The URL can be used to link to this page

Home My WebLink AboutJANUARY 22 2018 BUILD APPS2oru-Q$ll-NEW HANOVER COUNTY BUILDING PERMIT APPLICATION TY PEi RESIDENTIAL PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROIECT "Proiect Responslbility'' CITY: Number (office use) APPLICANT,S NAME:Date l-22- lP,"-Aii.9-PROJECT ADDRESS: SUBDIVISION:oT# PROPERTY OWNER,S NAME:PHONE # zlP BL LICENSE ztP "YltuPHON E 252-LzL - ?a97 PHONE:zra-Lzz- 1c?9 OWNER,S ADDRESS:Pa br 5//CITY CONTRACTOR ADDRESS:fu xo -'t Ett EMAIL AODRESS: CITY PROIECT CONTACT PERSON EXISTING CONSTRUCTION; E Alteration ! Renovation D General Repairs /NEw CONSTRUCTION: E/Erect New Residence D Additionto Existing Residence D Relocation *'}'TPTEASE CHECK AND ANSWER BELOW AI.I. THAT APPLY TO YOUR PROJECT**'} BZDet Garage (sF) - D Att Garage (SF)- n Sunroom (SF) Owner/Contractor: "Licensed QuoIilier" D Pool (SF) State Building Code and all other applicable State and local approved plans and specifications or chanSe in contractor D Porch (sF) E Storage Shed (SF)_ D Other {5F) to 5500.00'*+ "l*"-- Ll breennouse [5r) _! Deck (sF) ls the proposed work changin8 the existing footprint? fl Yes dNo Property Use/ O€cupan leF ilv n Duplex E Townh se Description of Work: DISCLAIMER: I hereby certify that allthe information in thisapplication is correctand all work will comply with the lawsand ordinancesand reeulations.The NHC Development Servlces Center will be notified ofanvchanges in the information. *'"NOTE: Any work performed without the appropriate permits will be in violation of the NC State Bl Signature: ts the property located in a floodplain? E/"". tr t'lo 7r"/'a't^''7 nf 2/}tn Existing lmpervious Area: - Sq Ft Total Acres Disturbed: New lmpervious Area:Sq Ft Existing Land Disturbing Permit: E Yes n No waTER: U/CFPUA f] community System El Private well E central well E Aqua SEWER: U/CFPUA D Community system n Private Septic ! central septic ! Aqua zone: - Officer: - setbacks (F) - (tH) - (RH) - (B) -Approval: - City: - Date: - Flood: (A) - (v) - (N) - BFE+2ft= - Comment:Permit Fee: S il ]!:".:.' i 'i,1. ,fih*Hltr <E'' ToTAL sq FT UNDER RooF lfot proposed wotkl Heatedt I t zft) unheatedt // ,O? ToTAL PROTECT cosT (Less Lot): S &4 OO ls the proposed work changing the number of bedrooms? ! Yes B4{o ls any Electrical, Plumbing or Mechanical work being done to the Accessory Structure dYes E No lf the project is a Relocation, istherea Natural Gas Line on the current site? tl Yes E/No ls there Electrical Power on this Building? /ves tr Itto g LlSgre'( - aol\J NEW HANOVER COUNTY BUILDING PERMIT APPLTCAfiON rrPE, RESITENTIAL pLEAsE Al{sl{ER ar.r- gJEsrrots orptrcod,t ro youR pRolEcr ?roject Responiibility- APPLICMTT'S M',IE:G-,-- *, ' a..,'+{.. ffi a/u DEVELOPER: -.i a-t-L. ( crLis DATE: PRO]ECT ADORESS:2o SUBDIVISION: PROPERTY OO'NER,5 IAIqE : or{{ER,s ADDIEsS: /2 ql7 uru CONTRACTOR:Jrt ?"& AOORESS: EMIL ADORESS:G, PROJECT COI{TACT pgx5qy, &nd.g...:K-o-"cll PTONE I: BLOCK *: LoT $: ttcetst *t 6 B// L PHOI{E *i 5T -b 76-Btod zI.P:Z7l,iV crw:le, q t- zrPt Z8 4lL*5?- fitt)<-znZ76i* *, ?-rr.4z7--6dt;a crw: 'fr. u CITY: EXTsTTNG CO{STRUCTTOII: I ar_re nlrroru ! netwarron I cereul neecns ! ner-ocrrrorl t{tH coNsrRucrror: ffirnrcr EH RESTOENCE o. ! oorrron ro Exrsrrl{G RESTDEitcE ..PLEASE CHEC( AND AiISIEN BELOW ALL THAT APPLY TO YOI'R PTO]ECTI flfarr camce 522 sF ! [surunoou -sF tr OET GARAGE (E PoOL <E I roncr 323 srfl sroucr SHED _ sF P}ONE SF llo I I .rflH tg ?:50Pt'l ! cneelxous r _ sr ! oecx _ sr OTHE R: rorAl HEATED sQ Fr. Zc,tts rorAr sa";Ttfi**r, TOTAL PROIECT C05T 1r,ess rorl t g / ?X? zfx-t # OF STORIES: INCY:tr SINGLE TAMILY b*5 TorAL AREA sQ FT:ze7 rs Any ELECTRTCAL, p,nBr G or ,n'crAflrcal ,,o,.k Belng Done to the Accessory structur.e] [ ves fi Horf the project is a Relocation, is there a r,raturar. 6as Line on the cu*ent srtil trv* EIs there Electrical powen on this Building? [lV"s Ito EPROPERTY USE / OCCI,,P DESCRIPTIOI{ OF }'l0R(: DUPLEXeo€Hru,:Si OISCLAIMER: lhel.by certit halal lnbmatjon h hls sppticrrion b cor€d.nd allworkwl! complywih he Stat6 Su dhg Coi,e aod alloherspp[cabte Srats and tocal tawsand ordinances and mgulatlons. Th6 NHC De v€topmen t SeNices C€nter wi{ be notli€d ofsny changes io the appoved ptans aM specifications orchange in contracbr orconrracb, inbnnarion. '_!{OTE:Any Work podormBd WO he Apprcpriale Pemltswillbe h Vblarion of th6 NC Sr.b Bldg Codc and Subject b Fin€s Up To i5000f" Oh,I{ER/CONTRACTOR: * ** * ++:| * r* * *+++ +* ** ** * ** ** *9i'Il Jit'J * * IS THE PROPERW LOCATED I1{ A FTOODPI.AIN? EXISTIIiIG IIiTPERVIOUS AREA SQ FT SIGI.IATURE :A httr , 4 .1/u*-,ru;fl'-- ***t*+* ****:t+* *,1,r ***:rr Ero TOTAL ACRES DISTURIED: *t**** **++ * ** *+ **+* **n YES NEti'l I PERVIOUS AREAs SQ FT EXrsT LArrtD DTSTURBTNG prnMrt, l-.1 PRTvATE wELL ! celrul well YES Ero wrrenr [l creua I cclr4uNrry svsreN I sEwER: BCFPUA I c$rrul seerrc I pRrvATE sEprrc I cour.rurtw svsre,r ZoNE: _ 0F FICE R: (FoR oFFrcE usE ol!y) x.EvrsEo oarE 04/11/12 SETSACKS: F: LH: RH: E. *i* SIPAIATE PER}IIIS REQUIREO FOR ELECT, T{ECH, PLBG, GAs EqJIP, PRETASS & JNSERTS ** PAYttErr nErtioo: Ecrsx EIcrecK (payaBLE, nol-tr-r.r;;;;;r''-fr'rl^iio'''Eorr.orr. * * *'t+'|'tt+++ *+'r'*'t**+ lt'l +**+ **** a**,pt*:| * *r*+,1:t*'*,t**r*** + *:r:t **a*** ** ****+** *** **** **tr**** ** Approval:_ City:_ DATE:_ FLOOD: _ _ BFE+2ft=Av[ rpEliil-rrot l{ulllber (offic€ U5.) Pto E s: 9It-7?.e- 8zi3 , .i. &,,' APPLICAITT'S I{AtItE: DEVELOPER: NEI^J HANOVER COUNTY BUILDING PERMIT APPLICATIaN rYPg: RESIDENTIAL PLEASE ANShER ALL QUESTICNS APPLICAEL€ "TO YOUR PRO]ECI ttc hfiroject Responslbilit]/' CITY: BLOCK LTCENSE *: CITY 2ot8-auo L€.--90 APPLICATIO umber (Offi.ce Use) DATE: PROJECT ADDR SUBDIVISION: PHOIE *: PHOt'l € ST zrp{4,*U1 LOT *: _ :, PROPERTY Od ER'S t{AIqE: Gd{ER,S ADDRESS CO TRACTOR: ADORESS: EI.,IATL ADDRESS: P PRO]ECT CSITACT PERSO : EXTSTI G CO{STRUCTION: I sur'rnoor,t -sF f] eneerurousr - sF TOTAL HEATED SQ FT: TOTAL PROI ECT COST tr-ess roo I $ PROPERry USE / OCCUPAflCY: PHG{E * Pl{ot{E #&9|Hr.'.}:Fl; ffi ves E rc n\& ALTERATION RENOVATION GENERAL REPAIRS RE LOCATION NEW COT.ISTRUCTION:ERECT NEI RESIOENCE oT ! aoorrror ro Extsrn{G REsrDEircE **PL E CHECK AND ANSI'ER BELON ALL THAT APPLY TO YOUR PRO]ECT: 5F PORCH \bATT GARAGE e4 5F ! oer ennaee SF I eoor-SF STORAGE SHED 5F DECK SF OTHE R:SF TOTAL SQ Fr uNDER noor:1511 TOTAL AREA SQ FT: # OF STORIES: Is Any ELECTRICAL, pLUttBINc o. TIECHA ICAL ltlo.k Belng Done to the Accessory structuret f] Yes If the pnoject is a Relocation, i.s there a Natunal Gas-Line on the Current sitef I Is there Electrical Po!,er on this Building ? l-] v"t [l no6,LE FAIVIlLY n DUPL EX TOWNHOUSE OESCRIPTIOfTI OF WOR(: and ordinancss and regulatlons. The NHC Development S€Nic6s Csn ter will be notlied of any changes in he ap contackrinft).meton'"NOTE:AnyWorkP6.fom6dW/OheAppropriaGPermitswillbEinV:oleto.oflhoNC Od{ER/CONTRACTOR:S I G{AI *+rr****+r.*+r*r.* *** * ** * **** *(I!11lii."J * * IS THE PROPERTY LOCATED IN A FLOODPLAIN? ** *****+* **** ******r(+,t + onr or change an conlract' fi YES Eno EXISTING I''IPERVIOUS AREA:SQ FT TOTAL ACRES DISTURBED: NEIII IMPERVIOUS AREA: -SQ FT EXIST LAND DISTURBING PERI'IIT:flves flrio h,ATER:c PUA col$luNlw SYsTEl"r PRIVATE [']E L L ! ctnrnal wrll ! co'turrw svsremSEhIER:CFeua I cEr'lrRAL seerrc !PRIVATE SEPTIC r'''.k 5€P;\RATE PERi{iIi lEr)U:33D iDR EL:(ir rlEcir, )Lg€, 6A5 EtUip, PtiFA05 A llisERiS *ri pAyMENr r{ErHoD: E crs, E cxecK (pAYABLE ro flrrc; [-] rreucAN ExpREss f] ncTrrsl I orscoven ,a,l* {. t,t* ****,**,r*,**;ti. i.,i* **** * **,r *,1.,t *,k1.* * rr* * *,1. **,&r,r *** )i. *'t* * *** * * * * **** *a,t* *+* ***,a * * *,* ** **,rt n ZONE:OFFICER: Citv:Aooroval:DATE: (FOR OFFICE USE ONLY) REVISED OATE 04/11/72 sETBACKS: F:_ LH:_ RH:_ B:_ FL@D: BFE+2ft= Ysqo I mmm :i NEW HANOVER COUNTY BUILDING PERMIT APPLICATI O N W PEi RESI DENTIAL PLEASE ANSWER ALL QUESTIONS APPI.ICABLE TO YOI]R PRO]F'T "Project Responsibility'' 2o$-Q(!Z1HO7 Application Number (office use) APPTICANT,S NAME: Porch ConVersion Date: 1-12-18 PROJECT ADDRESS: 4208 Crockette Road CITY: Wilminoton, Nc ztp: 28409 SUBDIVISION: PH2 Sec 5 Masonboro Forest PROPERTY OWNER'S NAME:Rva n&MarV Taro PHoNE *:910-232-97 44 OwNER'S ADDRESS: 4208 Crockette Road CIIY: Wilminoton. Nc ZtP:28409 CONTRACTOR: Porch Conversion BLDG LTCENSE q.76247 ADDRESS: 6821 Market Street CITY: Wilminoton sT: Nc zrP:28405 [] Att Garage (SF)_ EMAIL ADDRESS: oorchconversion qmail.com PROJECT CONTACT PERSON: Brian WaIsh PHoNE: 910-777-3363 EXISTING CONSTRUCTION: n Alteration t'Renovation D General Repairs NEW CONSTRUCTION: [] Erect New Residence I Addition to Existing Residence I Relocation ,T*,TPLEASE CHECK AND ANSWER BELOW ATt THAT APPTY TO YOUR PROJECT'"T'} D Det Garage (5F)n Porch (5F) /sunroom (sr)492 D Pool (sF)! Storage Shed (SF)_ n Greenhouse {5F)_n Deck (sF)n Other (SF) ls the proposed work changing the existing footprint? 5 ves /No TOTAL SQ fT UNDERROOF Vor proposed work)Heated:492 Unheated: TOTAI- PROJECT COST (Less Lot):5 10 740 ls the proposed work changing the number of bedrooms? tr ves /No ls any Electrical, Plumbing or Mechanicalwork being done to the Accessory Structure /yes fl No lf the project is a Relocation, is there a Natural Gas Line on the current site? ! yes Ef No ls there Electrical Power on this Building? pf Ves g1 lto,Property Use/ Occupancy: fr Single family n Duplex n Townhouse Description of Work: DISCIAIMEn: I hereby certify that allthe information in this application ir correct and all work will comply with the Stale guilding Code and all other applirable State and local laws and ordinances and re8ulations. The NHC Developmenr Service5 Ceoter be notified of any changes in the approved plans and spe.ifications or chan8e in contractor information. r"NOTEr Any work performed without the approp pe e in violation of the NC State Bldg Code and subject to fines up to 55OO.OO*.* Owner/Contractor: "Licensed Quolifier" t Jerem Martin Signature: ls the property located in a floodplain? n Yes Existing lmpe rvious Area: 4550 Sq Ft Total Acres Disturbedi 0 New lmpervious Area: 0 Sq Ft Existing land Disturbint permit: ! yes fl No WATER; [U -CFPUA n Communlty System n Private Well I Central Well ! Aqua SEWER: M CFPUA tr CommunitySystem n Privateseptic E CentralSeptic ! Aqua zone: _ Officer: _ Setbacks (r) _ (LHl _ (RH) _ (B) _ Approval: _ City:_ Date:_ Flood: (A) _ (V)_ (N)_ Bf Er2ft= _Comment: Permit Feei S /*o LoT #: 21 5 PHONE: 910-777-3363 I, NEW }IANOVER COLTNTY DEPARTMENT OF BUILDING SAFETY 230 GOVERNMEN'T CENTER DRIVE - SUITE i70 WILMINGTON, NORTH CAROLINA 28403 Telephone: 910.798.7308 Fax. 910.798.781 I lnl erne I : wwy,. nhcgov. com REGULAR RESIDENTIAL BUILDING APPLICATION STATEMENT OF UNDERSTANDING am submitting an application for a residential building permit to New Hanover County. And, as the applicant or person submitting the application, I check the boxlboxes below to acknowledge that: A I did not attach an official CFPUA document that acknowledged approval of the payment made to CFPUA. A I did not attach 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. E I did not attach 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. And because I did not attach the official proof of approvals along with my application for permit; New Hanover County cannot guarantee that the building permit will be issued within 4 (four) to 7 (seven) working days after the official submittaldate/time (the stamped date/time notation made by the Building Safety Department on the application or submittal document) Signed in acknowledgment: Agent Jeremy Martin Sign ure Printed Name 4208 Crockette Road tl g Address for the proposed residential work: Date q L$tJS NEW HANOVER COUNTY BUILDING PERMIT APPLICATION TYPE: RESIDENTIAL PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROJECT "Project Responsibillv' 2or&hroS Application Number (office use) APPI.ICANT'S NAME: PRO.'ECT ADDRESS: QftcJJ.e A. {+rrr TiT SUBDIVISION: PRoPERryoWNER'SNAME: r le+t-JutZ A .trtr OWNER'S ADDRESS: SCONTRACTOR ADDRESS:Ao,ov? CITY (J(.ztPZjSq(L: LOT f: PHONE #:qto-?r{-l ooBq crrY: {^ALJ\4 IUqA)N-t ztt:? 't-ll/Z.-, Date CITY Bt D6 UCENSE # ST:ZlPl EMAIADDRESS: F iti ara*-ri^q<e fA rnari I . corrr PHONE:\.,v g PROJECT CONTACT PERSON 6G)vg,f'PHONE EXISTING CONSTRUCTIONT ! Alteration n Renovation ! General Repairs NEW CONSTRUCTION: f] Erect New Residence E/Addition to Existing Residence f) Relocation **}PLEASE CHECK AND ANSWER BETOW AtT THAT APPTY TO YOUR PROJECT*TT n Att Garage (SF)_E Det Garage (SF)_! Porch (SF) E Sunroom (SF) \o -1q?'814 l:zJfiH l8 3t8l Pl'1 n Greenhouse (SF)tr Deck (SF) tr Storage Shed (SF) _ tr Other (SF) ls the proposed work changing the existing footprint? ! Yes ! No TOTAT Sq FT UNDER ROOF lfor proposed work) Heated:Unheatedi TOTAL PROJECT COST (Less Lot): S qK ls the proposed work changing the number of bedrooms? ! Yes €/No ls any Electdcal, Plumbing or Mechanical work being done to the Accessory Structu re f] Yes gzifo lfthe projectisa Relocation, istherea Natural Gas Line on the current site? E Yes !,rqo ls there Electrical Power on this Building? E4es n No Prop€rty Use/ Occupancyr q,,6(6gle family E Duplex ! Townhouse Description of Worki ADord Ol*JE TB LU]Sg *{\P*{ laws and ordinanaes and regulations. The NHC Development Services Center willbe notified of anychanges in the approved plans and speciflcations or change in contractor inforhation. +"NOTE: Any work perrormed wlthoutthe appropriate permits willbe in violation ofthe NCState 8ld8 Code and subject to fines up to $500.00.+. ol,vner/Contractor:Signature: "Licensed Quolifier" Print Ndfie ls the property located in a floodplain? n Yes fl No Existint lmpervious Area: _ Sq Ft TotalAcres Disturbed: New lmpervious Area: _Sq Ft Existing Land Disturbing Permit: E Yes D No WATER: \ CFPUA ! Community System E Private Well E Central Well ! Aqua SEWER: CFPUA tr Communiw System ! Private Septic l Centralseptic D Aqua-1 Zone: _ Officer: _ Setbacks (F) _ (l-H) _ (RH) _ (Bl _ Approval: _ Crty: _ Date: _ Flood: (A) _ (Vl _ (N) _ BFE+2ft= _ Comment:Permit Fee: S Y\ tr Pool (SF)_ APPUCANTS AME: PROJECTADDRESS: NEW HANOVER COUNTY BUILDING PERMIT AP PUAfl O N TY P E : RESI DEI{T|,AL PI..EASE ANSWER AI.I qUESTIONS APPUCABI.E TO YOUR PROJECT 'Prolect RsspooslbllM Co L L_C-'f-lL (J Date:i-r '^J sotS"ABa 18-10 9 Appllcetlon Number (office use) t - lc-t{ zt?t '73lWf suBDtvtsloN: pRoprRrr orvtEtrs nrrr, Cul*4- t t t OW ER'S ADDRESS: CONTRACTOR:tr}A ADDRESS: EMAIL ADDRESS: PROJECT CONTACT PERSO : tr Sunroom (SF) - E Greenhouse (SFl _ tu LOT[: I I 1t 0 .- 2q1- z5taL2-PHO ES: CITY: r. I I Llr.r r o'f zre, ZZYOT BtD6 UCENSE #;1Z c{e4 sr:MCzp PHOITE: PHO E:4lo z 1"1 - zqcru +"-6 n *orage Shed (SF) _ tr Other (SF) _ E(|STll{6 COJ{STRUCnO :tr ltseration E Renovation E General Repairs SW CON_SrRUCnOI: E/Aec ruew nesidence E Addhion to Existing Resldence t] Relocation ,/ .r.pLEAsE o{Eo( A D attswER BEr.ow Alr rHAT Apply ro youR pRoJEcrr* E att Garage lsr) I +1. trn tr Pool(SF) tr Deck (SF) ls the proposed work changing the existint footprint? fl yes No TOTAL SQ FT UNDER nOOF (for prcposed work) Heated;"Ja?-1_..',-........_ TOTAL PROJECT COST (tess Lot):o &A *{ ls any Electrlcal, Plumblng or Mochanlcal work betng done to the Accessory Structure E yes lf the project is a Reloratlon, ls there a NaturalGas Liry)dn the cunent site? D yes El4q6 ls there Electrical Power on this Euilding? E Yec pf o 6ls the proposed work changlrE the number of bedrooms? E y.a "Licensed Quolifref Nome Prcp€.ty Use/ Occupancy: gdnge family Ll Duptex tr Townhous€Ne,u lpBQof work: DlsOelilER. I hereby aenlfy that all the loiormation in thls appliotlon b conect and alt wort wtl, comply with the State EuiHing Code end all other applicable SBte and tocallav6 and ordinanc€s and r€gula0ons. The NHC 06reloFrent Serylcea Center wll be nodfied of erry dlanges ln the approvd phns and spedffaadons or dEnte ln coitractorinformation....NOTEl will be ln NC State TTIV\ Blds @den^J and sut ect to fine! up to \ ls the property located tn a floodplain? {ro , no b&tln8 lmp.rylou. Arca, 4 SC Ft Totat A.res Dtsturbsd , , &C J ty I{ew lmpervlorE Area:+1c 9 Sq Ft Existlng tsnd Dlsturbing Permit:IYerENo WATER: E CFPUA n Community System fl private We n Centrat We dG- SEtirER: a CFPUA E Community System fl priyate Septlc a C.ntolS.pti. gfi zone: _ Ofrc.n _ S€rbacb (F, _ (Utl _ (RH) _ (B) _ Appoyel: _ Ctty: _ Date: _ Ftood: tAl _ (Vf _ (Xl _ BFE+2ft='_ IComment:Permit Fe€: t t- L/r--.(./\--r\ unheated: l4qJ q......!|....rd}-- NEW IIANOVER COT]NTY DEPARTMENT OF BULDING SAI'ETY 230 GOVERNMENT CENTERDNVE - STJITE I7O WLMINGTON,NORTH CAROLINA 2MO3 Telephone: 910.798.7308 Fa: 910.798.781 I Interrre t : www.nhcgov. com REGUI-AR RESIDENTTAL BUILDING APPLICATION STATEMENT OF UNDERSTANDING I,am submitting an appli€tion for a residential . And, as the applicant or petton submittlng s below to acknowledge that:building permit to New Hanover Coun$ the app!on, I check the box/boxe I did not attach an official CFPUA document that acknowledged approval of the payment made to CFPUA' {O I dld not attach an official proof of a Zoning sign-offfrom the City ofdI \Mlnlington, for this work that will be done in the City of \Mlmington' d I aio not attactr an official proof of an approval granted by the New Hanover county gnrironmental Health Department, for this work that requires an approval from Environmental Health. And because I dld not attach the official proof of approvals along with my appll"ation folpermit; New Hanover county cannot guarantee that the bulldlng p"*lt *il1 be Issued withln 4 (four) to 7 (seven) working days after the off,clal Lubmlttal date/time (the stamped dateftime notation made by the Building Safety tlepartnent on the appllcation or submittal document) Signed ln acknovledgmont: Signature Prinbd Name Date r,7ld a tffln LILAddress for the proposed residential work: NEW HANOVER COUNTY BUILDING PERMIT APPLI CATION TYP6., RESIDENTIAL PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROJECT "Proiect ResponsibilitY' Application Number (office ure) APPLICANT,S NAME: PRO.IECT ADDRESS:/ l/2 Canopu b)a-a rdo-*-LL(*Oate: / -/b l6 CITY: LU aP: ZB+oq SUBDIVISION:-TL- "n I o ).>a.[q-J toT #3f PROPERTY OWNER'S NAME:O-,r^*-' c-c.+ +x,rs .,t J'l-L LLC owNER's ADDRESsT lZ9(1 Drr* a '-l- e& CONTRACTOR ).knRqctr- ADDRESS: (Z't[1 D.^v-A-.v.*- EMA|L ADDRE5S; J2oP K- Cl,A*-tr' c,--tn kowo f*-i(L, e or.n- A^J.e.: 2o--.i.. PHoNEs: 1t q-61G_gtoc) CITY IZot,ztP: Z7L I Y BLDG LlcENsE f: 6 8, /t, CITY:Sf: z\)C-ztP: zlc I PHONE ?tt -422-L qEo PHONE:1t1 -1qi- bz | 3PROJECT CONTACT PERSON: EXISTING CONSTRUCTION: E Alteration E Renovation ! General Repairs NEW CONSTRUCTION: EL Erect New Residence E Additionto Existing Residence E Relocation ''IPLEASE CHECK AND ANSWER BELOW ATT THAT APPI.Y TO YOUR PROJECT*** m Att Garage (sF)q71 E Det Garage (sF)_ ! Sunroom (sF)! Pool (sF) E Deck (SF)D Greenhouse (sF) ls the proposed work changing the existing footprint? [ Yes El No TOTAL PROJECT COST (Less Lot): S lfo aoc-t ls the proposed work changing the number of bedrooms? D Ves E t{o ls any Electrical, Plumbing or Mechanical work being done to the Accessory Structure E Yes EI No lf the project is a Relocation, is there a Natural Gas Line on the iurrent site? fl Yes .E[ No ls there Electrical Power on this Building? EI Yes E No Propertv Use/ Occupancy: [l Single Fa ily E Dupl Townhou Descrip tion of Work; S, E- Porch (sF)3Zc: D storage shed (sF) _ S. Ottrer 1Sr;5W- I i JflN t8 2r5?P[ JL € owner/Contractor A**eraeL.-1-r.-Signature: :Liceti:9f :q!oti|ie+ -, - .: ...---PrinTNome us Area: _ Sq Ft ls the Existi operty located in a floodplaln? D yes EL trto ng pervious Area: _ Sq Ft Total Acres Disturbed: New lmpe walrn, H CFPUA E Community System E Private Well E Central Well D aqua SEWER: ll CFPUA El CommunitySystem E Private Septic D Central Septic E Aqua Zone:officer: _ setbacks (F) _ (tH) _ (RH) _ (B) _ Approval: _ City: _ Date: _ Flood: (Al _ (Vl _ (N) _ BFE+2ft= _ Comment:Permit Fee: S r lY ao$tpg4u ToTAL sQ FT UND ER RooE (for proposed workl xeated: 39(sb unh.l^r"d, /3L6 DISCLAIMIR: I hereby certify that all the information in this application is corred and all work will comply with the State Building Code and allother applicable State and local 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 ExistinB l-and Disturbing Permit: E Yes n No Clear Form APPLICANT'S NAME: SEAN MCDONOUGH Print eMail NEW HANOVER COUNTY BUILDING PERMIT APPLICATION ryPEi RESIDENTIAI PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROJECT "Prorect Responsibiliq/' 2o l€- (!q2- r}g Application Number (office use) oate:'1211112017 PROJECT ADDRESS: 205 MARSHFIELD DRIVE clTY: WILMINGTON ZIP:28411 SUBDIVISION: SCOTTS HILL BLUFF LOT f: 28 PROPERTY OWNER'S NAME: NCA BUILDER lNC. OWNER'S ADDRESST 827 BAYSHORE DRIVE PHON€ #: 910-443-'1667 clTY: WILMINGTON ZIP: 284'11 coNTRACToR: NCA BUILDERS lNC.BLDG LICENSE # ADDRESS: 827 BAYSHORE DRIVL clw: WILMNGTON sTr NC-ZIP 28411 EMAIL ADDRESS: ncabuilders@ec.ff-com PROJECT CONTACT PERSON : SFAN fi,lCDONOllGH PHoNE:910-443-1667 EXISTING CONSTRUCTIOT{: ! Alteration ! Renovation ! General Repairs - NEW CONSTRUCTION: g Erect New Residence n Addition to Existing Residence n Relocation *.*PLEASE CHECK AND ANSWER BETOW AIt THAT APPTY TO YOUR PROJECTIIT D Att Garage (SF) _E Det GaraBe (SF)_ D Pool (SF) tr Deck (SF) ! Porch (5F) n Stora8e Shed (SF)_ ! Other (SF) n Sunroom (SF) X Greenhouse (SF) ls the proposed work changing the existing footprint? tr Yes E No TOTAL Sq FT UNDERROOF Aor proposed workl Healedt 3207 Unheated: 1822 TOTAT PROJECT COST (tess Lot)s200.000 ls the proposed work changing the number of bedrooms? a Yes {No lsanyElectrical,PlumbingorMechanicalworkbeingdonetotheAccessoryStructurenYesENo lf the project is a Relocation, is there a Natural Gas Line on the current site? D Yes Ezf{o ls there Electrical Power on this Euilding? n Yes gNo Property Us€/ Occupancy: V/Single Famiry n Duplex a Townhouse Description of Work: I2DEC l7 19!34ffi BUILD SINGLE ILY HOIV1E laws and ordinances and regulations. The Oevelopment Services centerwillbe notafied ofany changes in the approved plans and specifications or change in contrector information. *"NOIE ut the appropriate permits willbe in violation ofthe C State BldS Code and subject to fines up to S5OO.m... Owner/Contra Signature: "Licensed ls the property located in a floodplain? ! Yes n No Existing lmpervious Area: NA Se Ft Total Acres Disturbed: New lmperv ious Area: 3850 Sq Ft Existing Land Disturbing Permit: L.l Yes D No WATER; n CFPUA {Community System n Private Well D Centratwe n Aqua SEWER: tr CFPUA [] CommunitySystem E/Private Septic n Centralseptic n Aqua Zone: _ Officer: _ Setbacks (f) _ (tH) _ (RHl _ (B) _ Approval; _ city: _ Date: _ Flood: (A! _ (V) _ (N) _ BFE+2ft= _ Permit Fee: SComment: ioHc zo'Q-,ltn\jico ffi PHONE:910-443-1667 APPLICANT'S NAME: \$-, b 0ot8'(sq4 Number (of{ice use),l NEW HANOVER COUNW BUILDING PERMIT APPLTCATION TYPE: RESIDENTIAL PLEASE ANSWER ATT QUESTIONS APPLIC}BLE TO YOUR PROJECT "Proiect Responsibiliv, CITY Date 6./ {) PROJECT ADDRESS: suBDtvtstoN: Zl?t,2YYoJ' LOT #: PROPERTY OWNER'S NAME: OWNER'S ADDRESS: PHONE 8:16- crw: 7 -t (, )ZIP:2tYu ) BLOG LICENSE #:J-?OYC 5f: ^tL zlP: )k t/ ?0 PHONL 9/o'6"20 - /9J;- PHONET 9/O 6d-O -/?JJ- CONTRACTOR ADDRESST o ctw EMAIL ADDRESS: EXISTING CONSTRUCTION: ! Alteration E/henovation E General Repairs NEW CONSTRUCTION: C Erect New Re sidence F{dditbn to Existing Residence E Relocation .T{."PLEASE CHECK AND ANSWER BELOW AI-t THAT APPTY TO YOUR PROJECT'*' ,Z/att Garage (Sr) 7 t 1 ! Sunroom (SF)_ E Greenhouse (SF) PROJECT CONTACT PERSON: t'ar x ,(-A r,-, ,a+ E Det Garage (5F)_ ! Pool (SF) tr Deck (SF) ls the proposed work cha n8inB the existing footprint? Ezles E No TOTAT Sq FT UNDERROOF llor proposed work) Heated:'7aO Unheated: 1 / \/ TOTAL PROJECT COST (Less Lot):5 /Ao, cao ! Storage Shed (SF)_ tr Other (SF) ls the proposed work changing the number of bedrooms? A Yes {no ls any Electrical, Plumblng or Mechanical work being done to the Accessory Structure,[/Yes ! No lf the project is a Relocatlon, is there a Natural Gas Line on the current site? ,Bifes n No ls there Electrical Power on this Building?)Z/Ves a no Property Use/ occu pancy: Gngle tamily n Duplex ! Townhouse Description oI Work: 7*.^ d ^r , allother applicable State and local laws and ordinances and regulations. The NHC Development Services Cente. will be notified ofany changes in the approved plans and specifications or change in.ontractor information. "'NOTE: any work performed without the appropriate permits will be in violation of the NC State Eldg Code and subied to fin€s up to S50O.m"' I owner/contractor: >-*l-n ""X <")t'-,,ll sitnature: 2.-.-L ).L"- -d-l- "Licensed Quolitet" P nt Nome ls the property located in a floodplain? ! Yes_D-{ifo Existing lmpervious Area:_ Sq Ft TotalAcres Disturbed: New lmpervious Area:Sq Ft Existing Land Disturbing Permit: n Yes E No WATER: Z'CFPUA E Community System ! Private Well ! Central Well E Aqua SEWER: Z"-CFPUA f] Community System ! Private Septic f] Central Septic n Aqua Zone: _ Officer: _ Setbacks (Fl _ (tH) _ (RH) _ (B) _ Approval: _ Crty: _ Datei _ Flood: (A) _ {V} _ (N} _ BFE+2fb _ Comment: Permit Fee: S leJflH r8 9r808ll cqr c e.t<c- , ^/n 7 c,<c <arcre .-,-,/\ ,,.t"rh - + rau.'r, aScv ffi tr Porch (SF) _ Tetg - bu( FLOOD ZONE ]{EU' HAIIOVER COT'I{TY BUIT"DITIG PENil]t APfl rcAIr,I l:t,PE: mJEEt{ITAttu l* AllIx,u AllqrEfil,lEttftrc alrrr,llmtrorrrtlll.Ci.?lrry aa T/A Fh.lhrp! ffi rarmhc. (oafc.,Dl*'lthiAPT'LICA'iTT! UUIE:S@el! PftUECT AI'OIESI'I suaolvlsl(xt Thc cl€.k dtfiorlct C[IY:!P: lor* I !)cvr' :iJll@itm,I .i0rr AE @ITIITACT :$avEns Butdhg arDe ucaEtft 31626 ADDiDIC:6110 Oeander &nr $nc ZXt OIY:WillhCDrr tt: ltC apr EMAIL ADDGSS3 snidrdlor@hwrdhCloma.cun PIII E 910"794{@S PROJECT COI{TACTPTNSO :$ad Nddron {'0imlr{!a{616 ![!rf ClIrcrl*tr rhn tr fI*r tr crlrdHr w oo6tltru, d ml*r*,. tr raftbnb ffi r.{ia tr i*.di d e*a.rrpa {06 tr Dr-r.g*t- /r*,an I tr Pml6Fl O D.d6fl tr sbrl.: sh.d €n_-- tr odt.r (sn b dr rropcarut dlrrrhrdndlt*firt? tr vrr d no TOTAT SQ FIIFe'g} W pr@ Il!,t<l t*10r4 I lr th t lrad nft drrtllt tl. r!tirg.. ot f*osnr? tr Vr d fIt.rytt .nh0 'l*3o.H wt l-tldrl!.toth.f .y*n6rl tr yr d f.Fttx pl!.dbr E.lLILf lhflt X.fr{ G.3 l4. on th orrr* rltr? O f. d .rdr.rt ELcdalnorJfm$aaulf|? tr Vt dfr ri€rq t rroEF* f! lf Ur = Itr = r*.r orrcr@m ofwo*lLw Conltncton lI'O]lS: IltrSycr y dt.. ddt.bfltGtr hda.rradcl f csEt.d.l Et r,l coip.yfrr dr 5&lrd.tCon -d d dtr.Blath ltt rdto(.tbu. rtd q{hrE rd nfrAforr'.Ih. lolcDcdqn-rttrltaa Crlrr b.mi$dot Jr, da.ra.. h tha gbll.atd agaaficadoia adirhcdrffi $(D.o.r Iffi rnrtbr. "'X0lEr Aay rcrt S.E.ht EtdErl b. h t ld&. ddr tr SEmtun: in rllb 1t3 YJlwtlafloY\ B16o-urr-<_***14'fii P.rmft La: S Otfltll/Cmmn 'Udrnt,it qnlv B th. proFrty locrtd ln r tfoapmrf JVI I lo ffiia lmr]Ilolr^il: ZrLl 4ft ,cfunad tirtt. slrr.n3 klfr rlorn \l{ r\r mrY14 \L FLOOD ZONEfl*tr Tottl A.rrt tLtrhp.rtulrr: Lrbl q?t Uratd hrlr;rr*r tr vr /ro Wer* E! CFPU O Cdrtttr*y Sfrn tr prtva ur.l tr c.rt lwd g t{l|. n, sEwrr. d crpue Ot,w-,L15_o,*CoflrnnnltY Sy't m tr prlY tt S.pdc tr Cstrr.ls.p& tr A$r. Apflld: Coltn.t c parl ct- Clty: tr Sunroom 6fl - tr crrrnhour ffi- rorar imtt GGT (rt., r4: tl20p0__'ffi qbq tr.i'. i: i:,I 2 o /U- { /O NEW HANOVER COUNTY BUILDING PERMIT APPLICATIN IYPE: RESIDENTIAL PLEASE ANSIJTR ALL QUESTIONS APPLICABLE TO Y&N PRO]ECT "Project Responslbility" 18-s9 APPLICATION Number (Offi(e use) DEVELOPER: Robuck Homes Trianqle, IJLC PHoNE S: 9r9- a76- e2oo PROJECT ADDRESS: s149 Laurenbridqe Lane CITY: fiilminqton ZIP | 28409 LoT #: 012 CoNTRACTOR: Robuck Hones Tiiang1e, Llc LICENSE #: 57083 AIDRESS3 6131 Falls of Neuse Rd. ste 200 CITY: Raleiqh 5T: Ig- ZrP: @a EI4AIL AODRESS: i norbech@robuckhomes. com PHONE #: gls-a't6-s2oo PROIECT CoNTACT PERSoN: ,ral Norbech - i norbech@r:obuckhomeE. com PHONE #: 9L9-2"1't -ta2a EXISIING CONSTRUCTION :ALTERATION I nenovrrroru [GENERAL REPAIRS RELOCATION NEUI CONSTRUCTION:m ERECT NEW RESIDENCE oT ADDITION TO EXISTING RESIDENCE '*PIEASE CHECK AND ANSWER BELOlil ALL THAT APPI"Y TO Y0rR PROIECTI V ATT GARAGE 504 SF ! orr elnncr - sF SF P00L _ sF GRE ENHOUSE SF f| orcr _ sF Eponcr L-sF I sronaer SHED - sF OTHER: SF TOTAL HEATED SQ FT: 255s TOTAL SQ FT UNDER ROOF: :zoe TOTAL AREA SQ FTi 32oB TOTAL PROIECT COST t,ess r-ou : $224560.O0 # OF STORIES: 2 Is Any ELECTRICAL, PLUiIBII'|G or T4ECHA ICAL Wonk Belng Done to the Accessory Structure?Yes I No If the pnoject is a Relocatlon, ls there a Natunal Gas Line on the current site? f] ves fr ruo Is there Electrical Powen on this Bulldlng?I ves flruo PROPERTY usE / occupANcyt ffisrNele FAilTLY f]DUpLEx f]T0hrNrousE DESCRIPTION OF ORK! new home DISCLAIMER lheBby certit [|at all inbrmatlon ln hls appllcaton ls corecl and allworkgrll comp{ywih he Slate BuildlnO Codo and dloher eplicabb Stals and local laws and ordin6ncrs ond rogulalilns. Th6 NHC D€vgbpmsnt S€rvlcss Canl€r *lll b€ mlifbd otanychang€s in he appmved plans dld speclncadons or chsrge ln conlracb. ot conlac@r lobmdton. '_NOTE: Any Work tlerfoflned WD hg App{ofiab Pemlls \r,ill ba ln Vlo,afon ot lhe NC St€ts Bldg Cod6 and Subroct b Fhes Up To 3500.0cl" OITNER/CONTRACToR: charlea ,r. Bishop rv SIGNATURE: +:ir,i:i** * +:*+ *r,r )r ** * * ** * ** * * *(I i'll Jll"],(+**,t*r*t)*)r)r*r*,*'ix*+*****+**t*t****i*{.**,}*i:***+,tt)hr**)r* rs rHE pRopERry LoCATED rN A FLod)pLArNl I VeS [E] r,ro EXI5TING II{PERVIOUS AREA: O SQ FT TOTAL ACRES DISTURBED: 31.2* NEI,J IMPERVIoUS AREA: 2 024 SQ FT ExrsT LAND DrsTURBrirG pERr4rr: Ef yES fI NO I.,ATER :cFpuA E co|r,ruNrry sysrEm fl pRrvATE wELL fl crrurul wrll /=.2_L_i z7 Z6 SEWER: EI cFpuA E CENTRAL sEprrc ! nnrvarr sEprrc I coMMUNrTy sysrEM +** SEPARATE PERIi.IITS REQIJIRED FOR ELECT, I,IECH, PLBG,, GAs EqJIP, PREFABS & IIISERTS *'I'I pAyr4ENr i.rErHoD: E cnsr E cxec( (pAyaBrE To NHc) E ar'rERrcAt{ ExpREss E rclvrsn l]l orscovEn t* 't* ** * * *** *** t **** ** * * *** * tt*+*)i +*** **at t *t* * ** !t * * * * t* * *** *** **t** ***l *(+ * ** ** f*+ * **** *t ZONE:OFFICER: (FoR oFFICE USE OtrY) REVISED DATE 04111/12 SETBACKS: F:_ LH:_ RH:_ B:_ N Approval:_ City:_ DATE:_ FLooD: _BFE+2ft= APPLICANT's NAltlE: Robuck Homes rrianqle, LLC OATET 1/9/1,8 SUBDMSIoN: Laurenbrldqe BLOCK S: PROPERTY olrlNER'S l,lAritE: Robuck Homee Trianqle, LLc PHO0IE *: 9a9-a75-9200 ohlNER's ADDRESS: 5131 Fa11s of Neuse Rd. Sbe 29q CrTYr Raleiqh ST: NC ZIP:27609 I surunooN ,ot I -bs6 1fr" t t7 TIEU' IIATI(,I'EN O(x.lilW BUTIIXTG PERMITA,?trl,tf,t( ,:fpE: iESDEI{I|AInlA$$6tAlllqf,$rx6l,'lrA]lmrcui r rr:cr?i.l.Citotrfff Aiadqr[aaa.(.norf toAPPUCAJ{TI xAyg Stevar PROJECT d0O[Et5: suaDlvlsloil:Th. Cf3qk Ctrwlod* T/ &vilt Fh. Horl6 *l t5 loTf: p1166169 91G70,1-€@9 i ctw:&t PROPERTY OWITEPS TME S'brrB Af(tr! OWNCR'S rDilEst: 5/10 oldd..Drnp Sdto 200 gTYr Wlmlnobn * COflTRACIC Srlna Buldltg ^DOiE35: 5710 Olander tH}r Stt n orv: lvh*rbn ro6llcaltEt: 31620 4428,1o35I: trcEMAIL ADDIEIS; PiOjECT cdfl cIPEtO : Srd lddrobon tsrAxl'IUm W V*t@Ifi,rl tt d& It60 tnharbd:firf L tiOEclO06T (t!rE too:qr20,000 a*rt 01G791-86S0 psq6; 91-3112{6,16 ffiflflO OoXS rCIlOf: O lEndon tr Roovrdon tr {fnrrd i4rtn ewco 5l ,GI|O , d a.d [rrLdd.,ro. EJ Addtbnb Unairkhm! O i.locr0on ,^ t t' tll lltornrFo 'l5U O D11er{: Gfl _ d rutpA /01 tr suntoonr (sr, - tr todgrl_ O 55n,sro 1g1__tr errrntolr ffi - tr D..r6fl_ tr od1., 15n Itdl. p.opo.d rort.ifi dr..tr albotDrt *? tr yr d ffo s62 Bth p.o9o..aF,t dngf {rx;arrof b..nooG? tr y. d t.ob.ny b.trlC, rbahor rddro* ldnj&rr brh. f.c.rorytucrr. E Vr. d bf th. proj.d tr H.*r, f drrt. llt*rl Gr t+.on Onqn11 rt *ri tr t.. d-; - " b tft.'t ELcllctl torrrm tl$ f{t? tr Vrr df t@gttnl Orrrhdon oa o-r.,otdrtr*rrrry tr ordc tr Iol,r{lolr. Wodc ifl@iilrliJJJ g:2IBH ol.ct l.r* I haayr- ytt t.lllrhida.l h trltdrdoi 3.qrCnd { Etrl c.qtrfth dtirn llfAta C.d.hrr.d ordrt-rlld qda.rr ItaEICHqG-atrtk.C-E b.ndLd o,irdryE h rn ,tlt.r|dtrrrnrdon. ...Xm: f/iy xqtprtnrq, rdgltrli ryE h r-nf,{b. h rtuor dt r tE c& Oh.r/Contn6cL&'f!.dq&r.r'Crals Sbv!{r8 glrrtm: hfrr,o.t c lsth. prop.rtytodto, floodphh? tr Vrr d fo Edrrtg lmr.rulourrrr t l1\q s4?a .wtnprlhrrrAr.!: ll{1 sf n wAfEi: E cFpu EI conmoritysyrtrn tr prlt.t sara d creur tr ,-,.,1L'16 n*Cfltnl Srptc cuC ol fl).t Iotd Acrr. Dlrturtedr lB l*ft0trldDltrtfrarrnk tr v8 d m W.{ EJ Crrtrd Wd tr Aqx Sptam tr tr A4,. / tWorltz (NL dv Ittvl *h,l-M-frD < r;r+h_ I t1q' ooP.rmlt F..: S Commant: Ciiy lnspeciion ,9't0.254.0901 i)/tut , cz. NEW HANOVER COUNTY BUILDING PERMIT AP P LI CAT'O N TYPE.. RESIDENTIAL pttAsE ANswIR ALr QUa:flof.]s APPt rcAEtt ro YoLJR PRolEri "Proiect RetPonlibilitY' lot1 - lo L i1' 2,c17,1 APPLICANT'5 NAME: PROJECT ADDRESS SUBDIVISION: Rct'z CITY - tt:lry-zaP ) CITY _,_- -_ PHONE zrp,7bl51CONTRACIOR: ADDRESS: EMAIL ADORESS PROJECT CONTACT PERSON n'l PHON E 1q3 3 ?c7 t7 - l/b 7DEXISTING CONSIiUCTIONi :l alte,ation : Rrnovation I General nepairs NEW CONSTRUCTIONT : [rect New Resrdence 7 addition to lxistin8 Re5adence ] Relocation ... PIEAsE CH€CK AND ANSWER BEI.OW AI"L THAT APPLY TO YOUR PRO'ECI"' E Att Garage {St) - i- slnroom {5F)=--..- !.1 G.€anhouie i5F) -- t-l Det Garaee ist l C Porch {5F} . l FooliS[) I Deck {Sr) Ll storage Shed (Sr) ----7 Other lSF)l, ):ho 15 the gropo5ed work rhantint the existin, {ootpri t? : I Yes :' No TOIAT SQ FI UNDER ROOI llot ptoposed worli Heated unheated ToTAt PRo.,EcT COSI {Lesr Lot): 5 fao lstheproporedwork(hangingthenumberof bedroorng? : Ye9 Z No 15 a,ry Eleclrir3l, Plumbing or Mechanicalwork being done tolhe AcceesorY St.rrct re 7 Yei : No ti the proje(r is a Relocatlon, is th€re a Nalu.al Gas Lile on lhe (urrent sitel . . Y€a ,j No ls there Electrical Power on this BuildinS? Z Ye!: No Prop€rty Use/ Octupan.y: f-l Single family : Ouplex :l Townhouse -ro 14t)[(] 1; 315&ill Oes.ription of Worl: DISCIAIM€n: , het.by rertr,Y thal atithe iof!.m.rion i5lhi! .pp ilrlDn r; io(e.t irnd all worl willcomplyedh the Statr SurldinE Codt and all clh€' .ppl(abl€ SlaIe and lo(rl laes and ordinaflrerand rept.tion! th€ NhCOelelopment Serrces Cenrerwilt b. ronn.d of any.h.t8lr iulhe approved rlans and ,pe.iliralio.3 o..h;nte in contrndor ,nlorm.tion '".1,{OTt , Any woit perto.med wrhou! I h. appropr ate pe,4n1. ,iir b? jn lrora tion of rle N C Statl] 8ld8 Code r nd subi€(t to fine, trp ro S5oo 00"'' aLhlurr{ ?-_ SiEnatureOwnedcontla.tor: 'Llcensed Qvolilie; 15 the property loc.ted 'n a floodplain? i:l Yet I No Existing lmpervigu! Alea: __- 5q Ft New lmpervlout Areal .--Sq Ft WATEI: : CfPUA [.] communty system ! Private SEWER: n CfPUA,, CommunitY SYstem fl p.ivate zone: - officer: - Serback5 (f) - { Approval: -- GtYt - Date: -*- Flood lotal Acret Disturbed: -- Eristing land Oislurbiri8 Permit: : Yes - No we ll : C€ntral Well : Aqua Septic : I CentralSepric :""i Aqua rH) _ (Rr!) _. (8) _ :tl)-(V)- (N) -BrE+2ft=.-_'*Permit Fee: 5Comment: C.Affi Oale LOT #r__ PROPrRTY OWNTR'S NAME| - PHONE E oW'rlER,sADDftEssi---'--clTY]-'.-*-.-zlP:-.-..'' roDt"v - 4' z-?