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HomeMy WebLinkAboutDECEMBER 4 2018 BUILD APPS12052018091805: , NEW HANOVER COUNTY BUILDING PERI4IT APP L I ur lott TYPE: COttltE RCIAL PLEASE AIISIJER ALL QIJESTIoI'IS APPLICABLE T0 Yot R PROIECT "ProJect *"?'jilr.t2"p., _.+ # 20,6-l3qq018-3431 AFFTTIo{ llumbet (Offlc. U5.) -DAfEz 111y212979APPLICANT'S ilAtlE: .7665 Granr / splinr cRo3Aw46t ZO lB- lO oEVELOPER:.;print PRO]ECT ADDNESS: 6?36 calolina geach noaa CITY: w, tmiogton OCCUPANT/BUSINESS tlAr,lE: sp!inr cRg 3AH4 o1 PROPERTY Olll{ER'5 lo}lE: a,o.ty.6,., Torer coroorarj.on Oll{ER'S ADDRESS: 3500 Regency pkwy, sre 1.00 CIW: ..-., COITITRACTOR: TsC consrrucrion - LICENSE #: rsorg ADORESS: 129 Brolrn streer CfW: gohnsen qily EISIL ADDRESST j chorasGbuildrsc. com PROIECT COI{TACT PERSOITI: .1qnn 6hq13s EXIST CONSTRUCTION: lf Relocation, is there a N ...I' IS THIS A CHAI{6E OF OCCUPA CY Us€?T IF Yes, rhat ras the Previous Occupancy fypr! _ Ihat -P]() E S: ?04 ?Bs 4soe ZIP | 28412 -Pl(} E #: 9r9 456 5S9? ST: Ng ZIP:2151g . ST: py ZIP: 13796 - PHol{E #: 't t't A4B 6to4 - PHONE *3 1i'7 44e 6to4 (check AU That &p1y) ALTERATION T-'I REiIOVATIO T-1 CEI{ERAL REPAIRS T'] RELOCATIOII r Gas Line on rhebdnenr sire? f - Hf- No rs BLDG sdHI{IKLERED{-- Yesf-- iltt.r corsrnucrron, 5 ACCESSORY STRIrcTURE: ERECr EU STRUCTURE f] FASr TRAC( f] sHELr E UPFrr n aDD ro Exrsr srRUcruRE Upg!ade artenna on exj.stlnq torer If UPFIT - The Shell Permit *: n/a Is Elect Porer on thls Building fi.Yes r NO IX8fi?orrro* pRoFEssro{ L: Kimberry MarriD YEg l-. f,O +r*.* ls the I€r occupancy PH:919 661 G351 NC R # #R EG EG i o3't920 :038669EI{GR DE5I6N PROFESSIOIIAL LBsha Modi PH :919 468 0112 NC DESCRIPTIOI,I OF IORK: rrstalL 3 anrenna, 3 RRHS, t hyb ls lood or bevorages prepared or sorved in this structuro? f. yeslf- No ls The Property Located ln The Floodplaint l- Yes li No the Sl,ats Building Codo and sll other opplicabls St le Dlan! andNc Stato sDecilicotionsBldo Cod6 and OWNER/CONTRACTOR: Jeff crant / Asent SIGNATURE: (qqdfi, (P, rr.) Note: Oomolition notifcatirns & a8bestos lrnroval p€rmit applhrtionr alo to b€ 3ubrni[od usino tho applicatio.| iorm (OH 768) whelhor lh€ facility or building wa! found to contrin Asb6t@ or not. You arr qul6d to call th€ Nallonal Embiloo Sbndarda ior Hezerdoua Alr Pollutanb (NESIIAP) at (8lS)707-5950 at l.art 10 dlyr plknto th. danolilion of any ladlity o. building. Soa A!h.ro8 Wcb Sii.: httpr rrr.6pi-3tato.nc.u./6prasb6torahmp.hhl TOTAL PROJECT COST: 22, ooo BUILDING HEIGHT: 1 # OF UNITS: n/a rifLex cable to existinq tower. 96' 8" SQ fi PER FLR: _n/ a # OF STRUCTURES: n76 ACRES DISTURBED: n/a EXST LAND DISTURBING PERMIT? T YES Ji NO NEW IMPERVIOUS AREA: o SO FT EXISTING IMPERVIOUS AREA: pRopERw usE: f]oFFrcE [nesreuner{r I uencmrrLe[ eoucf]-mrfl coNDo OTHEF1g1g66mm SQ FT wArER: ICFPUA E CoMMUNITY SYSTEM D WELL _f[ zoNlNG usE CLASS sEwER: E cFpuA El cENTRAL sEpnc E- pRtvATE sEprtc E col,luurutrv svsrerl IFICATION ,..SEPARATE PERMITS REOUIRED FOR ELECT. MECH, PLBG. GAS EOUIP, PREFABS & INSERTS "" PAYMENT METHOD: r CASH l-. CUeCr lenVeBLE TO NHC) l-- aUeRrCAru EXPRESS l-- rr,rCrytSA l-- OTSCOVER (FOR OFFTCE USE ONLY) ZONE: OFFICER SETBACKS: F: LH RH B Approval:_ City: DATE_BFE+2ft Comment FLOOD: N PERMIT FEE: I r50t TOTAL AREA SQ FT : ],OO TOTAL SO FT UNDER ROOF: nza # OF STORIES: n/a # OF FLOORS: T- .A or6-t+q ,t{ q) Z+NEW HANOVER COUNTY BUILDING PERMIT APP Ll Uf I O N TY PE; RESIDENTIAL PIEASE AI{SWTR ALL OUESTIONS APPLICABTT TO YOUR Pf,OJECT "Prorect Rerponslblllty'' Appllc.tlon Numbar (ottl(!uta, te /-y/.r3APPI.IC4NTi S NAME: PROJECT ADDRESS: sUBDlVlSloN:Iq r?,,'7 L t <t !). aag-ri rt-.4(:crrY L t tta .) LOT J/ qc t".n I ro. ^.-, PROPEBTY OWNIR'S TIAME; OWNER,S AODRESS '2/o 4).'pos -) . /./ PTIONE 'i 7 C ITY:ztP ,L!-y!.__ tl ,) e o.1>e-', CON]RACTOR: ADDRESS:r,Oi vOlo - -Df J))8I.DG NSt CITY ztP 6EMAII. A PRO]ECI 'rJsA(aNce, co tY- ?*,tl'nt PIION 4t PI{ONE /0'4 {sr) 6 €X|ST|NG CONSTRUCTION: 0 Alteratlon [] Renovatlon F General Repalrs NtW CONSTRUSIION: E Erect New Resldence D Additlon to Existing Resldencc fl Relocatlon ...PLEAsE CH[C( AND AIISWIR BEI.OW AI.I- THAT APPTY IO YOUR PROJECT"' D Det Gara8e (SF)_D Porch {5r) /storage sh tr Other (Sr) ts the propored work changlnt the exlstin8 footprint? E Yet C No TOTAT SQ FT UNDIR ROor for ptoposed warkl Healedl Unhealed: A a) O All GaraSe (5F)_ n Sunroom (5t) ! Greenhouse (St)_ TOTA! PROjlcf COST (Less l-ot): S [J Pool{SF} n Dect (5F) I {,, l.r I ls the proposed work cha n8inS the nu mber o, bedrooms? O Yes Propefty Use/ O.(upan sintlslamlly D oupler 0 ownhouse dno ls any tlectrlcal, Plumblnt or Mechaolcrlwork belnt done to the Accessory Structure t lf the prolectls a nelo(atlon, li there a Natural Gas Une on the current site? D Yes ( l5 there ElectrlcatPower on thls Bulldlng? E Ye!El No Yes No (n" IDescripllon of Work:2 0lSCtAlMfR: I hereby (artily thit.lllha lnto,mallon ln ihit appllcallo.r l, rorr.( and.llworl willco,lply whh theSla16 guildin8 Code Inform,tlon,'.'NOTt, Any work partormed without the apprppri.re permnrwllltre ln vloletion ot lhe NC st.te SldB Code.nd lubieci er ap! roSsi layrr ind ordhrna€t rid rcguhtioot. tha HHC oevclopment saMca3 cente, t'/illb. nodflrd o, any (h.n8.t in the,p9(oved d.rnt lnd Owner/Cqrtractor:)Slgnature: 'uccos.d QuolitEr' .od.llo sccOlltatio to nn.e f ls the p;opeii locat€d ln a floodplaln? E Yes E/No Exlstlng lmpervlous Area: ----p- sq tt Total Acres Dlsturbed t _9---. /.1 N ew Imperylous Are a: U SqFt txlstlnS tand olsturblng Permltiu YSJ lf Ng wartni d ;FPUA E community system C Private welr D central welr o Aqua Cli ln:mCliOn tuactrs(r)r57 o'/?%roo n)rya Y?- otir n CentralSeotlc'd.,^n,dt,, lc.ibl! St.le .od kaa l hlnXe In (ont,acto, )0.@... re0,910.25 ID Communitysystem fl Private Se cel Se (r.H ) Dat d: (A) __0tEr2tt= Pcrmit feeCon)ment: Ityi (L DUt//Av4r N) /2/,r/k-(24 4-00t}ll 2, I l ll SEWER: rB- l3Vq+ APPTICANT,S NAME:aA",-- '2t(Z+ Application Number loffce use) NEW HANOVER COUNW BU]LDING PERM'T APPLICATIO N TYPE: RESIDENTIAL PTEASE ANSWER AI.TQUESTIONS APPLICABTE TO YOUR PROJECT "Project Responsibilit/ Date: / /. t/. r3 PROTECT ADDREsS: / 2- t o u) . ,,t as.r O 2 cL ctTt: /.,1J, L/n, Dc 1,:J ztP T!$a lo suBDtvlsloN LOT E PROPERTY OWNTR'S T'IAME: ownERsADDRESS; /2-/o 4)- p.so. ) R_ a.7,t,//. CONTRACTOR: ADDRESS: nv* &lu-- a P-,$ lL) ps CITY: /\r , l.;"'+.'."Sf dC ztP:18 !'JBLOG TICENSI # ./r i r" u->"*wo. lf EMAIL ADDRESS:aA2Al-{: tl .Nls ( aNcl , Lo ft1-PHONE14 ,6 tt &L 2PROJECT CONTACI PERSON: EXISTING CONSTRUCTION: tl Alteration E Renovation F General Repairs NEW CONSTRUCrION: n Erect New Resldence ! Addition to Existing Residence E Relocation ."PIEAST CIIEC( AND ANSWER BTTOW ATL THAT APPLY TO YOUR PROJECTTT' fl Att Garage (5F)_fl Det Garage (SF)_ Ll 5unroom 15 tl I Pool (SF) Ll breennouse lsFl I Deck (SF) ls the proposed work chan8int the existing footprint? n Yes E No TOTAT sq FT UNDER ROOF lJor prcposed work) Heated: TOTAL PROJECI COST (less Lot): S il ls the proposed work changing the number of bedrooms? tr yes d }lo ls any Electricel, Plumbing or Mechanlcalwork being done to the Accessory Structure q Yes lf the project is a Relocation, istherea Natural Gas Line on the cunent site? n Yes ElNo ls there EtectrlcalPower on thls Bullding? tr Yes'El No (n" Property Us€/ Occupa Single Famlly E Duplex D Townho CA uteA) C-o I SDescription of Work: informitlon. '. *NOTE: any $,ork performed without the priate permits wlll be ln vlolation ofthe NC State Bldg Code and subied ro fines up to 5500.m... 2 lawr and ordinanceg and r€Bulations. The NHC Developme SeMcescenter willbe notlfled oranychan8es inthe approved plansand speclfiGtions or chenge in rontractor Owner/Contractor: 'Licensed Quolifer" ) ls the property located in a floodplain? n Yes E/No Aisting lmpervious Area:5q Ft Sq Ft SlBnatur€: Total Acres Disturbed, __l> _ Exlstlng land Disturblnt Permh n Yes n NoNew lmpervious Area:G WATER: ECFPUA D Community System ! Private Well E CentralWell E Aqua SEWER: qaCFPUA D Community System n Private Septic D CentralSeptic D Aqua Zone: _ oflic€r: _ setbacks (F) _ (LH)_ (RH)_ (B) _ Approval: _ City:- Date:- Flood: (A) - (v) - (N) - BFE+2lt= -'comment: p€rmit fee: S -.'*14-t' "/7- enow,9 /0 " 3 27 'le Q D Porch (SF) -=_-_=-dstorage Shed (sF) - D other (SF) _ unheated: A {c> APPTICANI,S NAME: PROJECT ADDRESS: NK'*2o rB t3-l 9l Pe /r =3is?NEW HANOVER COUNTY BUILDING PERMIT APPLI CATIO N TYPE: RESI DENTIAI PLEASE ANSWER ALT OUESTIONS APPLICA8LE TO YOUR PROJICT 'ProJect R.sponslbllit/ Application Numb€r Iofilce u3el Date:a*/,.a , A)a^y*t ztP 2t? r'/./ 5 CITY suBDrvlslot'l PROPE RTY OWNER'S I.IAMT: OWNER'S ADDRESS: ,€ ,//iVmd<- C'7-CITY LOT 3 pHoNt ,l lto 3 ztP: ) 8/)) StDG TICENSE # N Sr:21Q-Zl?9,4// PHONET 3 PHOIJE 2o 3l2a/{7 CONTRAfiOR:t)4*o* ADDRESS:c!-7- EMAIL ADDRESS:l.-h,1/: N CITY PROJECT CONTACI PERsON J EXISTING CONSrRUCIION: 3 Alteration El Renovetion E General Repairs NEW CONSTRUCIION: E Ered New Residence . Addition to Existing Resldence E Relocation .T'PLEASE CHECX AND ANSWfR BCTOW AIL THAT APPLY TO YOUR PROJECT*Ti ls the proposed work chantin8 the number of bedrooms? fl Yes D No lsanyflestrical,PlumbingorMechanlcalworkbeingdonetotheAccessoryStructureDYes!No lf the project ls a Relocation, is there a Natural Gas Line on the cu rrent site? f: Ye5 fl No lsthereEledrlcalPoweronthisBuilding? U Yes D No Property Use/ Occupency: D Slngle Famlly n Oupler a Townhouse Description o{ Work: (io laws and ordinancet.nd ragulations. The NHC Oeveloprnent Se rvlces centerwa,lbe notllled ofanychanSes in the approved plansand spectfications or change in contractor informatlon "'NOTt: any work p.rformed without the appropriate permhs wlllbe h vlolation of the Nc State Bldg Code and subjecl to fine5 up to SSOO.m... Owner/Contractorl 'Licehsed Quolif er" /.rZ- S SlSnatu,e: TotalAcres Disturbed: Exlnlng land Diiturblng Permh: t] yes D No D*h.-/44-+ ls the property located in a floodplain? n Yes I No tuistlng lmpervious Area: _ Sq Ft New lmpervious Area:Sq Ft I WATER: )( CFPUA fl Communitysystem E private Well E CentralWelt E Aqua -"1 SEWER: B CFPUA ! CommunitySystem n privateseptic a Centralseptic E Aqua Zone: _ ofricer: _ setback (t) _ {t-H} -- (RH) -- (B} _ Approvali _ City: _ Date:-- Flood: (A) =- (V) _ (Nl _ BFE+2tts _ Comm€nt:Permit Fe€:9 $+s 11 Att Garase (sF]- [ oet e arase tsr) 5]Z D Porch (sF) - E Sunroom(SF)_ ! PoollSF)_ E Storage Shed (SF)_ n Greenhouse (SF) tl Deck(SF)_ tr Other(SF)_ ls the proposed work changing the existing footprint? C Yes n No ToTAtsQFTUNDERRooFaorprcpo5edwork}Heated:-Unheated:- rorAl PRoJECT cosT ltess toi: S Z 528, P 7 18-3080NEW HANOVER COUNTY BUIIDING PERMIT AP PLICATION TYPE: RESIDENTIAL PLEAsE ANsWER ALL QUESTIONS APPLICAELE TO YOUR PRO] ECT "Project Responsibilit/' Applkrtion Number loffice use) APPLICANrS NAME: Davidlluckner Date: 10/16/ 18 SUBDIVISION: PROPERTY OWNER,S NAME: David Buckner PHoilE #: 910409-2664 LOT f: OWNER'S ADDRESS: 1735 Canadv Rd CITY: Wilminoton ztq: 28411 CONTRACTOR: Buckner Build ADDRESS: '1735 Canady Rd EMAIL ADDRESS: .lbuckner(Abucknerbuild.com CITY: Wilminoton BLDG LICENSE #:70808- ST: NC ZIP: 2841 I PHONE: 910-409-2664 PROJECT CONTACT PERSON: PAYi6[ IUCKNEL ! sunroom (SF)tr Pool (sF) E Greenhouse (sF) ls the proposed work changing the existing footprint? E Ves { no ToTAL Sq FT UNDERROOF Aor proposed work)Heated: 4'12 TOTAT PROJECI COST (Less Lot): S29,000 PHONE:910-409-2664 / EXISTING CONSTRUCIION: E Alteration D Renovation :l General Repairs NEW CONSTRUCnON: D Erect New Residence E Addition to Existing Residence fl Relocation **.PLEASE CI{ECK AND ANSWER BELOW A[[THAT APPLY TO YOUR PROJECT'*T E Det Garage (SF)_n Porch (5F) E Stora8e Shed (SF)_ Unheated ls the proposed work changing the number of bedrooms? D ye ZfW ls any Electrlcal, Plumbint or Mechanlcal work being done to the Accessory Structure / Yes ! No lftheprojectisaRelocatlon,isthereaNaturalGasLineonthecurrentsite?DYesENo ls there Electrical Power on this Buildin8? g(ves lt No Prop€rty use/ occupancy:./ single Family E Duplex f] Townhouse Des.rlptlon ot work: iE- room- DISOAIMER: lhereby certify that allthe information in this appllcation is correct and allwork willcomply with the State Building Code and all other applicable State and local laws and ordinances and regulataons. The NHC Development Se.vices Center willbe notified of any changes in the app.oved plans and specifications or change in contractor information. "'NOTE: Any worl perfomEd without the appropriate permits will b€ in violat_ron of the NC State Eldt Code anl subject to fines up to 55d).0O... Owner/Contractor: David Buckner Sit'Lkensedeuotifier printNome H:";XffiK. ls the property located in a floodplain? n Yes E( No Exiding lmpervious Area: _ Sq Ft Total Acres Disturbed: N/A New lmpervious Area:Sq Ft Existing l-and Disturbing Permit: a yes fl No WATER: tr CFPUA f] Community System 16 private Well ! Centrat WeI n Aqua SEWER: Z/CFPUA D Community Sysrem E private Septic D Centralsepttc f] Aqua Zone: _ Officer; _ Setbad(s (F) _ (LHl _ (RH) _ {B} _ Approval: _ Crty: _ Datei _ Flood: (A) _(V) _ (t{}_ BFE+2ft= Comment:PerTnit Fee: $ Lot6 -l3q q q PROJECI ADDRESS: 1735 Canady Rd CIW: Wilmington zlP: ?8411 ! Att Garage (SF)- ! Deck (SF)_tr other (sF)- , -:il:,'-\) .../ t \+. 'ffi'' ?ae' l3l t L{ 18-3033NEI,I HANOVER COUNTY BUILDING PERMIT APPLI.ATIO\| rYPr: C0IiS{ERCIAL PLtAst A sl{tR ALt QUE5r10fl5 APPLIC-ABLE T0 YUJn PROIEtT "PPoject R€sponslblllt/' aFFr-ItITFn llul'ber (t*rlcc Usr) APPLICATaI'S MtlE: Gccdrlch trchicecgure, pA oEvELoPER: e:LI !ry!4i4rr94. !!!pROlEcr aDmE5sa irri i."Ji" g.ync Ro.d --.EITT! c.sE1a ltayne Ed OCCUPAT{T/8UsINESS ttAllE: e-n witmingron. L!C . Maria f;rquc PROpERTY O{tlER, 5 t{Ar,lE : o.ll wilnlrErt'l. Lrcg {ER'S AODRESS: 97oo p.6( ft2a Avr. 511t.2cx Cf TY: tor*virc CO{TRIEIOR: Gregory B. Lane Jr General Contractors _ LICEI{SE s: 59934 ADDRESs: pO Box 13070 CITY: Nsw 6!sn EAAIT PROIECT CONTAC? PERSO{: 6rgq6ry Bruce Lane, Jr. (Ch.<k ^11 rh.t ^F!:y) -DAfE 3 1o -2- lg PllotlC f : 5(o-2-rt7o7o ZIP't2sa2e 5T: xy ZfP: aq2la SIr NC ZIP3 28561-30Z0et fr-att-sTfr-PHOII E PT$NE |: ALTE RAT IOII REIIOVATItrI GEiTERAL REPAIRS It Rehcation, is lh€rs a Nalural Gas Lins on lh€ur16nl sh€? f-6S l-- *o IS BLDG S ELO(ATloli LERED{-_ Yef- If UPFIT - The Shell Permi.t fi: Is EIe(t lorer on this Buildlng f. Yes [, N0 .rr.. Js rHrs A CHA GE OF OCCUPAI{CY usE?r yEs l-- im ..... IF Yer, 1*at rar the Prcvlour occupancy Type? _ Yfi.t 15 th. t{€rr O<cupancy utfitoESlGt{ PRoFESSIoaIqL : coodrich ArchiE6cture, pA . PH:910.3{3.1065 l{C REG {:7434 EI.JGR OESIGN PROFESSI$IAL :-l{D JoneB Engir.cr i n9 PH :910, 52t . 5t81 ttc REG r;6ii6if- OESCRIPTIOfl 0F t&R(: n"iilliiIilrrarng - sel! srorage Faclllry ls lood or b€veragss pr€parod o( served in this stsucturB? f vesli. Ho ls The Property Located ln The Floodplain? l- Ves li Ho Bll ofEr Dpdi..bb Strte DkQ3 lnd 3D.dfi..lE!s NC lllre gkb Cade rld ,H*X rdr. O.rnoa,tdr rDulbdrtt E ..t .6 tlrEval ,.rm't.rta..EB ... b b. iur,nn.d 6rp ne eC{rsr tsm (Dr}i*3ft$ wtEfEr trr trofd o OUpp u.|| (gU r oo.rlm AEDGTT cr rpt. Yqr re rEqrrrd b crr t E r{.rsr.t €mlsbn Sandldi tq 8s:.rdos. Ai, pott 16rn3 (N€SHA4 AI91g)7[/-Eg5O d tc.|tt, &t{riq 5, rdC.rEIirr ol .{V b.fy or hrdiE S4 An C $Lb 9!.: mpr^M.eF rr!.. { ue,errej,bo5byalrnp nl,rr \J OWNEFUCONTRACTOR (Odtorl TOTAL SQ FT UNDER ROOF: ]2. 580 ACRES DISTURBED: SIGNATURE:' Gregory B. Lane, Jr TOTAL PROJECT COST: I608,2oo BUILDING hElGHr: 1? , f OF UNITS; TOTAL AREA SO FT: ]2,580 SO FT PER FLR: .r2,580 s OF STORIES: rI OF STFUCTURES: 1 OF FI-OORS: i- EXST LAND DISTURBING PERMIT? T YES T NO SO FT EXIST'NG IMPERVIOUS AREA: ( SQ FT PAYMENT MErHoo: l- CASH I-. cxecx tea;grg3ry'of,,4*.*,"* opREss r- irc/vrsA l-- orscoven ZONE: OFFICER SETBACKS: F: Ll.l RH BApproval:_ City: OATE_ FLOOD BFE+21'r, Commenl H PERMIT FEE::5 g 5,(x)_ PHOi.lE f: so2-2357070 Aguxt5s : EXIST CO STRIKTIOI: Noiifri cosrnwr:or; fl rnecr llEr srRUcruRE n FArr rRAcK I sx:r,r- n upFrr I aDo ro Exrsr srRtrruRE ACCESSORY STRUCTUN,E 3 NEW IMPERVIOUS AREA: pRopERry USE: EoFFtcE I nrsraunnrr f]uencANrrue[ EDucD AprE coNoo orHEr _ WATER: I-ICFPUA TI COMMUNITY SYSTEM ![ WEL' T1 ZONING USE CLASSIFICATIONFt g- SEWER: IJ CFPUA I..I CENTRAL SEPTIC O PRIVATE SEPTIC LI COMI,UNITY SYSTEM n\'\U, dt, iflBr /1 /.1 ILU /6 P'3 'Za'f /str r NEW HANOVER COUNTY BUILDING PERMIT APP LICATIO N TYPET RESIDENTIAL PLEASE ANSWTR ALL QUESTIONS APPI-ICABI I TO YOUB P']IJ]ECT APPLICANT'S NAME PROJECI ADDR ESS: SUBDIVISION I Oo PROPERTY OWNER'S NAME:,OWNER'5 AO ORESS ()x "Project Responsibility" o..)el-- crrv bl 4 ll.te // -/t^-/l- tr, 2t?/Ls/OE zt /t eo LOT 'i r' pHoNEr,: 7lo 33/-33:r/ crrY [.L, / L ii 2i z/at CONTRACTOR A DD RE55:To &r tt32- EMA . ADDRrss: J L) L,el \4 OOcl't e 6,tvto)( ..:ol-1 /rrr,r^ /,1n., + (bnl? c/r// f/ C-f --1 ,_., )u/:BLDGLtcENsEIi ,/t \ /4 't /L{itp _4,t/o('<,- 4--:-) .4 u -) -)-) < CITY: /L' / L - PHONE PHONE 7t" ld-c,- j a]L I Fiiou l8 3;34PH L) PROJECT CONTACT PERSON /L- ) u'ro rKr- U)tt,-'Aot-!.- EXISTING CONSIRUCTION: [] Alteration ! Renovation ! Genpral Reniirs\/ NEW CONSTRUCTION: I{ trecl New [ies].lence I Addition to txisting ltcsidenc(, :] Ilelo.rr on . *. PLEASE CHECK AND ANSWER BEI-OW AtT THAI APPLY TO YOU R PROJECT" * {^ SEWER: Zone: }(*" tt Garage (SF)7 E E Det Garage (SF)_ i I Pool (S[)litorag.:llred (5[ ) Ot lrer rl,i) l-l SLrrroo rn (St ) Ll Greenhouse (SF) _ D Deck (SF)__ ls the propo5ed work changing tl're existing footprint? n Yes I No TOTAT 5Q fT UNDER ROOF llor proposetlwolk) Heated 3202 TOTAT PROJECT COST (Less Lot)r S ooo unrleated: ?Oo 41te 0. nYiv bd" 6 %'-lsthe proposed work ch anginB the nun]ber of bedrooms? ! Yes ls any Electrical, Plumbing or Mechanical work being done to the Accessory Structure [ ] YesV*" lf the project is a Relocation, is there a Natural Gas Line on the current site? ! Yes ls there Electrical Power on this Building? ! ves! r.ro Property Use/ Occup Description of Work: ancY:SingleFamily D Duplex! lownhouse laws and ordinan.er a,rd regulationr. Th€ NHC oeveloprnent Services C€nte, wrll be notrfr€d ol any .lranti I lhe app.ovcd planr r,,d lpecification! or.hane." rnlormarion "'NOTEiAnyworkpcrfo.medwithouttheappropriatepermitrwll botrrvloli,tionofrhcr.lC rtc Uldp Codr nnd sul)rccl lo [inee ,]r, ro S500.00"' 'S>u A-ter,frn&owner/contractor ''Licensed Quolilier" Signature s the rjroperty located in a floodp a n? [ ] Yes Existing lmpervious Area 5q Ft New lmpervious Area 60€7 Sq Ft Total Acres 0isturbed .re Existing Land Disturlling Per l y'*" )/to.:'l c) WATTR: D CrPUn b{Co,,,,',',unity Sy!{em L-i Privatc Well D Crntral Well l l AqLiir \[Cf pro ! CommLrnity Systcm ij Private Septic { l Cenrril Sepr c L ] Aolra t' Officer: _ Setbacks (F) __ (tH) _ (RH) (8) __ Approval: _ Cityr __ Date: - I'loodr (A) _ (V) _ _ (N) BF[+2f1= _ Comment: plrnlit Fee: l, t% Ht*