€at€d:
(*, ltof
TOIAL PiOJECT COST {Less l-ot): S
ls the proposed work chasgintthe numberol bedrooms? 0 ver Cl ro
ls any Effil, Plumbhg or Maahankal work beinS done to the Accessory structure O Ycs Cl t{o
lftheprojectisanebcrtlon,islhereaNaturalGasLineonth€currentsite?EYcsEtaq
ls there glectrical Power on this iilg? f] Yer D tlo
Property Use/Family O ouphr ff T do
oD
Descriptio.l ot Wo.t:
OtSCIA$aGlr I hereby csnify th.t a[ the iniormation in thit appication ls co.r€ct.d r[ wort wi$ comp]y with lhe Slrle &rddin8 Code and .I sther :ptlreble St te a.d lo..l
l.ws and oi-din.nces and r€tulations Ihe t{HC Oevelooment Servrces Ce'|trr wlll b€ notified of any cheqel in the apprci.ed p{rn5 and s9€cifi.:liont o. ch.n8e rn conlr.do,
info.malaoo. "'NOT[: Any worl perfonned .ppropriate pennite will be in vloLtion ot th. t{C Stete 8ld8 iubjcct to finer u9 to Ssm.m"'
OwnerfContractoil
"Lhented Quglil er'
ls the property located in a floodplaio? Cl yeJ
&\-\*"Jilar Signature
Total Acres Oisturbed: ,DL,3
L
Sq tt
Sq Ft
f, rirtint lmperviou3 Area:
tlew lmpervious q-)-t
WATER:
SEWER:CfPUA E Community Synem E Private Septic O C€ntralseptic B Aqua
Zone:
-
otficeri -- Setbacfs (F)
-
{tHl
-
{iH}
-
(B}
Approralr
-
Clty:
--
Date:
-
fbod; (A)
-
(vl
F
tristirE tand Oirturblnt Parmftr E Yes E o
D community System E Private well fl centrdl well D Aqua
(N)gFE+ztt=\pq-
&
CONTRACTOR:
t,t v {/ra
n Pool {SF) _
tl Deck {5F} _
,/1
Can!|nent: PErmit fee: t
NEW HANOVER COUNTY BUITDING PERMIT
AP PLICATIO N TYP E: RESIDENTIAL
PLEASE ANSWER ATL QUESTIONS APPI"ICASI.E TO YOUR PROJECI
"Proiect Responsiblllv'
)otT- 21t
Appllcetlon
Number
(offlce use)
AppLlcANT,s NAMI, Herrington Classic Homes, LLC Date:zlz417
pRoJECT ADDRESST 4825 Goodwood Way 61ry, Wilmington ltP.28412
sUBDtvtstoN: Fortune PIace at Johnson Farms LOT #: zo
pRopERTy owNER,S NAME. Herrington Classic Homes, LLC PHONE '.
910-399-5688
oWNER,s ADDRESS. PO Box 538 cfw. Wrightsville Beach Ap. ?8480
CONTRACTO R. Herrington Classic Home, LLC BLDG UCENSE d.68106
AoDRESST PO Box 538 61ry. Wrightsville Beach 51. NC 21P.28480
EMAtL ADoREss: healher@heningtonclassjchomes.com PHONE. 910-399-5688
pROJECT CONTACT p6X5gp. Craig Johnson PHONE. 910-442-7500
EXISTING coNsTRUcTloN: E Alteratlon - Renovation fI General Repalrs
NEW coNsTRUcTloN: fa Erect New Residence E Additionto Existlng Resldence D Relocation
*t* t**
E att Garage {sr} 496 tr Det Garage (5F)- E Porch (SF)270
fl sunroom (5F)tr Pool (SF)[] storaee Shed (SF)
E Greenhouse (Sf)n Deck (SF)n other (sF)
ls the proposed work changing the exlsting footprint? n Yes E No
ToTAL sq FT UNDER RoOt ffor prcposed work) Heated:Unheated:766
ToTAL PRoJECT COST (Less Lot):50,000.00
ls the proposed work changing the number of bedrooms? E Yes E No
IsanyElectrlcal,PlumblngorMechanlcalworkbeingdonetotheAcressorystructureEYesENo
lf theprojectisa R€locatlon, istherea Natural Gas Line on the current site? E Yes E lto
ls there Elect.ical Power on this Euilding? fl Yes E No
Property Use/
Description of
Occupancy: EI Slngle Famlly E ouplex E Townhouse
workr Construct new single family residence
DtsctAtMER: I hereby certify thalall the lnformatlon ln thls appllcatlon iscorrect and allwork Mllcompty wlth theState Bullding Code and allother applkable State and local
lawsand ordlnances and regulatlons. The NHc oevelopment SeMces C.nterwlll b€ notifled ofanycha
lnformatlon. ar.NOTE: Any work performed wfthoul the appropdate permlts wlll b€ ln vlolatlon of the
in approved plans and cations or change ln contractor
and flnes up to S5o0.00$*
owner/6on1r".1or. Craig Johnson Slgnature:
"Llcensed Qudlne/
ls the property located in a floodplain? E Yes E No
txlstlng lmpeMous Area: _ Sq Ft Total Acres Dlsturbed:
New lmpervious Area:3143 Sq Ft Existing Land Disturbing Permit: E Yes D No
WATER: E CFPUA E Community System n Private Well E Central Wetl E Aqua
SEWER: E CFPUA tr Communlty System E PrivatesepticECentralsepticEAqua
Zon€: _ Otflcer: _ Setbacks (F) _ (LH) _ (RH) _ (B) _
Approval: _ Clty: _ Date: _ Flood: (A! _ (v) _ (N) _ BFE+2ft= _
Commert:Permlt Fee: S
q\vq-