HomeMy WebLinkAboutJULY 28 2017 BUILD APPSAdd,hDrl
APPLICANT'S NAME
PRO.lECT ADDRESs:
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dlrK?ef,
Nppkockvt
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",",ff271i1p,28142-9
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EW HANOVER COUNTY BUILD NG PERMIT
APP LICATIO N TY PEi RESIDENTIAL
PLEASE ANSWER ALL QUESTIONS APPLiCABLE TO YOUR PRO]ECT
"Project Responsibility"
CITY
PHONE #
CITY
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C.i"r,e_ Ztp
BLDG LI NSE H L
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PHONE Qr:'- 40q- 1b1z
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SU B DIVISION
CONTRACTOR ,ro
ADDRESS CITY
EMAIL ADDRESS:PHO
PROJECT CONTACT PERSON
NEW CONSTRUCTION ! Erect New Residence Addition to Existing Residence ! Relocation
***PLEASE CH ECK AND ANSWER BETOW ALI. THAT APPTY TO YOUR PROIECT***
OWNER'S ADDRESS:
! Att Garage (sF)_
L Sunroom (SF)
E Greenhouse (SF)_
4tl
! Det Garage (SF)
34a)
E Porch (SF)
I Other (SF)
! Pool (5F)
Z-Deck (sF)
ls th e proposed work ch a nginB the existing footprint? EzYes D No
TOTAL Sq FT UNDER ROOF Vor proposed work) Heated:
TOTAI PROJECT COST (Less Lot): $
I Storage Shed (S F)
ls the proposed work changinB the number of bedrooms? D y., Zd
ls any Electrical, Plumbing or Mechanical work being done to the Accessory structur " 8n/", Z Uo
lf the project is a Relocation, is there a Natural Gas Line on the current site? D Yes El-](o
ls there Electrical Power on this Buildine? D Ves ffi
ancy: 16ngle ramilyr'trdd ozr E Duolex E TownhouseZxiq \o c.AA baq\^.. c.lcou e {ey L^J KJlct-eProperty Use/ Occup
Description of Work:
lawsand ordinances and regulatrons. The NHC Develop me nt Services Centerwillbe notified ofany changes in the a p d1\ dnd :pp.,l'.arronr or Lldi Be .rl.o'lrra! o.formation r*'NOTt: Any work performed without the appropriate permits witt be tn viotation of rhe e and sublect to fines up to 5500.00..*
Owner/Contractor
t\ort,aS
"Licensed Quolifiet" Print Nome
ls the property located in a floodplain? O yes {no
Existing lmpervious Area: _ Sq Ft
Signature:
Total Acres Disturbed:
New lmpervious Area Sq Ft Existint Land Disturbing Permitr ! yes ! ruo
WATER: D CFPUA ! Community systern firivatewell D Central Well D Aqua
SEWER: E CFP|IA D Community System E/private Seprtc ! Centra Septic ! Aqua
zonei Officer: _ Setbacks (F) _ (tH) (RH)_ (B) _
Approval:_ City:_ Date:_ Flood: (A) _ (V)_ (N) BFE+2ft=
@
triL\e (
Commedt:Permit Fee: S
PROPERTY OWNER,S NAMEi
toT f:
EXISTING CONSTRUCTION: ! Alteration E Renovation ! General Repairs
Unheated:
2 r>r)-,tC f S-.I.:.
',,,&,,i
NEW HANOVERCOUNTY BUILDING PERMIT
APPLTCATDN TYPE : RESIDENTIAL
PLEAS€ ANSWER ALL QUESTIONS APPLICABLE IO YOUR PRO'ECT
'Proiect Resaonsibiltv
L7 -2325
Applicatlon
(of6c. u3el
APPL'CANT'S NAME:
SUBDlVlSlONr
Date:
ztP:CITY tc
LOT #
PROPERTY OWNIR's NAME:
OWNfR'S ADDRESS:
ADDRESS:,tt
EMAIL ADDRESS:
PROJECT CONTACT PERSON
EXETI G CONSTRUCIION: al
N€W CONSTRUCTION
Att Garage (SF)
tlq
TOTAL PROJECI COST (Less Lot)
i1 )"a/P}IONE *:
CIIY
c'/,tci L-
zlP
UCENSE T 3ttqq' ztpCITY:
$'
4/a-zcs -fst qPHONE
[] Renovation n General Repairs
New Residence C Addition to Existing Residence I Relocation
PTEASE CI*CX A'{O A'II'W€N BELOW AT.l THAT A'PTY TO YOUR PROJECT"'
Et Det &rase (sF)
-
A+Gi lsrl
Ll tunroom (sF)
n Greenhouse (SF)
ls the proposed work changing the existing footprint? [] Yes fl lto
TOTAT 5q Fr UNOERROOI llor prcposed work)*","a,.?:tJi
)rl
I StoraSe Shed (SF)_
! Other (SF)
ClbC)
ls the proposed work chanBing the number of bedrooms? E Y€|' E ffo
ls any Electrlel, Plumbirg or iHtankal work Feing done to the Accessory Structure E yes fl o
lftheproiectisaRelocetlon,isthereaNaturalGasLineonthecurrentsite?Bve.ENo
ls theG Electrical Power on
Propcrty Us./ Ckrupancy:
?OYesENothis
v 5\l u,r O ,/t-irr'{ it*^
Description ot Work:
D Duplex E Townhorrsc }t'tk*
DISCLAIMTR : I herabY .ettdy that all the nfo.matio.l i. this aprrlk tton ir correct .nd atl wort wtll cornpty etth the state Bullding Cod..l}d ordin.nc€s aod reSulation3. Th€ NHC Dei,ebprnent SeMcer Center will be notified of any drangei in the ippro€d plans andinformatlon. ...NOTfi Any work Frerforr$ed without the appmpriate pe,mtts will b€ h violatrcfi of the M 5tate Sldg Code and 5ubJect
Owner/Contrefto(:
"Licedsed Quolifier'
Signature:
ls the property located in a floodplain? A Uc Ad
Exhting lmpeMous Area: .-- Sq Ft
New lmpervious Area:? i0t.,Sq Ft fxining land Olsturbing permitr D yes D frq
Total Acr€s Disturbed:,(JI
and rllothlr applk bh State and tocal
spacifl(etions oi ahange rn contractor
to flner up to Ssm.m...
WATER:
S€WER:
e4ir^
Ycrpur
E Commsoity System fl private well 0 Central well E Aqua
fl Community System E private Septic E Centralsepuc E Aqua
Zorc: _ offfcer: _- setb.drs (r) _ (rfil _ lRHl_ {Bl
-.Apprual: .- Ctty: _ Dat :-- Flood: {Al _ (V) _ (X} _ fF€+Zft= .--
Comment:Permit Fee: S
1b 1.-\-
PROj€CT ADDRES':
u 2t h_? lrll,t
CONTRACTOS:
-/,)
i-
tlAv
y-
n Pool (sF) _
D Deck {sF)_
unrre"t"ar JIG
t\
) t: tl-{C r}
NEW HANOVER COUNTY BUITDING PERMIT
AP PLICATI O N rYPE: RESI DENTIAL
PLEASE ANSWER ATL QUESTIONS APPLICABLE TO YOUR PROJECT
"Proiect Responsibility"
Application
Number
(office use)
AppLtcANT,s 114y9; McKee Homes, LLC Date
pRotEcT ADDRESs: 1633 Flushin Drive
sUBDtVtstoN: Cameron Trace
61ry. Wilminoton 71p 28411
191 s. 1 15
pRopERTy owNER,5 1141y15; McKee Homes. LLC
OWNER,S ADDRESS: 109 Ha St., Ste 301
CONTRACTqR: GML Develo ment
pHONE #: 910-475-7100,727
s1p6 11651159 s 63970
ADDRESS : 109 Hay St., Ste 301 g11y Fayetteville 5T: NC ztP 28301
EMAtt ADDREsS: krivera@mckeehomesnc.com
PROJECT CONTACT PERSON Kenny Jones
EXISTING CONSTRUCTION: E Alteration n Renovation E General Repairs
NEW CONSTRUCTION: E Erect New Residence n Addition to Existing Residence n Relocation
*',}PLEASE CHECK AND ANSWER BELOW ATI. THAT APPLY TO YOUR PROJECT*'*+
E Att carage (sF) 401 E Det Garage (SF)! Porch (SF)282
Ll Sunroom (51-)n Pool (sF)E Storage Shed (SF)_
E Greenhouse (St)_n Deck (sF)tr other (sF)
PHONE: 91 0-475-7100,727
pHoNE: 91 0-475-7 1 00,721
ls the proposed work changing the existing footprint? ! Yes n No
TOTAI SQ FT UNDERROOF Aor proposed work)Hg21s61 2333 g6hg31q6; '1256
TOTAL PROJECT COST (Less Lot): S 1 16.650
lsthe proposedworkchangingthenumberof bedrooms? E Yes E No
ls any Electrical, Plumbing or Mechanical work being done to the Accessory Structure E yes ! No
lf thepro.iectisa Relocation, istherea Natural Gas Line on the current site? E yes E No
ls there Electrical Power on this Building? E Yes E No
Property Use/ Occupancy: n Single Family E Duplex - Townhouse
Description of Work: New Construclion, Sinole Familv Home
laws and ordinances end re8ulations. The NHC Development Services Center will be notified of any changes in the approved plans and specificationr or change in contractor
information. *'iNoTE: any work performed without the appropriate permits will be in violation of the NC State Bldg code and subject to fines up to SSOO.Oo..*
Owner/Contractor:Kelsey Rivera Signature. Kelsey Rivera
"Licensed Quolifier" Ptint Nome
ls the property located in a floodplain? E yes E No
Existing lmpervious Area: _ Sq Ft TotalAcres Disturbed:
New lmpervious Area:Sq Ft Existing Land Disturbing permit: ! yes E No
WATER: & CFPUA E Community System ! private We ! Central Well n Aqua
SEWER: E CFPUA E CommunitySystem E private Septic E Central Septic E Aqua
Zone: _ Officer: _ Setbacks (F) _ (tH) _ (RH) _ (B) _
Approval: _ City: _ Date: _ Flood: (A) _ (V) _ (N) BFE+2ft=1s7?Comment:Permit Fee: S
G/P/'d-
L t -2295\---\
E
ctry: Fayetteville 4p.28301
NEW HANOVER COUNTY
DEPARTMENT OF BUILDING SAFETY
230 GOVERNMENT CENTER DRIVE - SUITE I70
WILMINGTON. NORTH CAROLINA 28403
Telephone: 910.798.7308 Fur: 910.798.781 I
Internel: w,ttttv. tt lt c got'.tottt
4 to 7 WORKING DAYS TURNAROUND TIME FOR PERMIT ISSUANCE
STATEMENT OF U NDERSTAN DING
t,Kel Rivera , am submitting an application for a residential
building permit to New Hanover County. And, as the applicant or person submitting
the application, ! check the box/boxes below to acknowledge that:
tr I have attached an official CFPUA recei pt or document that has
acknowledged an approval of the payment made to CFPUA.
I I have attached an official proof of a Zoning sign-off from the City of
Wilmington, for this work that will be done in the City of Wilmington.
I have attached an official proof of an approval granted by the New Hanover
County Environmental Health Department, for this work that requires an approval
from Environmental Health.
lf the application is correct and complete with the required drawings, and if
there are no corrections or revisions to plans and drawings, and if there are no
further clarifications required by New Hanover County; New Hanover County
can guarantee that the building permit will be issued within 4 (four) to 7 (seven)
working days after the official submittal date/time (the stamped date/time
notation made by the Building Safety Department on the application or submittal
document). I understand that the 4 (four) to 7 (seven) working days only begins
when the aDplicatio n is submitted Dnor to 4:30 pm on any working-day.
Signed in acknowledgment:
Kelse Rive ra Billill )lJ,ililffi;li:"J:
Signature Printed Name
1633 Flushing Drive
Kelsey Rivera
Address for the proposed residential work:
Date
;;;-----1l-l
/).-- ri
-'i,"i..
rffi
o n-C) ( (D
NEW HANOVER COUNTY BUILDING PERMIT
APPLT cATtON Ty pE: RESIDENTIAL
PTEASE ANSiWER ATL QuEsTIoNs APPTJCABLE To YoUR PRoIEcT
"proiect Responslbfl lq/,
L7 -2363
Appfi.alion
Number
(ofiice u!e)
Date: b *7
zlP,
t3
AppUcANI,s NAME: Seventy West Builders. lnc.
PROJECT AODRESS:4e6 B,orbe C-r.rY+CITY
SUBDIVISIONi
PROPERTY OWNEPS NAME:
OWt,{ER,S ADDRTSS;
Tf: a
PHONE f,:qu)-32*
CITY I zrP: 384{\1
CONTRACTOR: Seventy West BuiHers, lnc,g1p6 ggEtr156 g: 64926
ADDRESS: 127 Grace Street cry; Witmington _sr: NC ap: 2B4Ol
EMAILADDRESS:Towestbuilders.com pxOr'rE: (910 3244447
PROJECT CONIACT PTRSON:*- PHONE:t0-- qSbJ
EXISIING CONSIRUCIION: I Alteration D Renoyation n GeneralRepairs
NEw cot{srRucnoN: N Erect New &esidence tr Addition to Existlng Residence I Eeiocafion
ttt a*
X ntt aaace (sr) 53b tr Da Gardse (sF)_ fiporch (sr]
tr sunroom {SB _-.--
El G.eenhouse (Sf)_
Descrlptlon of Wo*:
D Pool(sF)
tr Deck (sF)
g Storage Shed {sF}
--
tr other {sF} -_-
ls the proposed work changing the €xisting footorint? ( Ves tr tto
TOTAL SQ Fr UIDER RO OF (for proposed wo*1 Ueatea, JjN* Unheated:
TOrAL PROJECT COST (Less Lot): S 2?).000
Property Use/ Occupancy!S,ngle Famlly E fruplex O Torrnhouse
Is the proposed work changing the number ol bedrooms? tr Ves m
Is any Eledrrcar, prumbrn8 or Mechrnf*r work being done to the iccesory Structure tr yes !0 uo
lf the project is a R€location, is there a Natural Gas U-ne on the current dre? E ves S lto
ls there Electrical povrer on this Euilding? tr Ves $.ruo
t
OECUTI4Ea: I herei] cenit that all the Info.m.tlon tn this apdiction tr ao..Ect and all work wi( corJply l{ith the State Suldi.s Codcl6ws and ordlnan€J nnd .egula(bns, The NhC Devalopment Se,.,kes c.der wlll be notaflrd ot ally chan8es ln phlR andlrfor 3torl. ...MITt: Ary work pedo.med withort the approprbte pc,nltr vrill bc in viohtbn of the C
Crai-q Smitb Slgnatwe:
ls the property tocat€d in a floodplatn? tr Ves I no
Existing lmpervious Area:Sq Ft Total Acres Dlsturbed:,t0
.nd arl ortrer .pplkable SEt! and bcal
spedfBtirnr or chang€ ir .ont aclor
ro ffnes up to s50[m:..
orArner/Cootraclor:
'Licenred Quofifrel
Ne{, lmpervious Arsa t E5? q n. Exisdng Llnd Dkturbhg pemit; E y
Uffe, H cFpuA El communtty system tr pri\rdte WeI E Central wef E Aqua
SEWER: X cFpUA O
.o*, l{ X o,fl".,,$fA setback(F)# trrt # t**r # rgr ah
es Sm
epprwa: 0E av.
Commuhlty System n private Septlc E c€nt.als€ptic E Agua
Flood: {A)lv)- (N, x BrE+2ft=Btt-Permit Feei S
Commenti
Date:
?
Crry lrspecion Requreo, il Gi$r1r :;l
RLT\V
NEV/HANOVER COUNTY
DEPARTMENT OF BUILDING SA}'ETY
230 GOVERNMENT CENTER DRIVE . SUITE I7O
WILMINGTON, NORTH CAROLINA 28403
Telephone: 9 I 0.796.8A8 Fax: 9 t0.798.781 If krtrct : tu,nv. nh cgov, cottt
4 to 7 WORKING DAYS TURNAROUND TIME FOR PERMIT TSSUANCE
S TEMENT OF UND RSTAN ING
I,@,amsubmittinganapplicationforaresidentiat
building permit to New Hanover county. And, as the applicant or person submltting
the application, I check the box/boxes below to acknowledge that:
tr I have attached an official CFPUA receipt or document that has
acknowledged an appraval of the payment made to CFpUA.
A I have aftached an official proof of a Zoning sign-off from the City of
Wilmington, for this work that will be done in the City of Wilmington.
a I have attac,hed ah official proof of an approval granted by the New Hanover
county Environmental Health Department, for this work that requires an approval
from Environmental Health.
lf the application is correct and complete with the required drawings, and if
there are no corrections or revisions to plans and drawings, and if there are no
further clarifications required by New Hanover county; New Hanover county
can guarantee that the building permit will be issued within 4 (four) to 7 (seven)
working days after the official submittal date/time (the stamped date/time
notation made by the Bullding safety Department on the application or submittal
document). I understand that the 4 (four) to 7 (seven) working days only beglns
when the application is submitted prior to 4:30 pm on any working-day.
Signed in acknowledgment:
raig Smith 7 t14t17
Signature Printed Name
4a e- CoortAddress for the proposed residential work:
Date
i:ily lnspection Reourreo, 9l&254{r )o t}a) 2?
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATI$T rrps; RESIDENTIAL
PLEASE AIISI,iER ALL QUESTIONS APPLICAELE TO YqJR PRO]ECT
"Project Responsibilit)/,
APPLICAI{T'5 NAI{E : Norlh scaL r-tners ConsErLrcLion, Ll,C
DEVELOPER:
PROIECT ADDRESS: 8os Meherrin l4ay CITY: I,{i lminqton
SUBDIVISION: Autumn IIa11
PROPERTY O,il,lER'S tlAr4E: Mand- pre 1l
OI{NER'S ADDRESS: 8os Meherr-n l{ay CITY:tli 1m i :on
CONTRACToR: Norrh sta:e partners truction, LLC LICENSE #: ?0046
ADDRESS: p. o. Box 3se CfTY: I,rt I htsville Beach
EI'IAIL ADDRESS: of fice@norEhstar ecustombu ilders - com
L7 -237 3
ffi APPLICATIChI
Number
(Office Use)
DATE
PHONE S:
ZfP:28403
BLOCK $: LOT #: ie2
PtO E #: 9ta- 2oo-9:.7 4
PRO]ECT CONTACT PERSON: Jln wis
ExrsrrNc coirsrRucrroN: ! lrrrRarror I nrHovlrrot GENERAL REPAIRS RE LOCATION
NEN COI{STRUCTIOI{. I CNTCT NEII RESIDENCE O" f, MOTTTOU TO EXISTING RESIDENCE
**PLEASE CHECX AI{D ANSI,IER BELOhJ ALL THAT APPLY TO YOUR PRO]ECT:
Rlarr eauer -;;3{- tt
suNRooM _sF
GRE ENHOUSE
-
SF
Is thene Electrical po!"/er on this Building?
pRopERw usE / occupAr{cy: I srtole remrLv
DESCRIPTION OF WORK: Consrrtrct sin
DET GARAGE
-
SF
P@L _ sF
DECK SF
Yes I No
OUPLEX TOi^INH0USE
fi coccH <4<5F
I sronnce sHED _ sF
OTHER:SF
PTONE *: 206-9ts-0546
ST:ILZIP:28403
T No
TOTAL HEATED Sg NI ?419 / TOTAT SQ FT UNDER ROOF:31a ToTAL AREA 5Q FT: s ?('y'
TOTAL PROIECT C0STlr.essro') : g {4{,OAD # oF STORTES: ?
rs any ELECTRTCAL, pLUr'rBr{G or irtEcHArrcal r^Jork Being 00ne to the Accessory structure? n yesrf the project is a ReLocation, is thene a Natural 6as Line on the cunrent site? fl yes No
ql e Iani.l y Rcsidence
DISCLAIMER lh.rcbycertify lha! a[ i.bmalon in his apptication is corlBcrand a(\Ivork will conply wih he Stare Buitding Code aod s, ohcr apgticabte Srate and bcaland ordinances and regutalions. The NHC Developmenl Services CenDl wil be no
ilswillb. i,r Violation otlhs NC Stae BUo Code
ljfed ol aiy changes in he approved plans and specifications qI
ano sulrya 6 fines L,! ,o
contaclor rnirrmador.. ",NOTE: Any Work p€rtolmed WO tle Appropriata peft
OWNER/CONTRACTOR : rim wj.seman SIGNATURE :
** i* *,*+,*** *.,r,f *. -. --- - --,'.(IiTl{i1.1
IS THE PROPERTY I-OCATED IN A FLOODPLAIiI? T-I YES
EXISTIiIG II.IPERVIO{,S AREA: o sQ FT
NEUi IlilpERVIq,S AREA: >1 SQ FT
mrEn: I creua I cor,ftluNrTy svsrem I
**i?*!r***,*:*,*** !r*** *** * *** *** *ii**:*** *,*,* ,* * )* + *,*:* * ****
NO
ToTAL ACRES DISTURBED: >r.
EXIST LAND DISTUREING PERIIIIT: r-l YES I NO
PRIVATE WELI CENTRAL NELL
COI1MUNIry SYSTEMsrwen: @ creur I cENTRAL sEprrc f] enrvnre seerrc
r,' SEp..rRArE pE*tlrrs RESJiREO FOR ELra"i, tlEatl, pLBC, 6A5 rQulp, PiEFABS &pay.rEr{r }rErHoD: I crs, [.,rcK ( pAyaBr-E m mrl E *rrnl; ;;;, "'tr
n.rrrro"'' n orr.orr**+** '**'t'r'*** **'r* ***'* **'rr*'****** * !* 'r * * ** * * )r,r *,r,* * **ii** * **** *********,** **** * *:* * * * *,r ja *,r *,*,r * *,r
tu_(FoR oFFICE UsE qt:
ZONE:
Approval
Coflment:
OF FICER:"Nffr ,r, ct ^r, ,L r,g,^tvrsED 'ATE o4l11l'12
x BFE+2ft=VT
(EACKS: F:
7b
?k city: ll-lvl oarc
s
7 F LOOD:
PERMIT FEE:
'
t
ST: NC ZfP: 284Bo
PHOi,lE #: sao- 442 -'t 5i 4
)on-KC3
Print
NEW HANOVER COUNTY BUITDING PERMlT
APPLTCATION TYPE : RESIDENTIAL
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROIECT
"Proiect Responsibilit/'
23JUll l7 10 t -!.Bftl
-a3rt
Application
Number
(office use)
APPTICANT,S NAME:
PROJECT ADDRESS:l/
.s
e, SAl(*Hfia*, -Tl(-lc;*N
Date:6-zs-tz
ctr\, ru//./n /,/11l7VtV ztP Z8 L
T $; 3'l
PHONE #:s7
suBDtvrsroN:
PROPERTY OWNER,S
OWNER,S ADDRESS:?-L 1,16 xnl>a<te-t< b,z ctl: lr1.//L t?//7bP ztPl
CONTRACTOR:/A
ADDRESS:
EMAIT ADDRESS:
PROJECT CONTACT PERSON:Stt+r 'ft+rt>ei
s BLDG TICENSE f . (D'7(o a4
t.€cm I th,/ /un/.4 /iuv sr I l/L 7lP: Z
wone, LQa\ z3z-4s-zf
rrore, 14rd) 2 3Z-ClS-t t
*- rxtsrtre corusrRucTroN: n A') -/-{ ruew corusrnu c';.oN: {Erect
i-- **+
a-- /otu o.rr*" tsrl I €?A
9 tr sunroom (sr)
)
Iteration E Renovation ! General Repairs
New Residence fl Additionto Existing Residence E Relocation
PLEASE CHECK AND ANSWER BETOW ATT THAT APPTY TO YOUR PROJECT* *
n Det Garase (SF){Porch(sFl 9r
! Pool (5F)E Storage Shed (SF)_
tr Deck (5F)E Other {SF)
ls the proposed work changing the existing footprint? E Yes E No zllao73
n Greenhouse (SF)--
s
@
ToTAL SQ FT UNDERROOI (for proposed work) Heated:Unheated:
TOTAT PROJECT COST (Less Lot): $223
ls the proposed work changing the number of bedrooms?{ves a No
ls any Electrical, Plumbing or Mechanicalwork being done to the Accessory Structure dGa"o
lf the project is a Relocation, is there a Natural Gas Line on the current site? n Yes El'4{o
ls there Electrical Power on this Building? des n No
z/.
Property Use/ Occupancy: g'single Family E Duplex E Townhouse
i 1a
)1,
Description of Work:
PEn/ @ttsztett na<-z sl/unzF E+zvilcy
laws and ordinances and regulations. The NHC Development Services Center will be notified of any changes in the approved plans and specifications or change in contractor
information. *"NoTE: Any work performed without the appropriate permits will be in violation of the NC state ldg code a subject to fines up to 5500.00*'r
€az.,r'-*ozr''T%za>a/SignatureiOwner/Contractor;
"Licensed QuoIiIier"
ls the property located in a floodpl in?WGs a no
Existing lmpervious Area:Sq Ft
New lmpervious Area:5q Ft Existing Land Disturbing Permit: a Yes ffi
WATER: [] CFPUA tr Community System n Private Well tr Central Well EZ&ua
SEWER; ! CFPUA n Community System E Private Septic ! Centralseptic g/nqu3
zone:- officer:- setbacxs1lS1 [il l0 lRHl lO @ +4
Approvat:
-
city:
-
Date:
-
Flood: 1a1 ? 1v)
-
(N)
-
ero.xt= ll ?3./a-
'tffir;'
Clear Form
rotatAcres Disturb "o' O, lOOq /
or z-&03b :{ lt'- '
fi"*55 FLOOD ZCNE
NEW HANOVER COUNTY BUIu)ING PERMIT
APPUA|IO N fypE : RES|DENT|AI
Prlrst ANSI,VER AU qUESnONS APPUCABLI rO yOUi pROlECr
'P.ojed R!5por|3iHgty.
Date:
ffi
ra{,*.r
l"{ '
4pP967ry915 11496, Steves
pRorEcT Ao0t€ss:
suBDlvlslo{: Ttle Creok al yrillorxlc&
T/A Stevens Fine Homes
A e cllyr lvlmirEdon zp, 28<0s
loT s:0
PRoPERTY owr{rFt ,lAAire Ste!$s Building Company
OwNER's ADDRISS: 5/10 Obander Driw Suite 200
PHo E$:91G7943699
ctry Wilmingrton 2t 28403
colTRAcToR: Sievens Buddir8 Company
4ppx655; 5/10 Oleander Ori\€ Suite 200 dryr Wimirgton
EMAIL ADDTESS: snichobon@evensfi nehomss.corn Pl()t{E: 9
pggXg.91A32{515
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D(STlltG COt{sInUCflO,|: E AheFt on il R.noyauoo D G€i€r.lRepat6
ttEW COt{SmUCnOll: d Erect Neq, Bestdence O Addition to Ettsting Residefie n Reio..tio(
...P!,IASE CHECr AND A,{'WEi AEI.OW A[ THAI A,PIY TO YOUN PNOJECT" 'd ln earage 1sF) { 11 o Det 6arase (sr}- ,/r-*,r,
pRo.,Ecl conracr pERsog. Sbci Nicholson
n Sunroorn (5F)-_- D pool{g1.*-
D G.e€.hoq5! {SR-- tr Oecf (SF) -..-.-...-
li the propo*d wo* drrotiry tie edning footprtnt? O yes d ruo
TCTTAI 5q FT UI{oER R@t Wr pro#*d wot*})tE g}dt Ll?L <a1
Ltr*reatrd: J l'
TOTAI PAOTECT @5T iLess Lor)r S 120,000
DegdiFUon of Wodc Ner4/ Resid€nt al Constudion
ls the propos.d wor* chrnging the number of Hrooms? E ycr d Lb
lsarryElecli.al,Pk|.tlbkgorlrlldur|alwortbeingdonetoth€A.EessoryStruduretrVcrdlto
lf the proied i5 a ndocst fi,isthere! N.turalGa5 Upeoo thecurremshe? El Vrs d o
l. there Electrlcal Power on thb Euitding? tr yr. d.ilo
kop.rty Uid ocdrprn.y, d Sng. f"-fy tr Duplq tr Townhoure
it,r lrl oA
OEo.Uxq: I i...6y c.rriv rhat .lt t r€ ffim.ldt h ttis .pplr6d..r 6 drt.r ,.d .{ i/!rt uj!dnrly r/i6 nE sLt? gdbtf c!d. rrxl .I orrlr eTi,od. 5t bbwr.nd ordiM6 &d aslt ddtr lfu r{HCDG/€i6t trfi scrvis C-€.,r.r,ill b. rdn d of pL.E a.d tpedn(26uu ctintornr.lo.! "'xolf: Ant ro* p6fo.rEd dio.n 6e .lgropiet pcrmrB $! b. h r. ,i.cr u, r! !SOO&...
Owne./C-onlr.ctoc C.aig Stev€-ns Signatule:
Uc.n\.d Qtblifret' Prilt Narne
ls the propertv located ina floodplain? O y"s d.t$ |
Ensting tmp.rvio{s tue .t Llb .L * n
tl* trnpervtoos lrea: *!( sq rt IEdstiq Lztd Dkfir.tring F€.mk E yej E
lotat lcres Oisturbed: 113
]
t
wAIEn: d CFPUA n Communiry svslem Cf private wel EI Cantratwell A Aqira
SfwE* dcfpue fl coDmuniry syitem E privrte sepdc O centr.lseptk Cl equa 4 1r..- ,
Z,tnei , -r fficer: --. sethcfs (F) + (tfll - . (RH) ,r (8, i 5
Appror.l:
-
Gtyr
-
O3t?:
--
Rood: (A) 1r M r -0{l uir-Zr"
No
Lji/r,'i\
Coftment: ..:''- ,I -r,Permit Fe.: t
I
IIj
I
i
I
I
i
I
I
i
I
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I
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I
Ij
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i
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D StoGge Shed (5F) .-
tr other (5F)
!
I
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) ot: -Eo\7
Pllot'll lr
BLOCI( J:LOT ';
?5JUL 1? 1:1 1
Nft6l }IAN0VEE COUNTY BUILDING PERMIT ) rr-a31 I
'PP'JaruOII 7Y"E: R,ESIDEI\|iTAL
9tErSE ,trsEl tlL Q0E5IIOi5 lppuc&LE m mumioJfcr
"ProJ €ct }espoDs$f LttJ,!
DATE I
APPLTCATTOI
llurberr
(sfftc. U3.)
APPLICAI\TT'S
OEVELOPER:
PRO]ECI ADDRESS:
SUBonItsfolJr
PROPERTY d.}IER'S
Ot.I}'Ef,,S ADORESs:
CITY!H#WM
(
E
\
CIFY;
CTTY:
PlloilE *:
ST
ACCOI''IT *:
ptt0[E *:
PrftNr *: Q l0'3{t3"73
,ADDRESS:
EIlAlL ADDFE5S:
PROJECT CotfrAcf pERSo r Vo
ErrsrrG COII5TRUCE0N. n AtrFiAII{Dt I reitoranor n GENERAI nela:ns. I RElocATroll
lrEh.t tolr9rmrct:Ist: p[ rnrcr x$t RESTDE CE or E nOmoU To DGsTIt{6 REsTDE}rcE
'+LrAse €IEC( lJlD at6l r FElol, &L rMI Epptv lo your ptolicrr
flrrr aauer 4( pA' sr ! orr canmr _ sr Elp*qt
5UNRoC${5F tr STORAGE SHE0 SFf| onrauo.rsr -- .sr I oecr .- sr olrEl :
pnopEnrv usE / occumrtsyr Elsruole LY u,PtE(:tr
DESCNIPTTON OF UOh(:
sr Ilrcu_
rorAl HEATED rq rr,, ,{lQ( rorAl sq Fr r.h}DER r*r, dtQt/ rorAl AREA sa Fr: ql(X)
rorAl pRorEcr cosr&6io{ , r &aY.x) # oF srotrEs, I .5 "!s Ary ELECTBICAL, Ptlt,tBFlG oI tlEcHAUIclL Iort E€tia Don! to.tho A<c.r.ory Structuell E Vg" E Uoff the projest ls a Reldcatlcl, ts 1fierc a Naturnl 6s LlnE on the cd..ent sit;) EG E H"
Is there Electrical Parer on this Buildlrg? f:? Ves f]m .'
ztP:
,0Dfr\e-n-{et{
or.rNEn/corfiRAsioR:SI6MIURE,
*' r r+ * * r + r r. r r.r **.+ *...*.(i#lFii,al*Brt:!'-litt*+*$+tt+t*rl:i+*a*ttail*lrt*ti:r*rt:rtlrtla
rs rHE p&opERTy Lo.rArEn tN l rlooopLlnt If yrs Bw
ExrsTlllc ItlFERwotE llEA!
--sQ
fT lO?At.ACFES )ISIURBEO:
NE I :,.tpE8WolE .AAEA: .==--__ sQ FT ACrsT r,AtD DrsruRorilc pEsfir: [.]? yrs l:l ruo
uarrn, fficraa I ro,itrurv svsrar I enrvrrr tlru .[ cannel wellsEreR:fi cFPue E ceinnnr_ sEpIIc f] pRruATr srnrrc .fl cd,t{.tiirry svslR,
-. sflar.qrE, ptrRns RtQUrtt, Fot ELECT, fiEEt, pLS6, C$ EqLna, pRrFlls a,nsElTS '.rp^yrE r rErroDs lJ cesr LJ qrecx_ 1p.1lBlr ro rna) f,larlr lrca,tn I nczwsl po:scoirrrfr*i*rarrtal*ril+L+*+t***rt**lr**r********ll*J}rt*t*r,ttsatrr+r!rr*rl{attattrt*tat'ti+
. ,w,l,, ollc Galrrlr2rf,. a,l[_
X BFt+2ft-
--ll --1 rPERflrr FEEI t I .1., I
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APpt:o val
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{yrenals
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APPLICANT'S [ArtE :
DEVELOPER:
NEW HAITIOVER COUNTY BUILDING PER!,IIT
aPPL ICArrOrl rYPEr COtlllE RCIA L
pLEASE A slrGR llt Qt ESrIOr,rs IPpIICABIE TO YdJi PROIECT
"ProJect BesponslbllltF,
,1,/1 Ltl ('+
f1 L CrrV: L<.r i Lr.i vq
W
APPLICATIOII
llr.6$.r
(cfftc. Urc)
oorz, 1'{'/1
PRO]ECT AOORESS:
OCCUPANT/BUSINESS NATTE :
PROPERTY OI,JNER'S llAr,tE :
OI{NER'' AODRESS:
CONTRACIOR:
ADDRESS ;
€fiATL ADDRESS;
PBO]ECT CON'ACT P
PIE'{E I:
+o4/ZIP: Illf Ol-f
o{,t (-
CIIY:
LIC
CITY
sf I J/b,x?;73LLl
Er{sE r: n/ co ooeql.-a, H<iTT ' t -rrh11e, z3L7
o-
L/
{
5b
$oq C L PI()NE {:
PHOlrlE [:ix
Exrsr co srRwrror: [ rurrmrror{ f] *rt#il;li 'tt?rll*r- nrrarns fl REroc rror{ -tt Ralctloo. is there a Neru;t Gas Line on the cu-nenr site? [ veifi N" rs aloc spntN-xleneot p[f". flr.ro
tlEl.t cot{srRucrlotl r I enecr Et{ srRucnar f] resr rmcx n srelr. f] unrrr ! aoo ro Exrsr sr?ucruRE
ACCE5SOiY STRUCTURE:
Is El.ct Poecr on this Bulldlng n yes W6If UPFIT - The Shell Perml.t t:
fF Yca, ltet l,as th€ Previorrs Occupr'|cy Ttpe?
*r... ri tHJs A cufioE oF occupancy ustr flvts ffi""'
AiC'{ DESIGI{ PNOFESSIO.{AL:
EI,I6R DESI6I'I PTOFESSIOi|AL :
co,rtaln Ab.al6 oa rEt Yo{ alr |t$i.d b cal tl. Hrdo.lt
daioltb.r ol cry lbcdlt d hlltfrlo. S.. Aataio. r.j.b SL:
TOTAL PROJECT Cosr: ){,Ooo
lhat 15 the l{cri Occupancy iype?
E nhalon SEdanh 16 Harsrdo$ Ar Poluffi (NESHAP) st
r,t to - {L\ ' ((?Ac nE6 ,1
t tG Hff1t, or bulhlB w.c hr.|d !o
!{ lel t0 dey! Eio. io O|.
# OF STORIES:
* OF FTOORS:
-
SO FT
Plr
PH
NC REG I:
OESCRIPTIO''I OF I.'ORK :o
ls ,ood or bovtr8gr6s pr€pa.6d or sgrved kt Uis &uctrra?Yes No b Th€ Property Locat€d ln
the StEre
RE:{osrr)lldo: O.molfio,l notlic'ddB l aslndta rlanorr.t pdn il r99lhriron8 a'r b b. rulrnltud urlfiO tho lprahattat to.r'l
hl9rr*r$,a!l.at t .rE.sa/apua.bctdrlhinBhlnl
BUILDING HEIGHT:
TOTAL AREA SO FT :SQ FT PER FLR;TOTAL SO FT UNDER ROOF:
-
# oF STRUcTURES:
ACRES DISTURBED: _
NEW IMPERVIOUS ARE{I
Exsr rAND Dtsrunerxe eenurn flvrs I No
T
SO FT EXISTING IMPERVIOUS AREA:
PRopERryusE: ffoFFtcE Enesraunar.n fluencerrrnle [eouc ffi gmn* or,**,
HEx; EUBF:UI EBEilH:XUffi*E m*,,* nffillffif.ffi'-' SEPARAIE P€RMITS REOUIREO rOR ETECT. M€CH. PI.S6, GAS EOUIP. PR€FASS E INSERTS -,
PAYMENT METHOO:flcrsu f]oree( (pAyABLETo NHc)neuenrceH exrness I
U1 (FOfi OTFlcE USE ONLY)---ZONE:=-OFFICEB:SETBACKS: F: LH:_RH:_B:_Apprcval:_ Clty:-DATE: FLooD:-8FE+zffn
R
t\ o ,,/
Commenl PERMITFEE
lzlls,
\;\\,
PloilE t I
# OF UNffS:
L
NEI^I HANOVER COUNTY BUILDING PERMIT
APPLICA|ION TYPE: CO{MERCIAL
PLEASE ANSWER ALL QUESTIONS APPLICAELE TO YOUR PRO]ECT
"Project Responsibility"
:ll ,t^j a-""J Ur.
r\
./,\1 fuLT ac)l- to22
APPLICATION
Number
(offi.e Use)
,or.' 3l z1l'z- ilAPPLICANT'5 NAIiIE:
DEVE LOPER i PHONE S:
l)
ryN
z
!
PRO]ECT ADDRESS:a icf,
OCCUPANT/BUSINESS N'I''lE :
PROPERTY OWNER,S NAI'IE:
OWNER'S ADDRESS: H
s.i}/loe 8".
ADDRESS:
EMAIL ADDRESS:
PROJECT CONTACT PERSON:2
NEW CONSTRUCTION:ERECT NEW STRUCTURE
ACCESSORY STRUCTURE:
CITY:
LIcENsE #: 72fi4
cITY: \,l.r:i*-*r"F-
st @zrc'. Z'1 rooq
sr: l]c zrP: zalo I
crTY: V r ZrP|'Lc,-+a3
PHONE #:
12e
t-.1 , Ol "r^
I
O
PK)ilE #: 1\D -qqq rj)t
PHONE *:
FAST TRACK SHE LL f] urrrr ! mo ro Exrsr srRucruRE
-/ -/ ((heck aII Ihat Apply)
Exrsr coNsrRucrroN: Z ALrERArror I nercvarrot f[ ceryrnar- neelrns l-l RELocArroN
tf Rolocatioo, is lhere a Narurat cas Line on the Eirent snez I ve!"ffio rS BLDG spilixlrREoz I ves p[r(o
If UPFIT - The Shell Penmit #:
IF Yes, uhat Has the Previous Occupancy Type?
ARCH DESIGN PROFESSIOT,IAL :
**r.*:i rs rHrs A CHANGE oF occupaNcy uset flves {* *****
Is Etect Power on this Building p,Yes E nO
tJhat is the New Occupancy Type?
PH:
ENGR DESIGN PROFESSIONAL I PH
NC REG #:
NC REG #:
o-t Scr.,ct- u.t\ 3$arLDESCRIPTION OF
Pefr-c a.h'o"^ls tood or bovorsges
OWNEF/CONTRACTOR:
(aldrbr)
TOTALAREASQ FT I .,
rorAL se Fr uNDenEooF'- 'L bi-T.------7-
ACRESDISTURBEO: ^,/o\eNEW tMpERVtOUS AREA: A,.o ne.
./,pRopERTy usE: flornce l_jResrauneNr luencnNr[e leouc ! 6p1
Floodplain?ves ft-tto
lding Code and all other applicable Stale
n the aooroved olans and soecrficatronsVDlalrcn ol theNC Stale Bldq Code and
@NDo orHER: d!fie 9;q C Dra-l
v--
FI,\I:d,Srttve SIGNATURE:(-:
Nole: D€molhlon nolffcatons & asb€stG r€moval pemit applbatjons aI€ to l,e submhted uslng th€ appllcatjon form (DHHS-3768) wharher tho hcttity or bultding was found !o
conEln Aab€sloa or not You are rcqul.8d b call lhe Mtional EmHsloo Standads br lhz6rdou6 Ar Pollurants (NESHAP) at (919)707€950 st tsast 10 days p.ior !o rhe
d€mollton of any fadllty or bululno. See fubesbc Web Sli6: http/ rww.epl.sroto.nc.uyepussb€sto6!,shmp.ht nt
TOTAL PROJECT COST:45{ 000 surLorNc HEIGHT: 31 ' 1"# OF UNITS .L
SQ Fr PER FLR: th+# OF STORIES:
# OF FLOORS:
3
# OF STRUCTURES 3
Exsr LAND Drsrunarxc eeRurrz I ves [f-no
SQ FT EXISTING IMPERVIOUS AREA 1 SO FT
I
lWATER: UtrCFpUA fICOMMUN|TY SYSTEM fl WELL fIZON|NG USE CLASS|F|CAT|ON:
sEwER: EicFpuA - CENTRAL sEpnc E p-RtvATE sEpflc Sdoli$,ruNrw svsreu
". SEPARATE PERIVITS REOUIRED FOR ELECT, I!4ECH, PLBG, GAS EOUIP, PREFABS & INSERTS -'
PAYMENT METHOD flcesn flcxecK (eAvABLE To Nnc; firurlenrcal ExpRESs I rilcnrrse [-'l orscoven
ttra 19oo
REVISED DAIE {1 1/12
CONTRACTOR:
{-
ZONE:_OFFICER: _ SETBACKS: F:_LH:_ RH:_ B: fl. ,. tun_ .'I.,Approval:_ City:_DATE: FLOOD: ___ BFE+2fi= L)v?.P lu u
A v N ---->
Comment pERMlT FEE: $_
,$.qro)lctE-14@O,.. - .i, - ri.\
i@)
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TTPE RESIOENTIAL
PLT ASE ANSWER ALL QI] ESTIO NS APPL]CABL E TO YO UR PRO] L (1I
"Project ResPonsibilitY"
)ol1-e03
Number
Date 7 t1012017
APPLICANT'S NAME
PROJECT ADDRESS:
Danny Townsend. Sears
e R.l CITY Wilmington ztP 28412625 Hunting Rid
LOT fsuEDlvlSloN:
PROPERTY OWNER'S NAME:Rub EIrod PHON r a: 910-338-3508
Ridse Rd CITY Wilmington 217 ?8412
OWNER'S ADDRESS 625 Hunting
47330
CONTRACTOR Sears Home ImProvemenls BLDG LICENSE S
4523 Green Point Dr., #113 ctTYr Greensboro sT: I9 zlP: 274'10
ADDRESS
EMAIL ADDRESSI dvl7612@aol.com
PROJECT CONTACT PERSON Danny Townsend
txlsTlNc CONSTRUCTIoN: fl Alteration Oz(enov"tion E General R€pairs
NEw CONSTRUCTIONi ! Erect New Residence E Addition to Existing Residence E Relocation
NDA E LY R
E Att Garage (sF)-......_-
E sunroom (sF) -....--
E Greenhor.rse (SF)
E Det 6ara8e (sF)-
PHONE 336-847-1970
tr Pool (sF)
E Deck (sF)
PHONE 336-847-1S70
E Po.ch (5F)
-......._-E storage Shed (5F)
-
D other (SF)
ls the proposed work changing the existing footprint? D v"t ffio
TOTAL sQ FT UNDER R)OF (Jor Proposed wol{) Heated 100
ToTAL PROJECT cOsT (Less Lot)r S $4.954
Property use/ occuPan"Y, Mingl'Famlly E DuplexE Townhous€
ls the proposed work changing the number of bedrooms? E Yes Ef-ru"
,r"nULt"or,""t, Plumblng orMechEnlcal work being done to the Accessory Structure E Yes El No
{f the project is a Relocation, is there a NatLlral Gas Line on the current site? E Yes E No
ls there E ectrical Power on this guilding? El'Yes E No
Unheated:
ntertop,faucet, replace toilet, rePlace floorinqDescriptionof Work: Bathroom Remodel New vanilv, cou
DrsCl.AlMER: lhereby certify that allthe information in this application is correctand all lvork will complv w
L*i"",r "rar.-*, ""a ,€Sutataons. fh€ NHC Devetopm€ntservires center wi1 be norifred of any changes
,.r.,.rii.". '-'tlorE, anY;ork performed without the appropriate permits will be lnvlolation of the Nc 5
ith the state Building cod€ and.llother applicablest'te and local
in theapploved Plam and spe.cations or ch.nge i
code and subject to s up to S5o0_oo+
owner/contractor: Danny Townsend, Sears sltnBlure:
"Licensed Quolile." Print Nome
ls the property located in a floodPlain? E Yes E No
Existing lmpervious Area:
-
Sq Ft
New lmpervlous Area:
---
Sq Ft Existing Land Disturbing Perm
WATER: ErCFPUA D community System E Private Well E Central Well E Aqua
sEwfR: l/CFPUA E Community systern El Prlvate septic E CentralSept'c E Aqua
Zoner
-
Offlceri
-
Setb.ck (F)
-
(LH)
-
(RH)
-
(B)
-
TotalAcres Dlsturbed:ST;fugr,'t wd-
$to rlua-
Iti D Yes E No
Approval:
-
city:
-
Date:
-
Flood:(A)-(V)-(N)-BFE+2ft=-
Commenti Permit Fee: S
?5s &oq__ T L tPfi
3
$NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION ryPE: RESIOENTIAL
PLEASE ANSWER ALL QUESTIONS APPLICASLE TO YOUR PRO]ECT
"Project Responsibility"
CITY
Date 7't1 - t1
ztP:4+o9
Lor i: I 1..-
PHONE #1-7 o- %70
ztP:28?07
Application
Number
(office us€)
APPtICANT,S NAME:
PROJ€CT ADDRESS:
,ra
SUBDIVISION
PROPERTY OWNER'S NAME:
OWNER'S ADDRESS:
CONTRACTOR D
ADDRESS:
t L-L CITY
CITY
BLDG TICENSE #11ooB
sT: LLLztP: ZA?o I
PHONE
PHONE 9ro.rt{-3 317
EMAIL ADDRESS . C A<ree,^ @) )41l -11- . {1 c4
PRO,IECT CONTACI PERSON
EXISTING CONSTRUCTION: f Alteration I Renovation ! General Repairs/
NEW CONSTRUCTION: M Erect New Residence n Addition to Existing Residence tr Relocation
* *.I PLEASE CHECK AND ANSWER BELOW ALL THAT APPLY TO YOUR PROJECT **
n Att Garage (SF)_
E sunroom (5F)_
E Greenhouse (sF)_
E Det Garage (SF)_
tr Pool (sF)
y'Deck (sF)ZZ,O
E Storage Shed (SF) _
tr Other (SF)
ls the proposed work chan8inB the existing footprint? tr Yes ElZNo
TOTAL Sq FT UNDERROOF lfor proposed work) Heated:l8o t Unheated:
bnTOTAL PROJECT COST (Less Lot): S ooo
ls the proposed work changing the number of bedrooms? tr Yes y'No
ls any Electrical, Plumbing or Mechanical work being done to the Accessory Structure tr Yes - r No
lftheprojectisaRelocation,isthereaNatural Gas Line on the current site? n Yes E No
ls there Electrical Power on this Building? f Yes I No/
Property Use/ Occupancy: fl Single Family n Duplex n Townhouse
Description of Work:
DISCIAIMtR: I hereby certify that all the information in this application is correct and all work will comply with the State Euilding C
lawr and ordinances and regulations The NHC Development Services Center will be notified of any chan
all other applicable State and local
,fications or change in contractor
nes up to S500.00**'rnformdlion. "'NOTt: Any work perlormed wilhout lb€ appropflate permrts wrll be rn violation of the
owner/contractor, E/ l,s D- (lnrrter, si'nature:
"Licensed QuoliJier" Ptint Nome
ls the property located in a floodplain? /r". O *o
lect t
Existing lmpervious Area:Sq Ft TotalAcres Disturbed: ' O1
tr1s )"pnt g,ia-
s@xil5
New lmpervious Area:5q Ft Existing Land Disturbing Permiti Yes - No
WATER: D CFPUA n Community System n Private Well ! CentralWell E-Aqua./SEWER: I CFPUA n CommunitySystem n Private Septic ! Central Septrc g Aqua
Zone: _ Officer: _ Setbacks (F) _ (tH) _(RHl_(B)_
Approval:- City:- Date:
-
Flood: (A)
-
(V)
-
(N)
-BFE+2ft=-
+
Stat
Comment Permit
T5
LO
I Porch {SF)_