JANUARY 28 2016 BUILDING APPSNEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE: RESIDENTIAL
PLEASE ANSI,IER ALL QUESTIONS APPLICABLE TO YoUR PROIECT
"Project ResPons ibil ity"
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)pttr bbo
APPLICATION
Number
(office Use)
DArEt lz- //-/5
.- 7
<:, cr\) - ;-r t6'
zIP I
APPLICANT'S NA|IE :
DEVELOPER:
PROJECT ADDRESS:
SUBDIVISION:
B
Et t_
PHONE #:
\li4 t'.A
LrcENsE #:
3l 131
crTY: l-l v4
LOT #:
srtQ(zw: 2rYY 3
PIONE #: ?/o 9Zo 066
I
BLOCK *:
Dre,.r.D
K".^MPHoNE#:1-/_p
- f rz 11
rrPROPERry Oh'NER'S iIAIIIE:
OTflER'S ADDRESS:CITY:
CONTRACTOR:
ADDRESS:
o
Efi,IAIL ADDRESS:. (d rb-
PRO]ECT CONTACT PERSON:
It-.^* DeftN{i-<,
EXISTING CONSTRUCTION:ALTERATION
f] nrruovarroru
! eerurnal nrenrns
! RELocArroN
NE!'/ CONSTRUCTION:
F ERECT NE}'I RESIDENCE OTADDITION TO EXISTING RESIDENCE
,**PLEASE CHECK AND AI'ISUIER BELOW ALL THAT APPLY TO YOUR PROJECT:
fl nrr cnnnce
_ sF
tr
d d
SF
DET GARAGE
-
SF
POOL
_ SF
DECK SF
PORCH SF
STORAGE SHED5F
SFGR E
ENHOUS ESFOTHER:
TOTAL HEATED SQFrt I -1 97
TOTAL PRolEcT CoST,Lessrorr | $ l, O,o0O # oF sToRIEs: { 0..,
plil'3a
Is Any ELECTRICAL, PLUMBII{G or MECHAI{IGAL Work Being oone to the Accessory Structure?
p V"t E
If the project
is a Relocation, is there a Natural Gas Line on the current sitel I ves
Is there Electrical Powen on this Buildingl l--l v"r S r'ro
PROPERTY USE
/ OCCUPANCY:
F SINGLE FAMTLY DUP LEX TOh]NHOUSE
DESCRIPTION OF WORK:
DTSCLATMER: th6reby certity hat all inbrmation in his applicaton is
corecl and all work willcomply wih he Slate Euilding Code and all ohet applicable StaE and local laws
and ordinances and regulalions. The NHC De pment Services CenEr will be noiified of any changes in
tre approved pspec frcalions orchange io cootracloror
conracbr intormauon
"'NoTE Any enW/O lhe Appropriate Permitswillbe in Violation oflhe NC l b Fines Up To $500 00"'
OWNER/CONTRACTOR :SIGNA
+ ir * * j* r(,f *,*1. + *,li + * r.**r. *+* **{r+ * *rt* **1. +* + it,*
*,t *,t* *,* ** +,t + r. *** *+ +,r *,r + * + *+ * +,r + {.* +*,t * i. *
No
El,o
)
I5 THE PROPERTY LOCATED IN A FLOODPLAIN?
I-I VCS E[ ruO
WATER :
SEWER:
tr
CF PUA
CF PUA
cor"rmuNrry svsrrm
S pRrvATE vlELL
! crtrnnl well
cENTRAL sEprrc
! enrvare seerrc S coMMUNrry sYsrEM
tr
*** SEPARATE PERMITS REQUIRED FOR ELECT, MECH, PLBG, GAs EQUIP, PREFABS & INsERTS
'***
pAyr4Er,{r
rirETHoo:
Icrsn flcnecK (pAyABLE
ro Hnc;
I menrcAN ExPREss
E n./,rso 8,,
EXISTING IIIIPERVIOUS AREA:
NEW IA4PERVIOI,S AREA:
-
SQ FT
zoNE:
_ 0F FICE R:
SQ FTTOTAL ACRES DISTURBED:
EXIST LAND DISTURBING PERMIT:
fi ves
l-l ruo
8?
R
****++***+++x*r(*,tiri.+*x,tr.,*,*+**r(,t,ti.++1.+****,t+,*****)*)****xx)k)*:*'****'**)k**+i"(*****i<+*+**x**)*)***
(foR oFFrcE usE ol,lLY) REVISED oATE 04111/12
SETBACKS: F:_ LH:- RH:- B:-
Approval:- City:- DATE:- FLOoD:
-
BFE+2ft=
-
AVN
ST:_ZIP:_
PHONE #: Sn-yr* <-
I surunoom
n
ToTAL sQ FT UNDER noor,
-3 tA( ToTAL aREA
sQ Fr:
-
I
I
t,{
N,TLDING PERilTT tL-t2t
(tk{;a,t,,-b8?
T,PLICITTol,ai(.
*
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SITSIVISI :
$
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PioeatTY *r,I{r, s r$llr :
crxfR'5 aDonEss:
coaTir<foi:
AD €ST:
(ir"x tv/r*ar)
plor E
CITY: ,,/tl)zl9 | ?-r(/Z
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tal tlrtcr!
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TOrAI P*OJECT COlTra r,q t t 7-\w r Of STOiTES:
/
tr ,., ELE([l!Cr!, tLl/|lra q. iGtXfICla
rbrt
!.int Oorl
to th. t er!o., Sthrtultr St Ves
! fL th€ proJcct
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r B.tw.l 6.3 t1n on ti. Ct.rsn Jlta?
fi V., ftfro
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ft.t-.d.yro
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-4, en rirkAt tr-.rxrtmrocb-! , cnl^c! . c!tr..nr .
qffA,rcfiTllcTor fde SIOIATURE:
(rrinr i-l
rr nc prr?Erry Lo(AtE rx e rroxrrrr I vs fi n
m Dri ,?tLvlqrs llEr; _5Q lI rullr A(M glgntl€D:
lltrl t D€,lvfqrs rUA:
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ftrnr: l-l * .B *
srEr: E cFnJ^
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su: F ctpuA
fl (rrrn r sernc
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-
l#rs
il NEW HANOVER COUNTY BUILDING PERII|IT
APPLICATI$I TYPE: RESIDENTIAL
PLEASE ANSI{ER ATI QUESTIONS APPLICABLE TO YOTJR PRO]ECT
"Project Responsibilitf,
tllnx ltrtt
CITY: /,tt t r,/Nl 77)A,/
?ab*t4?1
tL'"12|,
APPLICATION
Number
(office Use)
s112,
/' K'-7 bAPPLICA T'S M}tE :
DEVELOPER:
O${ER,5 ADDRESS:
Ptl()tlE S:
Z-
PRO]ECT ADDRESS:
SUBDIVISION:BLoCK #: _ LOT f:
PHOI{E
#:
CITY: _ST:_ZIp:_
LICET{SE *:
CITY:5T:
_ ZIp: _
ZIP:
Zf)(zZ
COiITRACTOR:
ADOftESS:
EitAIL ADDRESS: pHONE
f:
PRO]ECT COI'ITACT PERSON :<Me PHONE
S:
EXrSr rtG CONSTRUCTrO]{:
f} rlrrnarrOru
! neuoverroH
! crtrnal REpArRs
n RELocarroN
NEr,J COr{sTRUCrroH:
! enrCr NEH RESTDET,ICE
o"
sl morrror To Exrsr {c RESTDENCE
*.PLEASE CHECX AND At',Sl.lER BELOh, ALL TIIAT APPIY TO YOUi PROJECT:
ATT 6ARA6E
_ SF I Oer Cnnecr sF
E poRcH
_ sF
suNRooM
_sF I eool
_ sF ! sronaer
sHeo sF
SF
I oecx
SF OTHE R:
ec,SF
tr
tr GR EENHOUS E
PROPENTY US
DESCRIPTION
TOTAL HEATED SQFT: ,IOO TOTAL SQ FT UNDER AWT:
{?-o ToTAL AREA
sQ FTI 9o
TOTAT PROJ ECT COST tess lou t $ Z(, awf OF SToRIES: I
Is Any ELECTRTCAL, PtUl4BItlG
or I.IECHAI'IICAL t^,ork
Being Done to the Accessory Structure? p V", I No
If the project
is a Relocation,
is thene a Natural Gas Line on the Current Site?
Is thene Electrical Power
on this Building?Elv"r lIruo
tr Yes
Elto
E
/ OCCUPAT{CY:
fi srrorr rar,ulv
! DUpLEx
f] rol.rNHousE
OF WORK:
ul'fr 6 9ltt
fi@
DISCLAIMER: lh6reby certify fiat all intormalron in
his applica{on is
corecl and sll workwiltcomply urih
he Stat€ Buitding Code
and ordinsnces and rcgulations. The NHC Development Servic€6 Cenbr willbe notfed olanychangos in he approved plaflsand
contacbr inlcmaton. "'I'IOTE: Any
Work Performed W/O
fie Appropri€b Pemits willbe in Violelion ofthe NC StaE Bld! Code
and sll oher applicable StaE 6nd tocat Iaws
specifications orchange in
contracbror
To $500 0(r"
OWNER/COTITRACTOR:(tle SIGIIATURE:
,r
*, )r+
*,* +++ + **:i,i. * * * ****** * *(I'*'ll Jil"J **
**** * ** * +*:r *:**)r:r* *,r**,r*,*:**+: + *+ + r*r ++ *
rs rHE pRopERrY LOCATED rN A FLoooPLATN?
fl vrS M no
EXISTING IIIPERVIoUS AREA:
-SQ
FT
NEtd II4PERVIoUS A'REA:
-
SQ FT
MTER:
SEI{ER:
TOTAT ACRES DISTURBED:
EXIST LAND OISTURBII{G PER
IT: N YEs
pm
fi creun
E corr,auNrry sysrEt,t
E pRrvArE wELL
! crrrnal wrli
fl crnun
f] cenrnnr sEprrc
E pRrvArE sEprrc
! cottt'tururrv svsrrr,r
*** SEPARATE PERI'UTS REQUIRED FoR ELECT, i4ECH, PLBG, GAS EQIJIP, PREFABS
& INSERTS *+*
pAyrrrENT
irETHoD: EI .os, flcnrcK (PAYABLE
ro rxcl
I ArtrucAr,l ExPREss
EDtczrrto fl orscovrn
* * * *,N r,* + *)* *,1+ + +* * **,t {.+ + :i :f:*
+* * *,t:t * *)* *,} * * *,t * * )t
*,},** **** '}:* * * 't ** *'t * +:t * **
+** * *,}* *:t** * * *:t * * !t,t * )i
(FOR OFFICE USE ot'lLY) REVISED DATE
O4l11/12
ZONE:
-
OFFICER:SETBACKS:
Approval:- city:- DATE:-. FLOOD:
- -
BFE+2ft
AVN
$rt
PROPERW OU,I{ER'S tlAfiE
: Q*le
d olb-(pqf
ffi
NEI^I HANOVER COUNTY BUILDING PERMIT
APPLI.ATIoN rYPE; COtIItlERCIAL
PLEASE ANSWER ALI QUESTIONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibility"
Dnvid
L.Ioxes, 9e.
?EL tb -1,1
APPLICANTJS NAI'IE:
DEVE LOPER:PHoNE f
: 5aO'4312-
PRO]ECT ADDRESS:
OCCUPANT/ BUS IN E SS NAI'IE;
PROPERTY OWNER,S NAME:S
CONTRACTOR:LICENSE S:
CITY:
t i\miuqtDN
zrP |
?8403
?63 . 'rrl+ Rlx
9ao.4ar2
PHoNE f : Flb3- btlgO l12
sr: NC zrr:3 94Cl
sr: hlc zrP:
l84oJ
CITY:
ADDRESS:
EI'4AIL ADDRESS:
PRO]ECT CONTACTERSON:
uc)PHoNE s: qbA-L.lgOy15
PHONE S:
ADD TO EXIsT STRUCTURE
(Che€k
all rhat Apply)
EXIST CONSTRUCTION:
lf Relocation. is there a Na
ALTERATToN
fl nercvlrror Dl cerenal nrplrRs
l-l RELocArroN
Gas Lrne on rhe 6irent sirez
flvei-Sruo ts eroc spil KreRrot
f] v"r flruotural
NEI.] CONSTRUCTION:EREcr NEr,.i
srRucruRE
! rasr rnrcx
f] snrr-r
! uerrr
ACCESSORY STRUCTURE:
If UPFIT
- The shell Penmit #:
IF Yes, what was
the Previous Occupancy Type?
***** rs rgrs a 6HANGE oF occupa1cy user
!ves Ero ----.
Is Elect Power
on this Building E Yes E ,o
what j.s the Neu occupancy Type?
NC REG #
NC REG #
ARCH OESIGN PROFESSIONAL:
ENGR OESIGN PROFESSIOIU\L:
PH
DESCRIPTION OF WORK:
ls food or beverages prepared or served in this structure?
EYes $llto ls Th" Property Locsted ln The Floodplain?
E Yes
Nl ruo
DISCLAIT'ER: Ihereby
nd ordin
cerufy that alllnformation inthe state Building Code and
in rhe approved iire€i3
all other a icable Slale
The
in
conlractor
$500.00-'Subtecilo
707'5950 al least l
B
oWNEFVCONTRACTOR:
DnVid L.
frreer 9e. STCUTU
TOTAL PROJECT COST:
A54qO BUILDING HEIGHT
(Oualirieo (Pd Name)
Note:Demolition notilications t asbestos r€moval pemil applicaljons are to be submitted using the applicalion form (DHHS-3768)
co arn Asb€sros or nor. You ar€ roquked to
callthe Narional EmEsion Standards lor Hazardous Air Pollurants {NESHAP) at (9'19)
dernoliton of any lacility or building. See Asbestos Web Site: htipl /vww.epi.staie.nc.us/epi/asbeslos/ahmp.hlml
# OF UNITS
TOTAL AREA SQ Fr : r
3OO APPAO^
TOTAL SQ FT UNDER ROOF:
_
So Fr PER FLR:
l?0O ApProx
# OF STRUCTURES:
\
ACRES DISTURBEDNO NC EXST TAND DISTURBING PERMIT?
I_IYES
EI NO
NEW IMPERVIOUS AREA; SQ FT EXISTING IMPERVIOUS AREA
pRopERTY usE: EfoFFrcE !nesraunarlr lueRceNrtre !eouc APTNDO OTHER:
SQ FT
WATER: EJCFPUA
SEWER: [}CFPUA
.. SEPARATE PERIVIITS REQUIREO FOR ELECI, MECH. PLBG, GAS EOUIP, PREFABS & INSERIS -'
ZONE:_OFFICER:
(FOR OFFICE USE ONLY)
SETBACKS: F:-LH:- RH:- B:
REVISED DAIE IU11N2
Approval:- City:- DATE:- FLOOD:
-- -
BFE+2ft=
AVN
f]COMMUNITY SYSTEM EWELL f]ZONING USE CLASSIFICATION:
E]CENTRAL SEPTIC L]PRIVATE SEPTIC f]COMMUNITY SYSTEM
PAYMENT METHOD:
flcnsn flcxecK (eAvABLE To NHcl fieuentcaru exeness fll,tcrutse I otscoven
b
Comment PERI,/lT FEE: $
APPLICATION
Number
(office Use)
DArE:-!-:Lq:!!-
owNER',s ADoREss:
3392 Clc.o lirln BeBch RA crrY:
l.)ilmiNg\pN , -
# OF STORIES: I
# OF FLOORS:
-
1T
(r T DF e.F
frt
NEW HANOVER COUNTY
BUILDING PERMIT
aPPLICAT,N TYPE: CoMHERCIAL
PLtAsg AII5I.JEF AII Q|'ST:OH5 APPI
ICAAL' TO YOUR PRO]ICI
"Project ResponEibility"
Dnvid u. J-ores. Sa.
Qotb*V?
'itET.
tU -1t
APPLICATION
Number
APPLICANT'5 NAflE:
DEViLOPER:
PRO] ECT ADORESS
oCCUPANT/BUSINE5S NAx E r
crrYr 16li 16 iNq+oN , r,J(
PHONE f,
?aO-43t?-
zI P: p8403
?63 -[f]+ Fnx
9ao
163
u
PROPERTY OT,UNER'S NAHE:
L 5-43rf
PHONE
':
-6qd0
rtz
sr: M: zIP:artr4oi
sr: 5l! zre: 1840J
PtroNE it nQZ -
Ln &A \ tg
PHONE
A:
CONTRACTOR
Nes- 'qr
ADoREss:
&qe Gnolim B€Arh Ad
EI4AIL AODRESS:
u
PRO] ECT CONTACTt R50ri
l)a.rid L-\7 LIC!ns r *:
C I'TY:
Exrsr coNsrRucrroN:
I ALTERATT.N
3 -r*;ii!llJ 'ii:';ii,
,r
Relocarion. ,s lhere a Naru.al Gas Lrne on rhc Ei rc.r Snc?
[v.I"fi1"
AL REPAIRS RE
LOCATION
IS BLDG SPNINKT i: RFD'
f, ve' ffiro
NEl./ CONSTRUCTl0r,l:IR ECT NEW STRUCTURE
FAST TRACKSHELL UP FIT ADD .TO EXIST 5TRUCT|,]RE
ACCE5SORY STRUCTURE;
If UPFIT
- The 5he11 Pe.nit s: Is Elect Power
on
rhis Buj.lding El yes f rO
a cHAr,r6E oF o(crlparcy usE?
f,vrs ffi lro .",'
lF Yet, uhat was the Previous oacupancy Type?l,,lhat i! the Ne!, OcauDan<y Type?
ARCH 0ESIGfl PRCFI55iotiAL INC RE6 n
EI/GR DESIGN PACFESSIONAL
,/)_ "-/ lc REc s
DESCRIPTICN OF WORK:
a
ls lood or bsverages prepared or s6rved in this strrcture?
[ves [lNo b The Propedy Localod ln The rtoooptarn?
[ ves
fi] No
OWNERYCONTRACTOR:Dnvid u.
Ioree, 3c. srcNeru
;Curaai igqt Ne.)
Nore: Oefl1oioon ncrrnc&o.3
t s$b.sros ,6rnov.l !.fin app[c'r'oru .,. to 06 rr/brl,tad .3d$ tt arpka'on lorm (OHHS-3766)
eh.!h.r lnc ttc,l
ccirnn Arb€Eos o, n (. You a,r roqurrcoloca t( N!11o.!l €mrssion S cn6rds tror B.ardols Ar PollLtunt' INESI IAP)
!t (913)107 5950 at leasi
oe.Er'li6 ol yli In - rr, or r- 1,1
) S.. Asbasiot w.b S;:. :rra i\er eo s'rr.
'/ i!.3i:,, Lri.5.'r":\lntl
1OIAL PROJECT
COST:
A5,4qD BUILDING HEIGHT, OF UNIIS
ToTAL ARFc sQ r L r"OO ApfPox
IOTAL SQ FT UNDTR ROOF:
.-
ACRES DISTURE"t"0 e EXST LAND DISTURBING P'IJIIil?
[ves ffiruo
WATER XCFPUA
SEWER ECFPUA
T""
=t."
)
so FT PER FLR: _I3Qo_APB.QA
# OF STRUCTURES: I
# or sloRrEs
# OF FLSORSi
SO:;
pRopERTY usE: E'oFFtcE ! nrsraunaNr f]rir rncrrurtlr
I eouc
! rer NDO C'|HER
-coMMUNrry SYSTEM
t] ELL EzoNlNG lsE clAsslFlcArroN
- CE\IRAL SEPTIC
f] PRIVATE
SEPTJC f]COI!tMUNI'} SYSTEM
;. r:)n:.i'r: \r:,'iti:. ,:I| -LII ;:r ''sir':tr'r"'
pAyMENT METHOD:
fiCrcx ficnecx (PAYABLE TO NHC) fllUentcaru exeRess
f] uclvtsr
f] otscovrn
zONE:cb OFFICER SETBAC
Approval:-f,!--City:tL,itft DATE: i l4 liz FLOO
^1-2
F,lrm
, ,
''usE oNr-Y)
KS: F'.N/A LHjNA RH:$U!- 8r
O: ' 7cr.. I' Br
adttrcpaU
E.2rr
i\nlT rEE: $
){r.notu
Com
DArE: I -
13-lL
or.lNER's Ao0REss:
?39a Cqen lir.ro BpAc
h M crrv: t,)ilmir.rgtoN .
'--Siii.
,rl
1
NEW Ii4PERVIOUS AREA:
.-.--__=._.- SO FT EXISTING IMPERVIOUS AREA:
& olb-1dx
L6 - 00079NEW HANOVER COUNTY
BUILDING PERilIT
APPLICATION
rrpEr RESIDENTIAL
Pt€asE ANSTER Atl QUESTIOIiS APPLICAELI T0 youR PRoJICT
"P.oject Responsibi.Iity"
APPLICANT'S flAllE: Robuck Homes Ti:'an .qi e, LLC
oEVELOPER
I Robuck Xonus
Triancje, rJLC
PROJECT ADORESS:720 Antler liiv.CITY:
SUBOIVISI0N: elron oeks
PROpERTy oWNER'S NAI.IE i :tobuck Homes rrianqie, LLC
O0INER'5 AOORESs: 6131 Falls ol Nelrse Rd. Ste 2CU CITY:Ra -L e rq)
COiITRACToR: Robuck Homes Tr1 1e
i:,c LICEII5E *: 5?c8l
ADDRESS:
6131 Falls of Neuse Rd. Ste 200CITY:ia I
eiq:1
EmAIL AoDRESS: i ncrbecil@robuck:1omcs . com
PROIECT COI{TACT PERSON: ,rd: lior:ec:l -
r.r !eca- ,
r.)! r.rir -ia: . ao:l
#APPLICATIO}.I
Number
(Offi.e us€ )
DATE: c 1,,12it6
PflOl'lE
#: 919 876,9200
ZIP:2a403
BLOC( #: LoT t: 16
EXISTIN6 CONSTRUCTIOI'I :ALTERAIION R ENOVATION
fl ernrnaL nrrnrns
! RELocArroN
NEW COT,TSTRUCTION,
fl rnrCr NEW RE5IDINCE o" I lOOrrrOl TO EXISTING RESIOENCE
..PI.EASE CHECK AI.{D ANsI./ER BELOI{ ALL THAT APPLY TO YOUR PRO]ECT:
ATT GARAGE 504 SFPoRCH lss SF
suNRooN
_sF
GREENHOUSE SF
I eool
-
sr STORAGE SHED SF
5F
I oecr
DET GARAGE SF
ST: \'c ZIP: :?609
ST:
J!_ZIP i 27599
PtEl'lE #: r19-a?6-920c
I No
Yesr No
5F OTI.]ER
ToIAL HEATED
5Q FT: zsrs ToTAI 5Q FT UNDER R00F: r7-cJ ToTAL AREA
SQ FT: -i:os
TOTAL PROIECT COST rress rorr : $ zz,iI50
ls any ELECIRICAL, pLUltBItlG or |IECHIIIICAL wo.k Being Oone to the Ac.essory
Stru(tu.e] E Yes
If the pnoject is a Relocation, j.s there a Natural Gas Line on the Curnent Sitei I
Is the.e Electrical Power
on this Euildin8l
pRopERw usE
/ occlrPAr,tcY:
E] srNel: rurlv
DESCRIPTION OF WORX: new home
I Yes No
DUPLEX
fl ro^rHnouse
O6lClAlMEtt I hereby cedifo mar ali inbnnBtion in his Epplcalion is core.t and allwod willcomplywih $e Slale Euilding Coce and allo0ter applkab]e SlaE and bcallaws
.ndo'dn ce5 ald .ca! raions
tiie NH C Oe Ebpmen r Se ry ices CenE. will be notl5ed
oi an y changes h Oe appoveJ plan s ,r d spetituarcns cl cnange n
co.racbr or
contact)l'nhrmarion"'NOTEAny!/orlPedomed$/,OteApp.opriaEPermiEwilrbeinViorationolrh6NCSiaEgrdgCodeandSlblecrtiFltrc5LrpIo55000.'
OWNER/CONTRACTOR:
cb:o tsishop SIGNATURE:
I NO
TOTAL ACRES DISTURBEo: . r?t
EXIST LAND DISTUREING PERHIT:
i-l ves I NO
SETBACKS: F:j_:-j:_ LH:--t- RH:- B:--:+
*** *** * +r**** *,* *,* * * *,* i. * * ** *,i ir * *
rs rHE pRopERTy LocATED rN l rrooorurrl I vrs
EXISTING IMPERVIOUS AREA:
-9--_ 5Q FI
NEI,U IIIPERVIOT,S AREA: 19s6 SQ FI
hrarER:
I crcua
f]COI{MUNITY SYSTEMPRIVATE WELLCENTRAL XELL
SETJER:crrur
I cENTRAT sEprlc
I enrvare storrc
I coMMUNrry sysrEm
"' sEPARAIa pERi:r-'-S REQU;RED FCR El
rai [ECH,p186, 6A5 EQLIl ','2:.A8S & INJ-.i' '-'
PAY|I€Nt fi!ThOO:
Icosn fianaa* (,A'ABLG ro rttl ! -.*rcnli txrxtss
tr rr/v15A 0rScovER
ZONE;-.; l OFFICER:
Approval:- City
(s
: oars, l 6 FLOOD:
Coflment:
. BFE+2ft=
N
PERI4IT FEE: $
PHoNE s: 919-8?6-920c
PIIONE
S: 9r9-?r7-r:28
# 0F STORIES: 2
.!
'ffi,
APPLICANT'S
2olb-lod
16-0007 9
APPLICATION
Number
(offi.e Use)
NATIE:
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE: RESIDENTIAL
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibility"
!:.:ii) :.i: :l!:-,,e:i
l: 1ar,ql., :L:
DATE: ir r:'r6
DEVELOPER: Robuck Homes TriansIe, LLC PHONE #: 919-Er6-92cC
PROIECT ADDRESS: -: .:,- ., rr :CITY: tr,itmi noron
ZIP: )b1a:.)
SUBDIVISION: Me I r
orr ,,'dks BLOCK #:LOT
#: I r,
PROPERTY
O NER'S tlAlr4E: R.buck Home:i
Tri.rirrle, 1,La
PIIONE #: 911 8r-6-:r2aa
OhTNER'S ADDRESS: ajl ll F'al l:i of ]el.:re F.1. l-:r e ;'lrlCITY: RalejqilST: r.. ZIP: ] r.|?
CONTRACTOR: Rcbuck Homes Trransle, LICLICENSE #: srn83
ADDRESS: 61.11 Falls of Neuse Rd. Ste 2a-.
EI4AIL ADDRESS: r I-.orbech.0 r obucktrcme,r ccm
PROIECT CONTACT PERSON: Jar Norbech
- rnorbecfrGrcbuckhomes. comPHONE #: .':-. : .a
ATT GARAGE 5' 1 SF
SUNROOM SF
DET GARAGE
-
SF
POOLSF
DECK
PORCH i!,SF
STORAGE SH ED
GR E ENHOUS ESF
SF OTHE R
SF
SF
sQTOTAL HEATED SQ FT:
z:qi, TOTAL SQ FT UNDER ROOF: r2.5 TOTAL AREA
TOTAL PROIECT COST 1r-u"" ro1 : $ ::r, ,rs'.. # OF STORIES:
Is Any ELECTRICAL, PLUMBING or IIIECHAT{ICAL Work Being Done to the Accessory Stnucture?
E Yes
If the project
is a Relocation, is thene a Natural Gas Line on the Curnent
Site? [
Is there Electnicat Powen
on this Building? fiV"t ["-l ruo
PROPERTY
USE
/ oCCUPANCY:
SINGLE FAIII1Y DUP L EXTOWNHOUSE
DESCRIPTION OF IJORK: :,e; i.,,,,1r-
OI^INER/CONTRACTOR
i l,rp e i..:lop SIGNATURE:
IS THE PROPERTY LOCATED IN A FLOODPLAIN?YES I
FT: r2rs
No
Yes!No
and ordinances and regulations The NHC Developmenl Services Center willbe noliJied
ofany changes in he approved plans and specifcations or change in contracrcror
conEacbrinformaton "'NOTE:Any Work Pe omed W/O
he Appropriale Permits will be rn Vio lation of rhe NC SraE Bldg Code and Subject b Fines l.lp To $500 00"'
+ + + * 1. 1. * i. i. + + + ,r + + + + ,t 1. 1. ,* ,* ,t ,t + + + ,t ,r + ,t ,t ,r ,t ,* ,* ,* 1. * * * * ,r ,*
* )r
* )* + * * ,f * * * * )r
* * * * ,r * * * * * * + + * * + * + * * ,* ,* ,* ,*
* ,r + i. * r. *
EXISTING IIiIPERVIOUS AREA: .SQ FT
SQ FT
SETBACKS:
NO
TOTAL ACRES DISTURBED: , ]2 ]
EXIST LAND DISTURBING PERMIT:
[*l ves
lTl uo
DISCOVER
F : LH: RH: B:
n
I.IATER:
SEt/ER:cFpuA
E CENTRAL sEprrc
f] enrvare seerrc COi\4i\4UNITY SYSTEI4
*** SEPARATE PERIIIITS REQUIRED FOR ELECT, MECH, PLBG, GAS EQUIP, PREFABS
& INSERTS ***
pAyr4ENr
nErHoD:
Icasx flcxrcK (payABLE
ro NHc)
EA ERTcAN ExpREss
E r'rc/vrsn
U
**x*x:L:*:*:*:**,*,*)*,**,*,******,t1.*+i.li*i(*{r1.**,*******r.r.,i*{.*ir+****)****,1**1.*1r,*)t+*:}*++x*)*,t***,tr(,***+l1r
(TOR OFFICE UsE ONIY) REVIsED DATE O4l11/12
NEW II4PERVIOUS AREA: 1 .
CFPUA COT4MUNITY SYsTET,1PRIVATE WELL CENTRAL WELL
aLl
I
BFE+2
tr
sT: :_:_ zIP : .:--:
PHoNE #: 919 !rr6-9i00
EXTSTTNG CONSTRUCTTON:
! nrreUrrOru
! neruOVnrrOH
! Cer,irnal REpArRs
f] RELocArroN
NEW CONSTRUCTIOru:
I enrCr NEW RESTDENCE
o"
! eOOrrrOru TO EXTSTTNG RESTDENCE
**PLEASE CHECK AND ANSWER BELOt/ ALL THAT APPLY TO YOUR PROIECT:
ZoNE:
_ 0F FICER:
Appnoval:- CitY:- DATE:- FLOOD:
-
AVN
a
!(t r
,c+
"ft
NEW HANOVER COUNTY
EUILDING
APPLI catlott nzPE: RESIDENTIAL
.11/: // ) r. --'u-'\_-./1\/)_ /Lt /PERMIT t/( ,/ Q-/e3
PLEA5E ANSI{ER ALI QUESTIOI{S APPI-ICAEIE TO YOUR PRO]ECT
"Project Responsibility''
4rJ//c
clw:
APPLICATIOiI
Number
(Offlce Use)
Plot{E #
BLOCK *: LoT #:
PHONE
#:-lzo-szy'o
APPLICA'{T' S ilA'48 :
DEVELOPEN:
PRO]ECT ADDRESS:
SUBDIVISIO :
PROPERW O^,I,,ER'S tIAIqE :
Oh ER,S ADDRESS:
cafiRAcfoe; LLry''
/tz
ADDRESS:
EfitAIL ADDRESS
I
CITY:
LrcE,sE f: Z//ol
CTTY:ltztt
,,AZ
Sr*orotrot f] cerurnnl REPATRs
n
srt <,arPt422?
,rrl ,rorry*:9V-Otz4t
'7'
PHOT{ E
RE
LOCATION
sF Tl PoRcH qE
L-I 5TORAGE SHED
OTHER:
SF
SF
NEI,I CONSTRUCTIOI:
I TNTCT NEH RESIDENCE
O" Er',,,,* TO EXISTING TESIDEiICE
,.PLEASE CHECX AND AllSllER BELOII ALL TIIAT APPLY T0 YOtR PRoJECT:
EXISTING CONSTRUCTIO :ALTERATION
fl nrr crnnce
_ sF I oer canace
! suunoor"r
_ sF I eool
_ sF
5F
SINGLE FAMILY
! cnrerurouse
-
sF ! oecr
ToTAL HEATED SQ FTI ,T.2 ToTAL sQ FT UiIDER
R@FI
'I?Z
ToTAL AREA
sQ FT:
ToTAL PRolEcT CoSTquessr,oj , S fit33O. * OF sToRrEs: Z
PROPERry
DESCRIPTI
UsE
/ OCCUPAucv:
Io oF ltloR*: *lna
fuOzo/ 7o
ouelex
! ToulNHousE
foo.,
/z-*rrta/,
Is Any ELECTRICAL, PLUITTBING or itECHAr{fCAL
Work
Being Done
to the Accessory Structure? fl V", I No
If the project
is a Relocation,
is there a Natural Gas Line on the Curnent Site?
u Yes
K,"Is there Electrical Power on
this Building?
(v"' EIro
/O
h€
hr'flrz
DISCLAIMER: I hereby certjry }lat all infomston
6nd ordinances and regulations The NHC D€
contacbr iniomalion. ".''lOTEr An
is corecland all work will comply wih he Stat€ Building
r
willbe notlied olanychsng€s in tie appmvsd plan
Permits willbe in Violation orlhe NC
SIGT'IATURE:
applicable Srare and locatt6ws
change in
conFactcro.
Up To $500.00"'
!t*+ *,t* * * ++ * )i:tr++ + *,t )* + +
OWNER/CONTRACTOR:
:t**,t + + * ,* :t :1.,*
* * + * **,1* ** *
tt*:r Print Nahe )* ** **t )t*)t* :** * * * ** * **
IS THE PROPERTY I.OCATEO IN A FLOOOPTAIil}
E
EXISTING II.TPERVIOUS AREA:
-5Q
FT
NEr{ rilPERvror,s RE ;3bs? se Fr
YE5
X.,o
MTER:
SE!t,ER:
H
TOTAT ACRES DISTURBED:
EXIST LAND DISTURBI 6
nrnurr: I veS
!-] rc
CENTRAL WELI.
! comr,tururw svsrrr,r
**+ SEPAITATE PERiIITS REQUIRED FOR ELECT, I{ECH, PLBG, GAS EqJIP, PNEFABS
& I SERTS *+*
Ecsn E CHECK (PAYAELE TO I'IHC)
tr AIiIERICAII EXPRESS
lJ nc/vrsr Ll DISCOVER
creua
! cotllluNrrv sysrEt't
D pRrvATE wELL
creua
I cENTRAL sEprrc
I nRrvarr secrtc
PAYttEt{T I,IETHOD:
:t***,t**:t *,t ,t + * :t,* * * + ,f )i ,l * ,t,l ,l + * * *
* * ,t
* *:* *,1.
* * * ,1 ,* ,t
* * * 'l * * * + * *,1 * * 't *:i *!** *:t*tl)t***,**+*,t)*,*++*:r *+++
**
(FOR OFF1CE USE OI{LY) REVISED DATE
O4l11/12
to-
ZTP ':
pRorEcr colrAcr eeesar htc/qf fa26 PHoNE
s: a '- 62- fltrtru
)(z-
ZONE:
-
OFFICER: sETBACKS: F:- LH:- RH:- B:- ()
Approval:- city:- DATE:- FLooD:
-
BFE+2ft=
-J
Av
N\ec
NEW HANOVER COUNTY
BUILDING PERJ'IIT
APPLICATION
rypf : COITIMERCIAL
P|-EASE A,lsll ALL Q{IE5TIO|{S APPLICABLE TO YOJR pSOl€CI
rProjcct Responsibllity"
ker,r'r Kc J Ii"
8olb 1cgB
15-00019
#
APPLICAI{T'S NA'iE:
DEVELOPER:
APP L ICATIOT{
Nuober
(otti.e use)
PRO]ECT ADDNESS
i
0 crTt I V ,lra i.rA
f.^
PHO E #:
zIPl et grz
pfour c, 11, .?i) - 17? (
sr tty2zw.t ?!2t1
OCCUPANT/BUSINESS NAI1
V AN'
PROPERTY OW ER's M',IE:
OtfiER'S ATDRESS:
t?l
/L.J irIn tt
6t4 r tzll a
0N <rnof h'"f;35aY
C\arl*k
) commcron: t, g,D,LICEiISE
*:
ADORESS;CTTY:
EltAlL A0DRE55
|
PRO]ECT CONTACT PERSOI,':
3
\\
5Tr
_ ZIP:
_
PK)NE T:
P}}or'rE s:
Exrsr coNsrRucrror{:
fi*renrrror ; *.*Jrl[ffi'fi^o?]iko. *carns
!
tf
Relocadoo, is
here 8 Narurar Gas Lrne cn the Cunent S s? Ll"cs XlNo tS BLDG SPP N
nErd
co srnucrro :
I rnecr NEH
srRUcruRE
I rlst rnlcx
fl sner,r-
fi uerrr
ACCESSORY STRUCTURE:
RELOCATIOI{
r<r.eneor
p ves
I r'ro
ADD TO EXIST STRUCIURE
If TPFIT
- The Shell Pennit #:
If Ycs, *lat t,a5
the p.evLo!5 occupancy Type?
Xo
DESCRIPTION O, NSPK. IT,.tc,/.,."41 w,tf
Is Elect Por€r on thls Eullding E Yes [ rc
$iat ls
ect dr, w,'{47.\lL -hI I rc nra r, lts-7
?a: 1b1-7.at/'-Z-1lt Nc REc r: 6il?/2
r,.rr rs rHrs A our{GE or occulucv usel
f] v:s fi1m ""'tlle Neu Occupancy Type?
-
n*vor St,
Cal<r
ls ftod or bolrerEgB p.sp{€d q sswd h t s saudwef
I vofiNo b lho Propqry tocatrd h tho Floo+bh?
E v*.8[uo
DISCI I.EAI Ih!..by clnily ul€l olllnfo.mstion in thB
Epglr3uql B co.recr and atl so,a I co?rCy wlh Ih€ Sr6te Buitdlng Coda end 6lt
oih3r.ppticalb SraG
ano locil l.,s and orddances and reoda{o.rs. The NHC Oeveloon'ern S€(vics€ Csnlar wilr D€ dodrijd o, ery 6a.qe, ln t,r€ oosDve, plarE arld sD€cfEations
or cilnse n Clllt,ado. o, conr'ado, Flqtu)non. "'l.lOTE: Any Wo k Pedorrrd WrO
tE Appropnits PenniG w,ll5€ i. Violeroi or rne NC SLru 8ld! Cods rn,
Sulie{r-io Fd}e. Up To
lt00.00 '
"rle c.l l,SIGNATURE:
pRopERwusE: EoFFrcE Inesmunnn ffiuenorrle n eouc EAPT flcoruoo orHER:-
EICOTTMUNTTY SYSTEM
-WEII flZONlt'lG USE CL SSIFICATION!
--
fi c:rrn* serrrc
[ fi'vnre s=prc pE6uuuxrrv svsreu
WATER: ICFPUA
SEWER: IICFPUA
-. S EPA'IATE PEI tII 15 AEQU R'CJ FOR ELECI, M
ECH PLSG, GAS EOI,IIF, PRE'AAS & INSEFTS
''
pA\GrEirr METHoD
flcsx f] cnecx (PAY BtE To Ntrc) EAMERIcAN ExPREsssa
E orscown
(FOR OfftCE USE ONLY)REV]sED DATE 'U f 2
SETBACKS:F:N\f\LH:t\ARn-NigB:!-I3x BFE+ar-_
N cICofimBnt
FLOOD:
,'', lnSnecltO.rr Req,.lr:m, 9l[t25{-0$li
oare: l) ' { -/ f'\l-(\
-J
\
tL,
=<P
\<
\-
v
ARCH OEsICI{ PROTESSIOMLI
EII6R DESI{it{ PROFESSIOMLI
'{
. codba tub.lb! or nsl You al! llqsLld t0 cd nll Ndo..a E ll.h. Star6.d. to UE d.r! A. PolLtro (I€6HAP) d{019)707-5050 atb-l t0 dart F16b ir
---.-/.-I . TOTAL PROJECT COST:, OF UNITS:
#OF STRUCTURES: I
#OFSTORIES: I
fOF FLOORS:
'AcREs DISTURBED: M/*
NE]W IMPERVIOUSAREA
A//L SO TT F*o
PERMIT FEE:
9--
SC
6cttr- 1ll
lk' ilg,,,....-..;.'
i.-&,
APPLICAT{T,S I{A'4E:
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE: RESIDENTIAL
PLEASE ANSWER ALL QUESTIONS APPLICABTE TO YOUR PRO]ECf
"Project Responsibility''
ITY:
BLOCK *:
CITY:
LICENSE fl:
CITY:
APPLICATION
Number
(office Use)
DEVELOPER:
PRO]ECT ADORES
SUBDIVISION:
DATE:
ztP :
tOT $: JA
4 ?7'(
PHONE
#:
NAITIE:
CONTRACTOR:
ADORESS:
rs rHE pRopERTy LocATED rN A FLooDILATN?
E ves
*hra.lry
&/
sr,/v-'zpJaq//
r jt24zrPtzfu/cly'rtlo) z z-)Bi.S'
s
ETUIL ADDRESS:pHot'lE #
PROJECT COiITACT PERSON:
.) /?ewte
*{Q/o l
-?.1-2?fr7
EXISTIN6 CONSTRUCTIO :
tr A LTERATION
P ner'rovarroru
! cerenal neerrns
!RE LOCAT
ION
NEW CONSTRUCTTOT:
I rneCr NEI RESIDENCE
o" ! AOOTTTOH TO EXISTING RESTDENCE
**PLEASE CHECK AND ANSI'JER BELoel
ALL THAT APPLY T0 YoUR PROIECT:
! arr cnnnce
_ sF ! oer eenacr sr
! noncu
-
sF
SUNROoM
_ SF POOL 5FSToRAGE SHED
_ sF
I enerruxouse
_ sF f] oecx
SF OTHER:t.'
fztlt sF -)ft)
TOTAL HEATED SQ FT:
//?TOTAL SQ FT UtrtDER ROOF:
dJ,)r TOTAL AREA SQ Fr | )) 2i
TOTAL PR0IECT COST lress r-oty :
$ /Q{a.'a f OF 5TORIES: /
Is Any ELECTRICAL, PLUmBfNG
or ECHA,{fCAL Work Eeing Done to the Accessory Structure?
{r", D*oIf the project
is a Relocation,
is there a Natural Gas Line on th€ Current Site?
[ Ves ffWo
Is thene Electrical Power on this BuitdinB?
ffV"s l-''l ruo
pRoPERTy usE
/ occuPANcY , {rrroi ranrr-v ! ouer-rx
f] TowNHousE
DESCRIPTION OF WORK:
DISCLAIMER lh€rcbyfi31all anlormetion in his applicaton is corect 6nd all work willcomply wih lfle Slale Building Code and a oher applicable State and tocat taws
and o rdn ances and regulations The NH C De velopmen t S€ rvices Ce n;r will be notfted ol any changes in
he ap prc
vsd p specifcalhns or change io
co.]iacbr intormation. '1IOTE: Any Work Performed W/O
fie Appropriats Pefinits will be in Viotation ofthe NC Stab and Subjecres Up To
Ol{NER/COilTRACTOR :SIGNATURE:
* ** )*:t1.*,t
*,irr * * *,1* *:l *,f *,* ,i +,* )*
i.,t * * * * )*
++ ri
+,t* ** *,*,*,f *,r )t
* *:r )r
* )r r*
++** )r * +* + *,r
*,i*,t)
EXISTING IITPERVIOUS AREA:
NEI{ IfiPERVIOI'S AREA:
d*o
TOTAL ACRES DISTURBED:
EXI5T LAND DISTURBING PER
IT: I:.I ves I Tio
SQ FT
SQ FT
COI,4I'IUNITY SYSTEM
tr PRIVATE liE LL
fl crrurnrl wruL
! cour.luutrv svsrem
MTER:
SElt,ER:
I cerurnal seerrc
I PRTvATE
sEprrc
*** SEPARATE PERI'IITS BIQUIREo FoR ELECT, MECH, pLB6, GAS EQUIP, pREFABS & TNSERTS ***
pAyrirEuT t4ETHoD:
I casa ffcuecx (PAYABLE
ro txcl I mrucA ExpREss
I rczvrso fi orscovrn
,* + )r
* * **,t ***,*,* ** * * )k
i. )t
* )*
***,1+ + *,t,t * * **,1*,f )* )*
* * !r
)*,t
*** *:* )* )i ,r ,*
* * * )** * * * )*
****,r *** * **,* *
t* )** )r
* + +,t ,t ,* ,*
ZoNE: 0F FICE R:
(FOR OFFICE UST ON!Y) REV]5ED DATE
O4l11/12
SETBACKS:
F:_ LH:_ RH:_ B:_
{rrouo
flcrua
N
Approval:_ City:_ oATE:_ FLOOD: _BFE+2ft=
PROPERW OdI{ER, 5
O ER,S ADDRESS:
PHONE
Pt,^,,^ '.,eJ /^ )A A,'f.r/ta ^, 1/*/.<7< , l! , "E .=
bfopg r'
Aoit-_11c{
#
CONTRACIOR:
ADORESS:,/,
710. tXa
APPLICATION
Nunber
(offi(? us!)
1", /'6
NEId HANOVER COUNTY
BUILDING PERMIT
APPLICA|IA TYPE; R ES
IDENTIAL
PI!A5E A''ISWEi ALL QUESII]!I5 APPITCABIE TO VOUR PRO]ECT
"project Responsibilitf,
APPLICAI,IT'
5 IIA,'IE ;
DEVELOPER:
t'--)
DA'!
PnolECT ADDRESS:
_
SUEDIVISIOt{:
CITY; l,r,'
PHONE
#
A€l2Lf4.)
P(OPERTY OWIIER'S NA,qE
!"
ohliER'S ADDRESS r Zt'1 ,
A.,t<,.1^4', <)'
)^LICEI,ISE
f:
3
zIP t7-1rt /
PttoNE
*: 7/D'Z9 z -O/>ZC
sf I
lllztP I z,gto
I
sr ':/!lL. up .24/2
s-'
qhc,jE
*: q)r'ZZ-9./D
pBa1e
*i 9/o 3//-iF. <
ELOCK f:
4,
7
y: v6att
P00L
_ sF
DECK SF
.<-TairaGE
sltED
---
sF
oTHl R: __ *_ SF
grtlrCITY i
CITY:
/.,
J e, ,'
/ Cc)
f';z:
EI{AIL AIDREs5:
DESCP]PTION OF
IISCLAIMEF Iherenycort
ol,Jt(ER/c0 TRACT0R
zoNE: j:-,i oFFICER
Approval.:.- Cit
5 ar:
!
PROIECT CONTACT PERSON: | /../1';,;td---|-
! o.-
caarce sr
f noecr ..i
EXIS']'IM CONSIRUCTION:A LTT RAT
] ON
flftnerrovarloru ll GEN!RiI F::;.AIRS
I ee
Loci-:,,-,l
rrrEw coNsrRucrro ,
I rrrcr NE!/ RESTDENCE
o"
! morrrou To EXISTTNG RESIDEiICE
.+PLEiSE CHECX At'lD ArlStlER BEI-OII
ALL THA, AppLY To YOUR pROrECl:
i_J aTr 6ARA6E
_ 5F
f] surunoon
_ sF
! e n:i:'rnousr
_ sF
TOIAL HEATED 5Q FI
ToTAL PRoJ EcT C05r ,ras" ror) , t 1f,'
/1 f oF sroRrEs : Z-
Is Any ELECTRICAL, PLU,{BIIi6
or }'IECHAI,IICAL
tlork 8€ing Donc
to the Accesso.y St.ucturc?
lZ Yes
trroIf the project
is a Relocation,
ls there a Natun Gas
Is there Electrical Power
on thi BLllding?Yes
PROPERTY
USE
/ OCCUPANCY::AT1I LY
f] oucr-ex
f] rowrurousr
Line on the curr€nt Slte?
f vnt figo
NO
t.,/,'ir4
drd o,dnances Bnd telulauons
n! NHC OevBbpmlnt Serv..6s L:oner wrIbe nolfcd oi anycna.!e!s ln
r€ +i ai,ons or
chr.€. i! conk&rcro.colr?.b. nlo6alion "'!OTE: A.y work d w/O lhe Appop.
ac P.willbe,r Violation ollhe NC SlaE To 1500 00"I 516NAIURE:
llll.iil"l -... -r.-:* i* *,|* ** * * *,r, ,,
r*;tr*
J-41t"/,
ara
't
K:
;/J.-:/
Le
.i.I hb,r:aon n his appri."*n
o.o*"t rnO ur*or"*
€€c-
Buildin! Codc
.nd at char argfcalte Slab ond toc.t
tes
EXISTIT{G II'IPERVIOUS AREA:
--_
5Q Fr
NEI.I Ir{PERvIoUs AREA:
_.- 5Q FT
rs rHE pRopFRTy LocarED
rN l rlooocurll f vrs E Ho
TOTAL ACRES DISTURBED:
TXIST LAND 0ISTURBTN6 ptRlrlr: I-'-l v:S [-* no
I.rarrR:
I creur
! coM]luNrTy
sysrF{ l _] PRIVATE
WELL
fl cerlrnnr wrir
SEIER:
! crnua f-'.] CENTRAL
SFFTic
i- pnrvarE seerr:
! cofifluNi-r' syirlH
!*a srpaRlTE 9FiHITS REQJIPE0 FoR E|-ECT, tlECH, PLBG, GAS
EWrp, pREFA8S a ll\lsrn.s ..,
payrENl
rlbrhoo:
I casx
f] curcx (payaBLE
ro nuc;
I orrnrcm
rxeness
f r./vrso l- orscwen
r * r. **r *: *1*+,|r *
+** r** i + ** *,|
+, tr* 'rit r.ri: *a, * irr.r
- (roR
aif:(E u5f
oiJty) F[VrsrD oayl 04/li/12 qbl
.* iL
'\r.,\ \ u1l3-{
TorAL sQ FT uNDER eoor
t
/7O4 ioTAL AREA
sQ Fr: _
_
cv);Pct b-]t
DATE :
PTIONE
*:
7
11p't?Q
APPLICATION
Number
(office Use)
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATIOTI,YPE: RESIDENTIAL
PLEASE ANSI.JER ALL QUESIIoNS ApPLICABLE To YoUR PRoIECT
"Project Responsibility"
APPLICA T,S NA'4E :
DEVELOPER:
o a-t'a o,
PRO]ECT ADORESS:
SUBDIVISIOI{:
CITY:
LOT f:
ztP tZS4n /
*: 7/o'231-6QO
s'tlLLL.ztP;"4{O
/
BLOCK *
PROPERTY OWNER'S NA'ITE:
OII{ER'S ADDRESS:
CONTRACTOR:I
PHON E
t\4
CITY:
(.
lbvl grtf'oucuse *,l7?z2
ADDRESS:CITY:
ET,IAIL ADDRESS:
aJet 1 6-pPtfiiE
*: 9)O'
Zz-gsO
PRO]ECT CONTACT PERSON:/v1
6rt.a PHoNE
*: 1re' z/7-oe75
EXTSTTNG CONSTRUCTTON:
! alrenarrOru snrHOVnrrOru ! e erurnal neenrns
f] RELOCATTON
EU CONSTRUCTIOT:
! rneCr NEW RESTDENCE o" I AOOTTIOI'I TO EXISTING RESIDEiTCE
**PLEASE cHEcK Al'lD Al{st{ER BELO{ ALL THAT APPLY T0 YOUR PRolEcT:
f] arr cnnnce
-
sF ! oer eaRaoe sr
! eonoi
-
sF
! surnoom 5F
f] eool
_ sF
I sronacr sHED
_ sF
! cnrrruxouse
_ sF ! oecr
SF OTHER:SF
TOTAL HEATED SQ t,H7/
TOTAL PROI ECT COST rr-ess rotr : $1r/1 f OF SToRIES: Z-
Is Any ELECTRICAL, PLUitBIt{G
or I'IECHA{ICAL Work Bei.ng Done
to the Accessory
Structurel
tr No
If the project
is a Relocation,
Is thene Electrical Powen
on thi
1S
sr:/@zw:2€/2:;*
there a Naturrl Gas Line on the Current Site?
Building?
Wv"t fluo
tr Yes
El+"
PROPERTY UsE
/ OCCUPANCY:5I NGLFAMILY
tr DUP L EX
! rowruuousr
CRIOFWORK:*lq J-.n t Uttl
t)
t /eJr;cc,/
4€
DISCLAIMER: Iherebyce iarallin tion in
his applicaton is cor.ecland allworkwil Euilding Code and alloher applicabl€ SraE and tocattaws
and ordinances and.egulalrons. Ths NHC Developmenl S€rvices C€nEr willbe nodiied of any chang€s an he approved plans and speci ns orchange io contracbror
DE
IS THE PROPERW LOCATED It{ A FL@DPLAIN?
EXISTIT{G I!.IPERVIOI S AREA:
_SQ FT
NEW IIiTPERVIOUS AREA:
-
SQ FT
!,rArER :
EI cF PUA
sEwER :
EI CF PUA
:/
ts willbe in Violation ofihe NC Srare 8ldTo $5oo 00"'
SIGNATURE:
conracbr inbmatoa "1'IOTE Any WorltBerformed W/O
he Appropnate Pen l
owNER/coNrRAc roR :,feh4 lv1 V 5 rt e < - I/t
, (Print [ane)t,i + + + + )r
* + + + * + *,* * + + +,* + + + + + + *,*,i,r * :i )r )i
*
E YES
Ero
TOTAL ACRES DISTURBED:
EXIST LAND DISTURBING PERfitIT:
tl YES
Euo
! coNrlururw svsrelr
I pRrvATE wELL
! crrurnal welr
f] cerurnal srerrc
I pRrvArE sEprrc
! cout'tururrv svsrrm
*** SEPAIIATE PER'I,IITS REQIJIREO FOR ELECT, MECH, PLBG, GAS Eq'IP, PREFABS
& IiISERTS ***
paynEr{T
irETHoD:
ficsn flcrrcx (PAYABLE
ro rxcl [ +renrca ExpREss
! rcTvrsa
f] orscov:n
**,t*i(i.***,t{.+++,rrr*+*+*)*)*)*)*)t***,**)t)t,t,**,t,t,t***++,t****+***)**)***+****)****,t****+*+,*r.*)***,i*x,t,t,t1.
ZoNE : _ 0F FICE R:
(FOR oFFICE USE oNLY) REVTSED DATE 04111/12
SETBACKS: F:- LH:- RH:- B:-
.[re
Appnoval:_ City:_ DATE:_ FLOOD:
_ BFE+2ft=
AVN
._&-,
I t')cc
rorAL sQ Fr UNDER aoor,
/1ffi roTAL AREA SQ Fr:
d
NEW HANOVER COUNTY
BUILDING PERMIT
APPLICATT1N
TyPE: RESIDENTIAL
PLEASE ANSIdER
ALL qUESTIONS APPLICAALE TO \OUR PRO]ECT
*project Respons
ibilitlp
fiw lplLa-^
BLOCK
*: _ LOT *:
2c(G'7Q
lL-tL-7
APPLICA T,S Ml'tE:
DEVELOPER:
PRO]ECT ADDRESS:
SUBDIVISION:
PROPERTY OU ER,S
I\IAIIE: Sc"Tf
OI.INER'
S ADDRESS:
coNIRAcToR, aa6 3 C
ADDRESS:
?
ac
CTTY,
LICEI{SE
*: T,
t1 iq ACCOU]'IT
*:
APPLICArION
Nunber
(OFfic€ Use)
DATE;
I.?\ -t b
PHOfiE
#:
Zfrt ZE clol
l't
PHoNE
#: 1./a a3?-?Zoy
sr| Nczrptz& qq
A
PHONE
PHONE
sTt ttL ZIp:?&ylz
*: 'l lor/
/.2z- t7Lb
ETIAIL ADDRESS:
PRoIECT COUTACT pERsoN: GACAItt <r*<l
zusrr'lc coNsrRucrroil:
f] alrenarrolr
I neuovarrou
I ceueur-
neccns
I RELoCATTON
NEW
COI'ISTRIETIOiI:
I ERCCT NEhI RESIDENCE
Or
ffi EOOrrrOr TO DOSTII,IC RESIDENCE
.*PL€ISE CIiEC(
I'@ AIIS}IER EELOI{
ALT THAI APPLY TO YOUR PRO]E6!
flerr ceuce
_ sF
I sur'rnoou
_sFI onerruuo:se
_ sr
! orr
oeaaoe sr
I mr+r
_sF
I oe cr
_ sr o'nER:
E POOL q-to SF
I srouoe riHED
_ sF
SF
DII'CLAIMER. I horaby
cenjt tlar a[ hbmadoo in hi€ appfcatoh ie
cofiect and sJl
and odhanc€s and rggularilns. The NHC Dg!€lopment Sorvicss canbr ',{ll be
not
contacl]r inbrmaton, .-NOTEI Any Work perbrmed w/O h6 ApplopritsB p6.miE
vDrkvil complywih l1o Stst3
&ildh9 Code and
di ohor agp$c.bte SEE,
ard to.al la /€
fied of an y
changes
h he app o \€d ptan6 and Cecifcsions or cfiangs h conE&br o.
willb€ in Molaton of heNC SEb tl Fin66 l, To
9500,00..'
* ra+**:t* +:i + +* ** ** ++ * *
**
ohlNER/coNTRAcTOR:
6 tc t1A <.,-^.t STGMTURE:
(print firee))t+:f
**++**+**:i+**+++***+**+***:'***+*+*+*+:t +**+***:i*** **** *x*+ r
**
YEs
ffim
TOTAL ACRES DISTURBED I
I5 THE PROPERTY LOCATED
IN A FLOODPLAINI
EXISTING IfiPERWOI,S
ARrE: 3 I CIIC SQ rr
P- \h oFFrcER:
$+e sElJltulTE pEtU.ttTS REqUTRED FOR ELECTT |{ECH, PLEG, GAs EqJ
pAyr4Er{T
}rErHoor
fl csn
f] crecr (IAvABLE
ro n*; [ ,r,.i
r."-,.,
*;1.*
*x** *:******* *:tst*i****!t:t***r.)t****** **t:i**rt* **:t :l;i+***,Ft ***t*
NEN
ilIPERWoUS
AREA: 10 Z0 SQ FT
E(IST LAro DISTURBII{G
PERIIIT:
[-i vrs
f ii r'p
rr$rER:
I cFpuA
n com4uNrry
svsrem
I pRrvATE HELL
I cerurnnl
uell
sEr.lER:
I crpuA
D CENTRAL
sEpTrc
I rRrvarr
senrrc
f] co&luNrw sysTEM
ZONE:
approval:
OY City:tr)lLlY1 DATE:
coffEnt:
I& "'-al nn: Ah/e:.10
!P, PRIFAES & I&sERTS i*:}
E] ficlwsA I orscoren
+:F *
*;i:i :*
'*:*+
* fr:i *:t:t )t :t:t*:t :t* )t;a:t:t
N
PERfiTT
FEE: $
(ro8 ofFrcE usE
o L
L
j &EVISEO OATE
64111/!2
ETBACKS: F:
FLOOD:
-
Zog,a.-,f, BFE+2rt=
--(a
cttl-ztchrd P o \:e \ocak
d c\o*r Jhaq \O/s.rr.\
Pr""Fr^\ L'-r.e 5 .
CTTY: u,k-A,^.
ToTAL HEATED
SQ FT:
_ TOTAL SQ
FT UNDER ROOF3
_ ToTAL AREA SQ FT:
_
ToTAL PROIECT COST (L""s r_o0 | g 3)/?oo # oF sToRIEs3
rs Any ELECTRTCAL, pLUtlSrNG on t4ECHAIrrrCrlL l^Jonk Being Done
to the Accessory
structure?fr ves I uorf the project i.s a Relocation,
is there a Natural Gas Line on the cunr€nt site? flves EltoIs there Electrical power on this Building?
f]ves ffino
pRopERw usE
/ occurpA
cyr
[} srruole FAmrLy
E BJpLEx
f] rouurousE
DESCRTPTIoN
oF
NOR(: -.rl STAIJ. v{G,L.,.d^ rIBeI,6LAc( Po6C
NEI,{ I-]ANOVER COUNTY
BUILDIN6
APPLIC^IION TYPFI R ESIDENTIAL
PLEASE AuslrE8 ALt- QUEsrrOfls AppLICAsLs T0 youfi pflo:lEaT
r?roJect Responsibillty,,
,ctb-nJr
PERMrr Wzlu]g
APPLICATION
Number
(ofB(a Ure)
APPLTCANT'5
DEVELOPEN:
-Ttx+
(,,t:
PRoJECT lDDnEss: 23l
SUBDIVISJON:L
PROPERW OI,INER'S NfuIE;
OUNERJS ADDRTSS:
s
CONTRACTON:
-ADDRESS:
$t
J
CITY I
BLOCK
II;
LIcENsE
*: a3311
DATE
i Pll"
IOI Jt:
ztP:
z€441L2\
F
Elt
{L.
tro(
J
s't|-l!_Lztpt28451
sTtNC
zrp:2Eqq tIO( CITY:..rd
E]4AIL ADDNES.'; IP|'NE
$: lEz.zrx
PNOJECT CONTACT PERSON:
l./,olt,^a
\ rlJ PIIONE
iI:
FXISTING' CON5TRUCTION:
E ATTENAIION'
f]RENOVATION 6ENERAL
nEpAlRs
I naocarroru
NE!,1
coNsrRucrroN
,
{rnua NEr,l nEsIDENcE
or flloorrron ro ExrsTrNc RESTDENcE
'*PLF^SE CIjEC( /lNo A SIJER BEt
fln-, uo*uu
t55 sr.
f] orr enracr sr fleoncu 318___sr
0l,l ItL THLI IIPPLY T0 YoUn pRotEaT:
suNRoot'l sF
GREENHOUSE
-
5T
P00L
--
5F
I oecr
.-- sn orHER:
f! sron,ree sHED
--.sF
' rs Any n.EcrRrcil, P,-ur,l81N6 on dEcSlNrcAL l,tork Belng Done
to the .Accessory
structuroi B ves [ ruoIf the project
ls a nelo.atloh,
is there a N;tunal 6as
Llne on the Current
slte) Eyes llo
fs there fl.ectrlcal Por.rer on tts outldlnsr
fl ver
fi r,ro
PRoP[RTy USE
/ 0CCUPANCy:
OISCRIPTION OF !ON(:
ToTAr HEATED Sq rr') 1131 T0TAL 5Q FT UND
Z,toT0TAI. PR0IECT C0sltr.o.srd)
; $o6O
5I 6LE TAfiILY DIJPLTX
s,\L
5t
ER ROOF: ?-/L\7 TOIAL AREA
sQ FT:
.-=-
,l OF
STOnIE5: I ,5
DlSCtAiMen: I
herel,y cerli,
tal all
hbnnstlo^ h t,s applcgIon i!.o,rocl ind altryArkwlll
3od ordhEncss ard rsguhl,ons, Ths iSlC tuvobpm€nl S6rv[es csntar !,,llb6 nottud orsn
coa! dcl]r
hbrnalor, '"NO]'tt Ar'y WotX
?ulom.dWO h. App.op.tat pslmrhvilbe jn
cornply rrlltl t\o S lots oulHhg Code and a, oth
6rarpllcablo Slals and locsl lsws
OI{NER/CONTBACTOR:
rl
rl d<r sI6NATURE;
, +{, r* ++++r* }*+}+****. *. i* #l'Il liTl***++**+*++++++*+++-+++*****+++*++i.*++*+++*++**f +***+t
r.s rHE pnopEnry LocATED r,l a rlooorLarN?
lf, ves Wa
I
ycharges l4 tu approved p,an s Bod spsclnca onsorchangs h 6ntra6bror
l$s NCSlah 8d0 C{d6 sndb fines uplo i500.0d].
TOTAL ACRE5
DISIURBEDI O. 01EXISTING rl,lPERVIoI,S
AnrA, - -SQ FT
NEl,, II4PERVIoUS AREAT j.tL,_ se FT-Jr"droEXrST LAN0 rrrSTURErNG pERltrT: E yEs
cot4t4ufiIry 5Y5TE
I rnrvare r,rLL
I CENTRAL
I'fLt
COIIIMUNIry SYSTEMll celrrar-
srrrrc
l] cnrvarr
srenc
I
Approval:-. cl ty:*t|\A* DAI E;BFE
t2ft=
rm:'En:
ffi crrul
sEr.,rR I
zl crPUA
+'' SEPAIATE PEIi}IITS REQUIN€D fOR EI.ICT, T,IECII, PLO6, 6A5 EQU]P, PfifFABS
E IISERTS I*1
pAyfiENT r,rErHoDr
ffi crsrr
fiorecr (pAyiBLE.ro
fiHc; flI}rrnr.nr **urr f{ ,.zrr* [lorscover:t++++++-tt*+*+*+*+*+*++*)t*++++:*,+*++***+*++*+tt*+:r.**+*****++++**+*tt+++***1**+f1.*****+++,1*
zoNE;
*[Li< orrrcgn:dL .)
(roi offIcE usE otl
SEIBACKS: F:'rd r,,-$- nn: {.1.1 s;J'vtsEo
o^rE o4t'1t'2_vv rl\
qcomrnent:
FLOOD:
Enl,lli r:EE
| $
PHONE,i':
162-zaoc,
I ,l-roututousr
a
Y
NEh] HANOVER COUTITY BUILDING
AP P LI CATI O},1
TTPTI R ESTDENTIAL
PLfASE
AllS!'Ei AtL qlEsTlotis AppLlc^stE tO youn pRoJEcI
r'Praject R;sponsibluty',
..1/ 0
tb' )]2--
pERMrr
?Et lttt -bq
APPLICATION
Numbct
(offl(e u56 )
APPLICANT'.5 ilAI'lE i
DEVEI-oPfR I
PRoJECT ADDRESS io
-sUirDIVISf0i{i
t DATE I(
I LLC-flloNE Ir:
+
CTIY;
la
_ . BLoCK
#:
zrP |
6qtz.
Lo'f tl: ZZ
PttoNE.ll: '182-7 ?PNOPERTY OUNTR'S I.]AJ'lE :
OWNER'5 ADDRES5:
coNIRAcIon: T7.,
tl ol
aoontsS: tl9
EI.IAIL ADDRES5;
PnOltCT CoNTACT PERS0Nl
[-J enrrrHousr
.----- sr
PBOPERTY USE
/ OCCUPANCY:
DESCRIPTToN ol: l!ronl(:
ATT 6ANA6E
suNR00h
q59 DET CAIIAGI
POOL
o6
TY:Lsr: Aqzrpi ZBqr(
sT:.lUe
zrp: 2E([r(
LrcENsE
it: I SS
{l
CITY;L,.lond
Pltout tt: 181.1Ro6
RELOCATTON
5F
sF 0
tHt'R:SF
e
(,J
'Jlu 6"
U
EX]STIN6 CONSTRT'CTION:
NEI,J CONSTIIUCTION:ERFCT NEl,l RISIDENCE
or.4DDITION TO EXISTINC RESIDENCE
EnsE clll(( Al.tD Allsl,lElr UELoll /lLL T Af lfPly T0 voUR pRolEcT!
C^
t\<r-
DECK
5F
ToTAL ITEATED
5Q rr: 1,131 ToTAL sQ
FI UNDER noor t /2,(12 IoT L AREA
s0 FT:
TOTAI. PROJECT C05T(Lessrd)
: $740
ll oF sToRrEs: 1,5
Is Any ELECTflICA!, PLUI01NG or l,lgCH,lNICAL l,brk Belng Done to the .ilccessory Structure?
fl Ves I lo
ff the project
is a nelocatioh, is there a ilatural 6as 1.1
Is th(:r.: Electrical PoBer on
thls Building? pVus filo
ne on the current
sltel E Ves'
fl ruo
ffiru,, norr,.,
I ourrrx
Dlscl AIMER: I hsr6by c.rlJly tr.l r:l hbrmallon h hls appliaton ls conel and aI
tdrt rdlt6omp,y
rrl[l fi6 Stats Bulldlng Cods ard at ooersppllcabls Sraro aad ,o.aljar?s
611d odlo&1cos and rdoulaloni, Th€ NHC Oavabpm€nl 56 rvbls Cenrgr $,i11
be nolltsd o, Bny ch&Uos ln t\6 approvsd plans andsPo! Illcalbns or ch.ngs
h.oll6cbrol
contacbr hbrmrlon, , r'NOTEi Any llbrk P6rformad WrO |116Atpropdatg Poffdti refl bs h WIaIon onha NC Sla
ct{NER/CoNTBACT0n:'fiEs)
+:*|++:*,r +* ++**++r+****+*++* *(itl lil'] * *
I5 IHE PROPEIITY LOCATID IN A FLOODPTAIN)
EXI5TIN6 IIIPERVIOUS
AREA; - sQ FI
,,lJ.t 6.0
16 BUo C6do Fnd S{racl b f h€s uo To aEOo.OO.,.
/UJ l,^-516I]4TUNE:
***,+ ***+ +*+*+ *++j+ + + +*
*
f *l YEs Ld No
.;;;;J--,-,*;;-*
TOTAI. ACNES DISIURBEO, O,O1
I.IEI{ II4PIRVTOUS AREA;3165 so rr EXIST IAND DISTUflBII,IG PERI.IITI E Yfs
I,JATER:
rurr
I cosrururw sysrEH
.E pRrvATr wrlr.
f] cENrnAr
t,lftr
.5EI,JER:CFPUA
tl c[NTnAL SEPTTC
l] nntVlrr srtrrc ! co,qflul,ll]y sysTE,!
loDroval: Citv; L), L
^\ DATE BFEr2ft-
*.+ sEp.qRAIE pE llTS f,EQUTRED
FoR H-ECL !lEC]t, prBG, 6 S EQUrpr PR€FAB5
& JUSERTS .r+
pAyr4EMr ETH0D:
ficnsr flcfircr (pAyABrE.
ro nrcl pAlrrnrcan rxenrss
f,] c/ws; fl olscovER*t,t,f,r**+,tjf*:t++;l*+*++++*;!*****;r*****+*.+++*+*+*:l+*t****+*+*++**++*+++++++++n+++*++*+*+*+**
zorr:
,-pl{ orrrcrn:
(foi offICE llJ6 o
l
SETBACKS: F:
Y) .. , I P,lvtsaD oAfE a4/\lrz
l1J ru: 5.5'nr:
* e:;J1l
IWComrneot:
i-ls],t-FLOOO:
prn T FtEt $
?tDNe
$: 18l.Z8o$
! aLtrnarrolr'
I ne
ruovlrror'r '-[ cENFRAL REpArns
5F
{.l,nn 21t ' ,,
I sronntr srED
_-.sF
H'*
4,-3,
&
APPLICANT'S NAME:
DEVELOPER:
s. 1
NEW HANOVER COUNTY BUILDING
APPLICATION IYPE: COMMERCIAL
PERMIT 1.6
-LLz
APPLICATION
Number
(offic€ us€)
PLEASE ANSWER
ATL QUESTIONS APPTICABLE TO YOUR PROJECT
"Project Responsibility"
S. T. Wooten Cororat ion DATEi 7/75/2a76
Wooten Corpora E ion PHONE #: 9ta t62 a32s
OCCUPANT/BUSINESS
NAI'IE:
s. r. wooren Corporarion
PROPERTY OWNER, S NAI'IE :
OWNER,, S ADDRESS: p. o.
S. T. Wooten Corporat ion PHONE #: 919 -
218 2834
Box 2,10 8CITY: wilson
CoNTRACTOR: s. T. Irooten cor LICENSE #: 283s
ADDRESS: p. o. Box 2,108CITY: wi - sonST: NC ZIP: 2?8ea
Eli,lAI L ADDRESS:
Butch Lawrer, butschosrwcorp. comPHONE *: 919 218-2834
PROIECT CONTACT PERSON: Bobby Butlock, bobby. bul lockasrwcorp - comPHONE #: 252 29a 7s44
(Check A11 lhat Apply)
EXIST CONSTRUCTION:ALTERATION R ENOVATIONGENERAL REPAIRS RE LOCATION
l, Relocation, is there a Natural Gas Line on the Current Site?
nYes
ilro IS BLDG SPRINKLERED?
Iv". f]No
NEW CONSTRUCTION:ERECT NEW STRUCTUREFAST TRACKSHELLUPFITADD TO EXIST STRUCTURE
ACCESSORY STRUCTURE:
-J
rJ
.\-tt
e
If UPFIT
- The Shell Permit #:
IF Yes, what was
the Previous Occupancy Type?
ARCH DESIGN PROFESSIONAL:
ENGR DESIGN PROFESSIOTIAL: NC Development Enqineers
Is E1ect Power on this Building
I Yes
fl ruo
PH:
****,, rs rHrs a CHANGE oF occupANcy usE? EyEs!n
\\J-tfI
NC REG #:
PH:919,803-8704 NC REG #: t9a2t
-
DESCRIPTION OF WORK: consEruct fouodation for 2 30oT silos & scales next to existinq asphalt silos
\,I
Z
DISCLAIMER: I hereby certify thal all informaiion in
lhis application is correct and all work will comply with the Slale Building Code and all other applicable State
and local laws and ordinances and requlations. The NHC Develoomenl Services Center will be notified of anv cnanoes in the aoDroved Dlans and soecrficatrons
or cranqe rn
conlraclor or contractor r-nformatron. 'NOTE Any Work Performed
w/O lhe Appropriate Permiis willb'e in Violalron of the\lC Stale Bldg Codeand
Subiectio Fines Up To
$500.00"'
ls food or beverages prepared or served in this structure?
EYes T
No ls The Property Located ln The Floodplain?
! ves I No
OWNEFYCONTRACTOR: n s
sIGNATURE:
R S Lawter'Jr'(Butch) Lawter,JI
(Oualii6r) (Pdnt N6ho)
conbin Asbestos or not. You are requircd to call the Natonal Embslon S'tendards
br Hazadous Air Pollutants (NESHAP) at (91
9)707-5950 at lesst 1 0 days p.ior to the
dernolilion ol any iacility or building. S€€ Asb€stos Web Site: htlpj vlw.epi.state.nc.us/epi/ssbestos/ahmp.htrnl
TOTAL PROJECT
COST: s127, o5o
flzoNrNc usE CLASS
f]coMMUNrrY SYSTEM
WATER: ECFPUA fl coMMUNrry SYSTEM ulWELL
CENTRAL SEPTIC I1I PRIVATE SEPTICSEWER:
E CFPUA
(FOR OFFTCE USE ONLY)
IFICATION:
r 2
PAYMENT IVETHOD:
Icnsn I CHECK (PAYABLE TO NHC) IAMERTCAN EXPRESS
I rvrCnrrsn IOrSCOVen
*'SEPARATE PERIVITS REQUIRED FOR ELECT IVECH PLBG, GAS EOUIP, PREFABS
& NSERTS *'
ZONE: OFFICER:SETBACKS: F:- LH:- RH:- B:
Approval:_ City:_ DATE:_ FLOOD:
__ _ BFE+2ft=
loD -
-?'M\aaJa^-
N
PERMITfEE: $
&-' Slo;
PROIECT ADDRESS:
:10 SurEon -,ake :loadCfTY: wi
tminqron ZIP :
)s\ a2
ST:
I!_ zIP:!f!j3-
Y
What is the New Occupancy Type?
BUILDING HEIGHT: s:los -;: ' # OF UNITS:
TOTAL AREA SQ FT
:2-925_ SO FT PER FLR:z_!21_ # OF STORIES: NA - slab
TOTAL SQ FT UNDER ROOF: o #OF STRUCTURES: _r .r* z =iro" #OFFLOORS: ra - srar
ACRES DISTURBED: 0 EXST LAND DtsTURBtNG PERMTT?nYES ElNo
NEW IMPERVIOUS AREA:
o SQFT EXISTINGIMPERVIOUSAREA:2?7.43s SQFT
pRopERwusE: lorrtce lnesrnunlrur lueRcnrurLe Ieouc !ner lcor.roo orHER:Aspharr pranr
REVISED DATE 4/11/12
i-
Comment
AUU - -) >--)
rPeZ15-3'.4LNEl.iJ HANOVER COUNTY BUILDING PERIIII
APPLICATION IYPEi COIIMfRCIA L
PLEA5! rn5tafr
Att Qlt5T:Qt5 l9pr.ICIIIE r0 yqrn pio)t(]
"P.oJect Responslbrlity''
Tribrrle Consruclion. ::a
AP P'. IC AT IOX
Nufibea
(orfl(. U!€)
oar::12..l6.15)t!LICAI:r 5 ryA'aE.
CONIRA(-'A T
D:VE TOPER i
achliee Ventures LLC
UA
OCCUPAI'II/BUSINESS NA'1E iSlock
Atilrircfils
PROPERTY OI{NER'S NAAEI PCACI]ITEq \ICI 1UTCS LLC
ol.rNERrs aDcR€ss 1C S. Cardinal Drive
t':loNE l: 910'251'5030
.-' flc , .
c:rY: Wilminqlof
--- LICENSE t, -99901
-
crTY; Wllminqlon
PHo E {: 9'10.25 i.5030
c:- r \ oriz:P | 28401
iructior
Ati. .ti 1 vc!: NC :;, 26103
:r,lll i tssi I , Jr,- -pro*e
rr 910-251-503C
PliolJE jl I J
Exrsr c'Nsrnucrro r
! atr:nai:orr
[! *.ilffi;li*t 'fr':'.'ilr^. nrparrs '-.l R:LocArrox
I Rotoca on, is rhere a Naru€lGas Lins on lhe;,"rrsi:or
tr:"ir]'lo s g-oo soiii<ren:rr Ivos []rro
NEll coNSrRUCrIONr
f] enecr Her srRUcruRE
I rasr rracx
! sntr.l
] ucrrr
f rcc ro Exrsl srRUcruR€
pRorrcT r:uTACr PrssoN: Eliar: {aiser
ataE550tY -<r Rr -- .
If UPF:- - Ihe Shell P.-.rit f: I5 E1e<t Poxer on this .luil.ding i:'l YcJ fl *O
.!r.. .\ IFts a (HAtit6E .. o(cuper{cy ,5Er f rt: _- n9 ,....
Ir yps, rh.. las !rr previous occupa..v Typea OliCe^VarehoUSe,fiit j.s lq. Np!
O((ri,ii.y Type>','u I i:,-, r
prr, 910-793.3433 {c RFG ':atcH Dt51:\ PrcritsroL t: c n Harlis Archi"'.1 rIe
rN6R 0tsr6N pRorEsslo)taL:
DES(RIPrI.'r oF r,1o8(: Rehnb bliJ:Jiri {ol Mulli-Family unitg- -{!11':r 1)
t6 tood orbsvorseos prop6r6d o. ssned in lhisst.o:{urts? EYas
mNo b 'f hs Prcp8rly Lc,ci,lad ln'IhB Floodplsin?
n Yes
sirn r!
llrD E:i'" "0 coda ali: olLcrha. uro .jr!a sl,le: '-1, (' ',r b,rr.,^tklr.1.r_- -'c!r'.:\rr cJC,nur-
owtiEP"CONTRACiCR:-Brian Kaisor
.1L--:>
400 iiurLDrNG r i:::}rr 20
SIGNATURE
r*{- o*:tr.r Dtr.rr!,! i: "be!ro!,d, !r3l rqF,r srrkrl.{s r^, o be sulr-i:,.::5ii rihs:;rtslpn lorn (Dri'ls'::all wh.lher:rr r, !!orl,rlrltrJrrrro!rdla
MhhArt c.,n oryo{o.i,}rrrodlo=rrn1r"n-.r,E,nb.ron9r?,2l.lo..!!ri3.!5al.Pi{r*t 1\r!ir,,.1(1,ir:7.6!5131 u5.t l0dlr F&r '.
tho
doorolibn ol.^y,ddlity o, hr lrrh! sc€rlbttbaY/ea sJrt
hlllr,rvw cpr
sldG.rc lgtploslr5.s/ohmp llnl
roreu pnolrcr
co:;- sEt0
TCTAL ARE
SQ
'-
TCTAL SQ Fr riNfrrn noor: j!,) ]t_-.
AOH.'S D:sI.lRoF, N/A
sa rr PEn FLR: 12,540
, OF S'I i
UCTURES: 1
LxS r LAND DrSTUlErlrc cenu r
frvus I NO
NFw [.lp:F...roils ARFA: SO FT EXISTING IMPEAVIOUS AREA:
FRcFla] u-q:. I lci.rrcE llREsrAURANr
l EqcANntE
I EDUC
;! e,r -]cottoo
\yArEa lIcFor]A
s-,.,,ER. .'.-: . .- tA
PAYI/f lrT
Mf-f i-11
[:lcAsH EcHrcK (PAYABLE ro NHci
[lue ctc$t exrnrss f]tlc/i/lsA f otscovEn
]lSOMMUNITYSYSTETI : IWELL! OEiITRAL SEPT a i - ,l.itvATE S=PTIC
lzCNlNG U:: :LAS:^rF CATION:
f ]]iJMMUI.] :.i SYSTEM
,,' J r.)l ina8,t'r:r'Gns!0!r,.rrn'^ir\ Irr ,, 'j
z0ti
AppIOYA
rlE:l 1t(:-- -.. aE usEONLY}r: X un:_js! rbAUK$:nx: I g:4-l-erE*ztI
N
P:ritllT FEE:
$.- _
Lii
FLOOD:
__
-Commerl
DATE
z-i .'.i.
(ffi,I
I
PHI NC RE6 T:
, oF uf;1:s: 10
# OF STORIES: 2
I Or rt.OOaS:
_-I-
/a11 tt .-
/,,, !, ","
(ffi,
COI{u- a>-l
Peztus5qL
NEI,{ HANOVER COUNTY BUILDING PERMIT
APPLICATION rTPf ; COI'4I1ERCIAL
PLEASE AXS!/[R ALL QUESIIoNS APPLICA0I,E IO YqJR PRoIECT
"Project ResponslbIIlty"
APPLICAIION
Number
(orflce U5o)
oATE:j41!l!-APPLICANT'S NAI4E ITribute Construclion, lnc.
DEVELoPER: Peachlree Ventures LLC
pRolEcr ADDREss: 210 Greenfield Skost crrYr Wiiminqt0n
0ccuPaNr/Busr,rEss NAI.{E : Block Apa(menls
PROPERTY OWNER,S N,tt.|E:Peachtree Ventures LLC
otlNER's aDDREss: 10 S. Catdinal DrivecrrY: Wilminqton
coNTRAcToR: Tribute conskuctioulgt LrcENsE #r 60001
aoDREss: 10 S. Cardinal DrivecrTY: Wilmington
Er,rArL AoDREss : bkaiser(Okibuteconstruction.com
PRO]ECT CONTACT PER5ON: BI|AN KA|SEI
PHoNE *r 910-251-5030
ztP | 2U01
PHoNe *: 910-251-5030
sr: NC zrp: 28403
ST:
NC ZIP: 28403
prorr
*: 910-251-5030
Pnorue r: 910'599-8130
*rr+* rs THrS A CHApGE or occrrpa1cy usrr
IVtS [il6 *****
rF Yes, Hhat eas the Previous occupancy lype? oflicg/lvafehousahat is the New occupancy Typ
If UPFIT lhc Shell Pcrm'it f;Is Elect Power on this Building E Yes E tO
er MultiFami
PH
PH
910-793-3433 uc nrc r: 4290ARCH DEsIGN PROFESSIoNALi
ENGR DISIGN PROTESSIONAL:
DESCRIPTION OF WORK:
NC REG f:
Rehab buildino for Multi-Family units (Phase 1)
16lood or boverages propar€d or served in lhis stluaure?
[Yos ffiNo 18 Tho Propsdy Located ln The Floodplain?f] ves
ffi No
DISCLAI#ER: ' hErcby cerUly thal 6ll lnlomolion I,l
end lo(allaws and urJlnanc€s and rooulalluns. Tho
or chsnos in cuntroc.ur or contrallor ii'ormslion.
"'
Sublccllo F
ncs Urr To5500.00"'
rhh spplhsrion Is clrecr a1(l allwork willcomply \ailh rhe Slale Bui
NHC Dsvoloom0nl Sorvlcos Contor wrl uo nolrhod ol anv chan0esi
NOTE: A'.y Work Pe/o'r.ed WO lhe fupropda(e Pernits |+ill60 ln
n lhe aDorovsd Dl€n6 und suerilfrcallLns
violallon ol lleNc slal6 BUg Cods snLl
lourr.t) (filr Xor*)
cooEh Aabolbo or nol You .m roqslrsd to call ths Natbn6l Emh{lon
Stsrd.dr lor
h.zrdous ,rlr Pollutrnl6 (NESHAP) at (919)707-5950 at lgarl l0 d.y6 prior lo tho
domolhlonot6nytsdl(yorbundh0.SeeAlt€sto6WebSllarnlprlrlr.epr.sl6le.ncuyepl/asb€stos/ahmp.ntml
ldlng Code snd allolher applicsbl€ slaie
OWNER/CONTRACTOR:Brian Kaiser
SIGNATURE:
)
ToTAL PRoJECT COsr: $800,400 gurr-ornc nEronr: 20'
f OF UNITS; 10
TOTAL AREA SQ FT :20,010
TOTAL SQ FT t,NDEn
ROOF: 20,010
ACRES DISTURBED:N/AEXST IAND DISTUREING PERMIT?
E YES
I NO
NEW IMPERVIOUS AREA:SQ FT EXISTING IMPERVIOUS AREA:
pRopERryusE: lorrrce f]nesreunnrur
luencerurLr !eouc ffiaer f]coNDO OTHER:
SQ FT
WATER:
SEWER;
#CFPUA
CFPUA
El CoMMUNIIY SYSTEIi!-.
fIWELL EZoNING USE cLASSlFlcATloN;
ECENTRAL SEPTIC LIPRIVATE SEPTIC f]COMMUNITY SYSTEM
PAYMENT METHOD:
ICASX ICXECK (PAYABLE TO NHC) EAMERICAN EXPRESS EMCNISA I OtSCOVen
SFPAHAIE PERIVIIS REQUIRFO FQR EI ECT,ITIECH, PI8C, GAS IQUIII. PREFAES & INSENTS
"'
(FOR OFFICE USE ONLY)
SETBACKS: F:_LH:_ RHr_ B:
REVISED DATE 1UI1l12
ZONE: OFFICER:
Apploval:- C
Commont PERM|T FEE:
DATE:_ FLOOD:
_-- BFE+m:__
AVN
s
((heck
Al hat lpply)
EXrST CONSTRUCTTON:
E ALTERATTOru
ffi RrruOVlrrON
! Crlennt- REPATRS
E RELOCATTON
tt Rotocarton, is rhere a NatL'at Gas Lrne on tle dirent site?
E]""iE ruo ls B-DG sPR'iiKLEReo?
ffi ves
flrvo
NEu CONsTRUcrrotJ'
! rnrcr NEh, srRucruRE
! rasr rnacx
fl sHrr-r-
! uerrr
! aoo ro Exrsr srRUcruRE
ACCESSORY sTRUCTURE:
Cothran Harris Architecture
NI'{
SO FI PER FLR: 12.540 #OF STORIES: 2
# oF
srRUcruREE;T- *
or rlooRs: -2-
Qctb))9
ft? -/04NEW HANOVER COUNTY BUILDING PERMIT
1920S APPLrcArr@t rvPE: RESTDENTTAL
PLEASE AIISIIER
ALL QUESTIOI.{S APPLICABLE TO YOUR PRO]ECT
"Project Responsibilit/
CITY: wilmington
BLOCK #:
APPLICATION
Number
(office use)
DATE: t/Lt/1-5
PHONE S: 91o -3so.a'|44
ZIP.. 284]-2
LOT #: 1
PHONE #: 910.350.1744
T No
Yes I No
YES!NO
REVISE0 0ATE 94111/12
APPLICANT'S llAIqE:
Bill Clark Homes of wilmington LLC
DEVELOPER:
8j.11 Clark Homes
of wilmington LLC
PROIECT ADORESS: 462L sikes Dr.
SUBDIYISION: BerreMeade
PROPERTY OhINER'S l,lAllE: Bill clark Hoftes
of wilmington LLC
oI{NER'S ADDRESS: 12? Racine Dr. suire 201 CITY: wilmington
CONTRACTOR: Bill clark Homes of witminsron LLC LICENSE #: 34s86
ADDRESS: 12? Racine Dr. suite 201 CITY: wllmingtonsT: ryc' zIP: 28403
EIIAIL ADDRESS:
rgill@Bi llclarkhomes .
com PHOiIE #: sL0.3so.L744
PROIECT CO{TACT PERSoN: Richard cit},/Bi11 clark Homes of wilmington PHONE #: 910.3s0.1?44
ExrsTrNG co{sTRUcTroN:
! alrrnnrroru
! neNovarrou
! crNrnrl Reerrns
! RELocATToN
NEt{ CONSTRUCTION:
E ERECT NE[.J RESTDENCE
o" ! aOOtttOrtr TO EXTSTTNG RESTDENCE
I.*PLEASE CHECK AND ANSI{ER BELOI,I ALL THAT APPLY TO YO.'R PROJECT:
I arr
eruee q (&
! surnoor.r
! eR e eruousr
SF
SF
5F DE CK
f] oer cnnecr
! eoor
SF
dtL SFPORCH
SF
I sronnce snro SF
SFSF OTHER: Patio:120
TOTAL HEATED SQFTIIf,OS TOTAL SQ FT UNDER ROOF
A2A, TOTAL AREA SQ FT:35tI 1
ToTAL PRolEcT CoST(ressro0 : $\\i,53O * oF SToRIES: z
Is Any ELECTRICAL, PLUI,IBING or litECHAl,lICAL Work geing Done
to the Accessony Stnucture?
E Yes
If the project is a ReLocation, is there a Natunal Gas Line on the Current Site? !
Is there Electrical Power on this Building?
PRoPERTY USE
/ OCCUPANCY:
I SrruCLe reUrrV
5Q FT
SQ FT
Yes!No
I ouer-ex
I rownHouse
DESCRIPTION 0F WORK: New coflst.ruction
of single famity home.
OISCLAIMEFt lhereby cerlify hat allinbrmalion in lhis applicaton is
conecl and all work will comply wih rle Slale Building Code and alloher applicable Srare and local laws
and ordinances and reOulatjons The NHC Development Services CenEr willbe notfied ofany changes in fie approved phns anr
change in
conlracl,rror
conlractor informarion.
"'NOTE: Any Work Performed
w/O he Appropriale Penn its will be in Violation of the NC SlaE Adg Up To
$500.00"'
OWNER/CONTRACTOR:
Richard Gitt/BcH of wirmingron SIGNATURE:
** * *,*,i,* * **,* * * ** * * * * * * * ** * * ** * * I * * *,1* * * * + * * * + * * * * * * * * * * ** *** * * * * * *+* + * * * + * * * ** * * *,t,t,t * *
rs rHE pRopERTy LocATED rN A FLooDpLArrir
I-l yes!NO
EXISTING IMPERVIOT'S
AREA: O
NEW IMPERVIOT,S AREA: 3808
TOTAL ACRES DISTURBED: .27
EXIST LAND DISTURBING PERfiIT:
r.nren,
I creua
f] co[MuNrry svsrem
! pRrvArE wELL
! cenrml well
sEuER:
El crnua
f] CENTRAL sEprrc
! enrvare
serrrc
! co$MuNrry sysrEM
*** SEPARATE PERI;IITS REQTJIRED
'OR
TLECT, I4ECH,
P186, GAS EqJIP, PREFABS
& INSERIS ***
payirE
T ETHoD:
! cAsn
I orecK (
PAYABLE
ro r,rnc;
! atenrca ExpREss
E rcryrsl ! orscovrn
***:t *** )* )t:** * + *:t :t * *:i:t * *:t:t:i*:t* * + +:t + * *** ****,t,t** *** **:l:*:*,t * )*
* * *:f * ,i :r :r ,t :| :t :t:t:t * *** **** ** ** *** * +:t
ZONE: OF FICE R:
Approval :
___,_ City:DATE:
(roR oFFrcE ust onLY)
SETBACKS: F:
FLOOD:
LH:RH
N
B
BF E+2ft=
[a3-
sT: N!, zIP: 28403
re
ffio,rutl
zou
2cta.r1
//t -
/rtf
APPLICAT]ON
Number
(offlce Use)
DATE: !/ lt/ i6
Pllot{E *i 910.:so. 174.r
719.- 2aa1)
LOT *; r
PHONE #: 91c..190.17t,1
5 : N"C
lf P: 28441
ST: NC ziP
| 2alor
PH0NIE *: gio.:so . r:,rl
PHffIE fl: 9r.l.3so.:?4,i
NEI^I HANOVER COUNTY BUILDING PERMIT
APPLICATION IYPE; RESI DENTIAL
PLEiSE ANSUIER ATL QUE-(-]OIiS APPTICABLE IO YOUR PRO]ECI
"ProJect Respons
ibll lty'
APPLfCA{T'5 M}tE: tsilI clark 'rones
c i1r.1ngEo1 LLc
DEVEL0PER:
EiIt ctark ro1.: of 6iir.ingtol LLc
PRoIECT ADDRESS: 4621 sj.kcs Dr. CfTY: wilmlnsloi
SUBDMSIo : Fell -uead€BLoC{ t;
pROpERfY O/!]NER'S NAIIE: Bilt Clark liomEE
of wilni.ngron LLC
otlNER's ADORESS:
rl / xactfle
ur. sr::e 2U L CITY: l4ltmrllgLon
CONTRACTOR r tsi1l clark sones of wilminglon
l,LC LICENsE *t 34s85
AmRESS: 127 Racl:e Dr. suire 2c1 CITY: ililmingEon
EttAIL ADDRESS:
rqi t l(iBr 1:c1a:k|_.- r{;.con
PROIECT CoNTACT PERSoI'I: Rrchard Giil/sill Clar). iiones
of wilmi:1qton
f surunoor,r SF
EXrSTrnG CO{STRUCTTON:
f ATTERATTON
! nenOVrrrON
f Cenrnal nrtNnS I RELocATToN
NEhr CoNSTRUCrrorl,
f, ttecr EN RESTDEt,tCE o"
I aOOtrrOn TO EXTSTTNG RESTDENCE
IEASE CHECK AI{D ANSI.]ER EELOUI
ALL THAT APPLY TO YOUR PRO]ECT:
ATr GARAcE tl ( 3 sF *I l:- crnnce sr
E poncn
'l '',''
'L SF
GREENHOUS ESF
POO L
D ECK
SF5F
SF
STORAGE SIIILT
5. oTHE R: !'-ic: l,r
TOTAT HEAIED SQ FT:1JC5 IOIAL SQ FI UNDER ROOF:1iiJ-a, TOTAL AREA SQ FT: }9TT'
TOIAL PRorEcT coST rr.css r.or)
: $ 1,1] 5il * OF SToRrEs: 2
Is Any ELECTRICAL, PLUTIBr
G or I'IECHAIIICAL Hork Being Do.e to the AccEssory
Structure? E Yes
If the pnoject
is a Relocatlon, is there a Natural 6as Line on the Current Site? ! ves I Ho
Is there Electrical Power
on this 3uildin8?f-ly"s lENo
PROPER]Y USE
/ OCCUPA CY:SIN6LE FAI'1ILY DUPLEX
I roul,rnousr
oESCRIpTIo{ii
0F WOR(: lteq ccns!::ucr:on of single fanily i--.he
I No
rch3n9e n contrac.dr.i
,ts Up 10 !50o_0r'-
!.. * i * * r t r. + i r
,. r,a e*
YE5 NO
d/r!o,dnancesandrEguE0onsTheNhCDevek:-eniS-"-:r-i(jenErwi,tbenoifiedrt6n
con14lol inbmado.. "'NOiE A.y\'r-.! p.r.l;::t W/O
r|c Aprroprior n.o,lswi b.in
OI.INER/CONTRACToR
: Ricbard Grtr,/BCH of wilminsccn
IS THE PROPERTY LOCATEO IN A FLocDi!AiNI YES
€XISTI\G IMPERVIOT'S
AREA: .
N EI.I
IIIPERVIoUS AREA: ]808
sQ'r
5Q FI
iTI xo
TOTAL ACRES
DISTURBED! .2?
EXIST LAND OI5TURBIN6 PERIiIiT:
lihT i R
5:r.-:
crpue
[l co$;uuNrry
svsrru
! pRrvATE r.rELL
f ctHrRal r,lrrr
cilul f] cExrRAt sEprrc
fl pnrvnrr senrrc
I commuNrTy
sysiEir
--..,:': -:- rlrrl ..- EL---, !.
pAy!!!Nr
ilrriooi ]casx .-- cxrcx (payaBLE To lrl€)
f orentcax
excness
! rcTvrsa
(ijr ilt i,. / '- t(l , Pl.r " _ irr( I _ .,.
DISCOVIR
r *t r *r: t**** tt 1l * rt*r r.* r rr rr r1r
iFon orrra! u9r o[y) rlvjsic DArE
€!/11/r:
ZONE: ) OFFIT.I: I .,,, s:TtsAcKs:
F: . LH: RF: B:
Approval: City; DATE: FL@O: .. BFE+2ft=
r
ll
ffi
NEW
rvED jAil 12 20S
2olb:l30
tb- /oi
APPLlCA'T]CN
Numbei.
DAI I
PHONE #: !1
HANOVER COUNTY BUILDING PERMIT
APPL|CATIOII IYPE; RESI DENT
IAL
PIEAS' A}I<LFE ALL QUTSIIONS APPLI(A8TE TO YOUi
'J{C]ECT
"Project Responsi.bility''
. -' 6ARAGF
APPLICANT'S NAnf : - lt i
id!)- rir..:! or !.r
r t-.::.rt,jr LLa
OEVELOPER:
!:11 rr..'---: cf riit11::-- - l,:-:.
PRoIECT ADDRESS:
r:r:! , ,.. . ,: (lTY: :.,.nr:.: ):l
SUS0IVISIO : E.i].t1,..n BLoC( S:
PROPERTY
o{.INER'S tlAi'E: -.ii Il aia:i. ;i-- 'l :{rli::1:::r :!:
OtlNtR'S AODRESS; rr- ! -r)e D:. sr-.-e :i: CITY: !.iL^r,r'r;_-cn
CoNTRACTOR: Brll (rliIk H',,.s of l,rllr' ::a:":r i,LC LICENSE fr: 'j,rs86
AODRESS:
:2'l :1-::Ie Dr. sui-,e 20: CITY: liilrin,lcrn
E|'!AI L A0DRE55:
-:i l:.1: r 1^1 -.--h.- . s...-
-
PROIFaT CONTACT PERSON: .r.l-ri 3:ll !ili a:a!; :3-o-- .i n':
)T::r.i:oi
!.16
/21).t
ZfP: :8i l
l4LOT f:
PIIONE *: ?::
5I : l'a
5T
PHO",]E f :
PHONE S:
Nc ZIP; 261?ti
i1c l5c.lf{.i
9:C.l;l _'r',i;
I
o S!00 0C'
EXTSTING CONsTRUCTTON: [_-] ALTERATION 1__.1 Rrruovnrloru
f nrnrnal nrearns j] RELocArroN
NEI,J CONSTRUCT:CN:ERECT NE[,J RESrD€NCE o. IlOOrrrOn TO EXISTiNG RESTDET.TCE
..PLEASE CI]ECK AIJO AXShER E€LOH
ALL THAT A|IFLY TO YOUR PROJECI:
AlT GARAGF 45c SF
SUNROO}I 5F
GRFENHOUSE SF
5F
SF
fl eoo L
f orcx
SF poRcH 1-- 0/ r 10 st
.- ]AGE
!' ..
OTHE R: l'. -
1. :5i
SF
roTAL HEATED
SQ Fl: :lrr TOTAL SQ FT UNDER ROOF: -rr..: ToTAL AREA 5Q Fl: r
ToTAL PROIECT COSTiL,.l<.roo:
$ '-zt.trc S OF STORIES:
r ,r,'tor:
I5 Any ELECTAICAL, pLUflgING or IICHAI{ICAL l.,,ork geinS Done to the A.(..in.y Structr,.r)ves ! lto
If the project
is r Re.location, i.5 there a ilatural. cas Line on
the Cu.rent Site? fJYes Tl llo
Is there Electrlcal PoHer on
this Buildingll-lves [!j no
pRopERTy usE
/ occupANcy; p srruclt ralrrlv
f ounttx
DESCRIPTI0iI OF I'J0R(: :-.w
:c: ':'.1.-!:c:.
.: .-;:"
":e f.- -1\
lOI.JNHOL.a
,i
i,l:.ILe$andr€lulatons. IheNtlC O.vohr.: 4nl
Ser,;ar aerw*ilbenol,iedol.nychang€ein r-.' lppovo
..^ra.bi.fir':1.n"'NOTEAnyWordrt,r.":.rw/O!.lcAir"r:rrFI!--T.swittbeinV)otalonot,r.r\Car'rF
OhINE R/CONTRACToR:
,r::::::.1
lill./3cll cf ii:jlnrr --: rrL SIGNATURE:
IS THE PROPERTY
LO{ATED IN A TLOODPLAIN?
EXISIIiIG IIIPERVIOI,S AREA: TJ 5Q FT
NEI., ]IIPERVIOUS AREA:
]439 SQ I,t
YEs
E *o
TOTAL ACRES
DISTURBED:
.:,
EXIST LAND DISTURBING PERAllT
I crlrnal we rr
n colututini'svsrem
YES IliJo
WAITR:
E CFPUA
SEI,JER I Z CFPUA
n coylru,rr;y svs.;n I l pRivart r,tELL
! ceurml sEpTra
D pRrvATE sEpTrc
pavriaNT,iErHoo a/\sH
[.*.cr< 1onvn"ls ro
u<1 ] r*srrcAN
Exrn.sg J ral"rro Eorsaor,o
( 0R ,
.rL U5t
0{ll)
Sf ':3ACKS: F: ).-
tavlSao DAIE enl i 1/ 12
ZollE: t-
Approval
oFFIc!R: L[-
City:'w RH:
\ Er:+2ft=
ll
Dti F
LCOD:
IH
7tt
,'
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE: R ESIDENTIAL
IVED JAN
1p Z0lO prEAsE aNshrER aLL QursrroNs appLrcABLE ro youR pRolEcr
"Project Res pons
ibility"
i12'/o{
ffi APPLICATION
Number
(Office Use)
APPLICANT'S l,lAltlE:
B1fI Cfark Homes of Wilmington LLC
DEVELoPER:
Bill Clark Homes of Wilmington LLC
PROIECT ADDRESS: 1218 Matteo Dr.
SUBDIVISI0N: . BelleMeade
PROPERTY 0}{NER'S tlAfi'lE: Bill Clark Homes of wilminston
oldNER'S ADDRESS: 127 Racine Dr. suite 201
CoiITRACTOR: Bill Clark Homes of wilmington LLC
ADDRESS: 127 Racine Dr. sulte 2ol.
EIiIAIL ADDRESS:
rgill@Billclarkhomes. com
PROIECT CONTACT PERSON: Richard ci11/Bi11 clark
CITY:
LLC
I,liImingEon
BLOCK #:
PHON E
PHON E
DAIEt t/a/2016
*i 91o.35o.1744
ZIP i 28472
LOT #: .36
*: 910.3s0 - 1744
CITY: wilmington
LICENSE #: 34s86
CITY: wilmingion
Homes of wilmington
ST: NC
ZIP: 28403
5T: NC
ZIP: 28403
#'. 910.350.L744
*: 910.350.1744
PHONE
PHON E
ATT GARAGE 450
SUNROOM
GREENHOUS E
EXISTING IMPERVIOUS AREA:
NE I PERVIOUS AREA:
SFDET GARAGE
5F
! eoor
SFDECK
SFPORCH 110,/
110 SF
STORAGE SHED
SF OTHER: Patio 1s4
5F
YesNo
,*,t***x***x********
YES NO
SF
TOTAL HEATED SQ FT:230a TOTAL SQ FT UNDER ROOF: 2e74
TOTAL AREA SQ FT: :rza
TOTAL PROIECT COST lress ro9
: $ tzt,zza # OF STORIES:
r w/uon
Is Any ELECTRfCAL, PLUMBII{G or IIIECHANICAL
tjork Being Done to the Accessory Structure?
If the pnoject
is a Retocation, is there a Natural Gas Line on the Current Site? ! VesI No
Is there Electrical Power on this Building?
l-l Yes I No
PROPERTY
USE
/ OCCUPANCY:SINGLE FAIYI LY DUP LEX
! rowruHousr
DESCRIPTION OF WORK: New construction of slng1e fam11y home
DISCLAIMER: lhereby certity hal all inbrmalion in tlis applicalion is conectand all work will comply wih he State Buildang Code and alloher applicable
Siae and locallaws
and ordinances and regulations. The NHC Developmenl SeNices CenEr will be notfled of any changes in fre approved pla
conlracior inlormaton. "'NOTE: Any Work Performed W/O tre ApprcpriaE Perm ils will be in Violation of the NC
Stae Adg
ge
To
$500.00"'
OiIrNER/CONTRACTOR:
nrchard Gl11/BCH
of wilminsron SIGNATURE:
********x*it+**,a,**r.,t*,t,*,t,t****r***+++++*+********)t,t++++,**,*,t,*,t**x**,*,*
IS THE PROPERTY LOCATED IN A FLOODPLAIN?YES I NO
0
3439
SQ FT
SQ FT
TOTAL ACRES
DISTURBED: .27
EXIST LAND DISTURBING PER IT:
WATER:CF PUACOMI.IUNITY SYSTEI'1PRIVATE WELL
CENTRAL WELL
SEWER:
I cFpuA
E CENTRAL
sEprrc
! enrvare seerrc COMMUNITY SYSTEM
*** SEPARATE
PER'IITS REqJIRED FOR ELECT, I,IECH, PLBG
, GAs EqJIP, PREFABS
& INSERTS ***
PAYI{ENT METHOD:CASH
Ecrecr (eAvABLE
ro NHc)
nA ERTcAN ExpREss
rrclvIsa DISCOVER,t,*,t*****:*i*ii**x)k*)i,t**,*,i,r,**x*+,*,t,**+:tjt*,*,*)*+:trt,*,*,*)t*rt)t)t,*,**+**,t,t,**+:*,t,*,*,*++:*,*,t,t*+:t,**,t++jixx**+jljk
(FOR OFFICE UsE ONLY) REVISED
DAIE O4l11/12
ZONE:
Approval:
-)
N
T
I
DATE :
SETBACKS: F
FLOOD:
LH:RH:
BFE+
E/
zft4
-)^5;{
EXTSTTNG CONSTRUCTTON:
! nrreRarrOru
! neruOVnrrOru
! Crrurnnl REPATRS
E RELOCATTON
NEr,{ CONSTRUCTTON:
E ERECT NEH RESTDENCE
o"
! aOOttrOru TO EXISTTNG RESTDENCE
**PLEASE CHECK AND ANSWER BELOW ALL THAT APPLY TO YOUR PROJECT:
SF
OF FICE R :
City:
RECEIVED JAN 12 2016
NEW HANOVER COUNTY BUILDING PERMIT
APPLI carlott rYPE: RESIDENTIAL
PLEASE AIISIIER ALL QIJESTIOIIS APPLICABLE TO YOIJR PRO]ECT
"Project Responsibiliqf
2oru131
It, -tob
APPLICATI()rl
l&mbe r
(Office Use)
DArE: 'ltlItvAPPLICANT'S NAiIE: stevens Buildino companv T/A steven6 Fine Homes
DEVELOPER:Navao Devel,t
PRO]ECT ADDRESS:CITY
sUBDMSI0l,l:e(ee
PROPERW O${ER'S MltE: stevens Buildino comDarv
O{NER'S ADORESS:
s710 oleandei Di
BLoCK f: _ LOT #:
PTONE *:
PIONE #: sLo
-7s4-a6s9
ztP
IE
11233.92_
)
ST :
!q ZIP :
-234!i_
ST: g ZIP:233!l
PIO E #: 9l o
-7 94.a6s9
PTONE #:9Lo-332-8s1s
err ll\
ivF sui te 2OOCITY: wilminqcon
COi{TRACT0R:
stevens Buildinq comDanv
ADDRESS:
s71o oleander Drive Srri te 2OO
LfCEllsE f: 31626
CITY: wilminqron
EiIAIL AIDRESS: sn i chol son@sr evensf i nehomes - com
PRO]ECT COT{TACT PERSOT,I:staci Nicholson
EXTSTTNG CONSTRUCTTON:
I alrrnarrOU
! nrmVnrrOr
! errenal nrearns
fl RELocATToN
EW CONSTRUCTION:ERECT l{E}r RESTDENCE o"
! AOOTTTOH
TO EXrSTritG RESTDEI{CE
ATT GARAGE oo sF
! sunnoom
-sF
! cne eucrre
_ sF
I oer crnacr
! eoor-
_ sr
! oecr
SF PORCH 00 SF
! sronncr SHED
_ sF
SF OTHER:SF
TOTAL HEATED SQ FT:1t01
TOTAL PROIECT COST 1r-ess ra1 : $\20 .00f OF STORIES:nA
Is Any ELECTRICAL, PLt IEII{G
or IECHAT{ICAL t,ork Eeing Done to the Accessory Structure?
El Yes
I5 THE PROPERW LOCATED II{ A FLOODPLAIN?YES T I{O
ExIsTIl{G IiIPERvIOt
S AREA: A5q0 SQ FT
TOTAL ACRES DISTURBED: 1/3
irEH rroERvrous lutee
@q et EXIST LAND DISTURBIT.IG PER IT:
Ives @rrc
rorAL sQ Fr UNDER **r, 11'11 rorAr AREA sq
dno
If the project
is a Relocation, is there a Natural Gas,rline on the curnent Site?
[ves flffo
rs thene Electrical Power
on this Building?
l-lv"t fllro
E
PROPERW USE
/ OCCUPANCY:srirGLE FAMTLv
! ourr-ex
! rowunouse
DESCRIPTION OF WORK:Ner,, Resi d.nti a] Construction
DISCLAIMER- lhereby cenit hal all lnbrmatbn in fiis applicarioo is correct and allworkwill clmplywih fie State Building Code and alloher applicable
$aE and tocat taws
and odinances and regulations. The NHC Developrnent SeMces Centr willbe notifi€d ofany changes in
he 4prov€(, plans andor charEe in coflt_acbr or
contaclor inbmatbn. "llOTE: Any Work PerfonrEd w/O he AppopiaE Permilswillbe an Vbb[bn ofthe NC SrEE Bldgines Up To
S500.0C"
0UI{ER/C0I{TRACTOR : craiq srevens SIGNATURE :
**,*,*,**,* *,**)r ** ** ******* ** * * *(IlTl Nil"]** )i++* )i)r*)r *:i+ ++ ji+ ++++ +++ +++**+*+ ++,r*,i,t*****)r
**
(FOR OFFICE USE OI'ITY) REYISED DATE O4l11l12
SETBACKS: F:_ LH:_ RH:_ B:_
*** 5EPARATE PERI'lITs REQ{JIRED FOR ELECT, I,IECH, PLBG, GA5 EqJIP, PREFABS
& INSERTS ***
PAYIIEMT iTETHOD:
E CASH
tr CHECK (PAYABLE
IO IIHC)AIITERICAI{ EXPRESS
E r.rclvrsa
E DISCOVER
*+++ +*,1++*)i *)r)r* )r***** )*
**:i)i:i)**)i **:* **,** )* )*,t*,*
** )*,t * * **:it )r:t )r )r )r**+++++ +++ ri+ ri+ ++ +:i:i + it
+:i:t* *
+** * rt
zoNE:
_ oF FICER:
Approval:_ City:_ DATE:_ FL00D:
_ BFE+2ft=
AVN
Conrne nt :PERfiIIT FEE:
ijl
.*'TPLEASE CHECK AIID AI{SWER BELOJ ALL TH/TT APPLY TO YOIJR PRO'ECT:
!'TATER:
I creun
! colt'ruNrry svsrru
! pRrvATE WELL
! crurnal uerr
sEr'rER:
EI creua
f] CENTRAL sEprrc
! enrvarr
seerrc
! corvrMuNrry sysrEM
(
).tt
)ZIRECEtvE!r JAr 12 2013
NEW HANOVER COUNTY
BUILDING PERMTT
APPLIC,TIN TYPF: REST DENT IAL
PLEISE AII5IIEfi ALL QUE5TIOIIS APPLICAELE TO YOUi P8O]ECT
?roje(t Res pons
ibi.l i.qd
ib toto
"&
EE
APPLICATION
ltunber
DEVEL0PER | \-avar PIONE $: q:c-rt.r-s;l-o _
PRO]ECI ADORESS;
. 'i-I
SUSOMsIOI: fl1ri:f:ck - fhf ir'it n,
CITY: ui:q:r,--;i
BLO(K S:
PROPFRTY OI.}IER'S N!,va ii. Fi,irdina a.n..-r
O,it.:i'5 Ai-i:.: 'r :
t, " tr s.:::! :CITY: irilmir .. r:1
COaTTRACToR: sE€..'n:r Bui l.:: au c::-.anv LICETEE #: 1.,6 2 6
AIX)RFSS:
irlc ot 6ander o!:ye CfTYI rl rm , .,.
au,1IL ADORESST '- s,,. . ....rs: --
PRC]E5 CO{TACT PERSOi: sr i1-' Nich.)lr-.
LOT S:
PK)NE f:
ST: jg_ ZIP;Je4o3
st: Nc l:P: ?a..r
STORAGT 5HED5f
SF
YesL4 No
plsnE *:
PTONE S:
EXrST rri6 CoI{S-rRUC l' l0 :A: -
'
RATIONRtNoVrrrlN
I elrirll arnares
! RELoci-:ol
TIEH CON5TRIJC-iCN:ERECT NE!,] RESIDEIICE o.ADCITION TO EXISII}J6 RFSIOEI,ICE
..PLEA5E CHECX AltD AfJSitEn BEIOW ALL T]|AT
Apply TO YOUR PROIECT:
.: ' GARAGE OEi GARAG:SF poec* ? sr
I sunnoou
-sF
I eoou
_ sr
I crcr
_ sr
SF
If the f,'.'eat is a Relo(.1tio.,
is ther€ a
Is there Ele.t.ic.l Po\,rer on th'-s EuildlnB?
OTHTR:
r.'. Gas/Line o'1
the CLr.ent Site?
ves
ffi to
,:PtiflHoJSE SF
ll i_,.
PnOPERTY IJSE
I OCCtJPhllCl-:a:'.. : FA I Y DUP i- EX T0r,lfii la .,5 :
DESCRIPTICtr! OF I}IORX;
OlSCl.A!,€* nr€by
c.njt.t!r !i ,lt na,bF n flis apgliatt$ a c6r..r r,,., Jr wiwit cornpry en i€ Slare &r$dho Cod. a{ ar on€r..,ir:" }€ SEE ara tocat taws
"aj.Rra.!.raidreqlLrron\:xoNHCa!,,.,rrrenrS.N..saerp:srbcrc:!e:otanycnruesniroorp@€dptss&69ecit6ar6nsorcneg€'...-r6cbfo.(irt rr., hbmstbn.
'-NOMi, r,..-r nr.lor-.d WiO le A,E:.rnnro Pt, . l|qll D€ n
VbE[b. ot u|e NC SL?r lbg'.." r)p
r0l5@.0cr-
otft E R,/CONTRACTOR:5IG{ATURE :
(trlnr qrn..
I5 THE PROPERTY LOCATEO IN A FLfiDPLAT ?
Exrsrr{G rHpERVrou,
orro. '.:Y i n rr
N€t{ IIpERVIO{JS
41g6, ,i' - 5p rr
r ilo
TOTAL ACRES OISTURBED:
EXIST
L$D DISTUREIN6 PERfiIT YES
YE5
I,IAT E R :CF PUA
I comrulrw svsrrrn
fj pRrvarr wELL
I r:nreaL wErL
5EHER;
U crpuA
J CEITRAL
sEprlc
f] enrvlrr sterlc
I co!,.rulrT] sysTEM
.,' SEPAFATE PF8$ITS PfqJIRTD rOP ELECTJ qECH' PLBG, 6A5 EQUIP, PREFAES
E INSERTS ".pAyrE"'
iErHoo: D .o.* D cr*< (pAv^&E
ro
**1 [ *.ir* .;".;, -
E;;z;r;i "-
E orr.or.",.......:,-...... ir,r!rr.r,**rrrrr
ZONE:
\l(
Arr-ova]:_ City:_ DATE: . fLOOO:
(ror oFrl:r usE a{ry) xr!I5!o DATE
O!/1r/r.i
SETEaCKS:
F:
i, ; t-H: 5 RH: .),
B: i., --,
It{Ur-nv (-z?
{ EFE}2+.
CCorYr:e
nt:
\u\. lU PERI{IT FLt
6{
APPLICA|TT'S llAflE: @r_____._._- DATE: ;r,r
.'.',
TOTAL HEATED SQ TT: I.I. TOTAL SQ FT (IIDER
RMF: ' '-' TOTAL AREA SQ FT:
TOTAL PROJECT COST ruass rot ; I rzc ooo * OF STORIES: 1\
Is Any EIECTRICAL, PLtIlBILG or TECHATIICAL Lork Beint oone to the A(ceslony Structu^el
f,l V"s E] lo
RECEIVED JAN 12 2016
2ol6)32_
NEhI HAM)VER COIJNTY BUILDING PERMIT
APPLICATI I TYPE: RESIDENTIAL
PLEASE ANSWCR ALL QIJESTIONS APPI.ICABLE TO YO{'R PRO]ECT
'ProJect Responsibility"
/b107
APPLICATIOiI
ttumber
(offtce Use)
Stnuu finultorno lh ilttorrs 0u,t4rnq C0,n9611 DATE: i
tl tbAPPLICAI.IT'S MIIE :
DEVELOPER:?
PROJECT AIDR
SUBDIVISIO :
JT l
BLOCK
CITY:
LICEl'lsE *:
CITY:uJilm
LEX
! rouuxousr
PK)NE *:0
zl
LOT *:
ploNE
*: $@lrtl.qbql
sr:'N0 zipiT34o,
ACCOUT,TT #:11e
srtNL zrp.t eglo'tt
Plo E *: 1q4-$h1q
PK) E *: ?rA-lA57
ESS:
t\
PROPERTY O{NER,S Mi4E:
o*t*" or*455, 91t0
,,0n?
uitiiillInto
(
COT'ITRACTOR:t\5
ur/ltflf4 0
ATDRESS:1t0 0
EIIIATL ADDRESS:
,
0t
PRO]ECT COT,ITACT PERSON:Xo
PRoPERW USE
/ OCCUPAI'ICY:
d SINGLE FAMILY
loho
EXTSTTilG CONSTRUCTTON:
f] ntreUrrOU
I neUOVnrrOr
!CrNrnar nrearns
! RELocATToN
NEW COI{STRUCTTOil,
fr eneCr NE}t RESTDENCE o"
E mOrrrOr rO EXTSTTT{G REsrDEr{CE
**PLEASE CHEC(
_-J
I rl Arr GARAGE
alst{ER
b0
BELO{ ALL THAT APPLY TO YO'R PRO]ECT:
sF ! orr ernace st El ,o*c, ldV se
If the project
is a Relocation, is there a Natural Gas, Line on the cunnent site? ! ves
Is there Electrical Power on this Building?
[v.r ftno
dno
AND
I sulnoom
-sF
E poor
-
sF ! sromee sneo SF
! cnerruuouse
_ sF I orcr
sF oTHER: tf0n oft 5F
ToTAL HEATED sqn: ?,5A0 ToTAL sQ FT UI{DER awT:1,Ai'O ToTAL AREA ,Q,.,,9,?&O
TOTAL PROIECT COST tre+s rat I $no,o0of OF STORI ES:A
Is Any ELECTRICAL, PLIfiBII{G or IECHAIfCAL tJork Being Done to the Accessony Stnucture?
E YesT4 No
6
DISCLAIMER lhereby cedjry fd all inbmatbn in this epplicaton is corecl and
allworkwi[ complywitl he Stale Buibhg Code and a[ oher applicable SiaE and tocat tau/s
and ordinances and regulatbns. The NHC Developmenl Services CsnErwillbe noltfed ofanychanges in he eproved plans and
conlracbr intormalion.
'-NOTE: Any Work Perfomed w/O he ApprcpiaE Permits will be in Violation oflhe NC SlaEEldg
or change in
contracbr or
Fines up To
$5O0.0o.'
OWNER/CONTRACTOR:(6'5 t'10 SIGNATURE :
,*,*
{.*,****,*1.* * * * +,1.1.+ + t*:t:1.* * *(Prlnt Nare)***:* )** * * * ** *)* * )*:k:*,* )*
*)*
Ncul tr,l,e
IS THE PROPERTY LOCATED IN A FL@DPLAIN?
Fl vrs
i/i* r( *i()i*)** *** )t
iro
TOTAL ACRES DISTURBED:
,i )t
*** *****,**,* * )*,*,k ,*
x
EXISTIIiIG IiIPERVIOUS AREA:1lg'(5Q FT
SQ FT
ls
NEw rrlPERvrous AREAT i l91 EXIST LAM) DISTURBIiIG PERfiIT:
I-I YES NO
IdATER:
SEWER:
q
fr
creua
! coi4r4uNrry
svsrrm
! pRrvATE wELL
I crrrRal wrlr
creua
! cENTRAL sEprrc
! enrvare
seerrc
! coMMUNrw sysrEM
**1. SEPARATE PERIIIITS REqUIRED FOR ELECT, IIECH, .PL8G, GAS EQUIP, PREFABS & INSERTS *}*
pAytlElr
rErHoo:
! case ficnecx (PAYABLE
ro nncI EBrLL accdJr,tr
E nclwsa I orscown
)r,* '** ****:t+*:t**,t *)i)* * **:i +:t:i+,i*****,t,***)i *+)t:f:i++,t:i+)t *,t,t,*,**** ***** + +,* rt
*,i ,l,t *,* * )*+*:i:t+ +,t,t+**,*,*,t*
(FoR OFFTCE
UsE ority) RE\rtsrD DArE O4l11l12
ZONE:
_ OF FICER:SETBACKS: F: LH: RH: B:
Approval:_ City:_ DATE:_ FLoOD:
_ BFE+2ft=
AVtI
fr
11 Al oerrrra(0
t\[0
Conment :PERMIT FEE:
crw:
DESCRIPTIOI{ OF HORK:
CPflJA
lnv N lotu-7tz
APPLICAIT'S IIAT.IE:
DEVELOPER:
PRO]ECT ADOR
ESS:
SUSDIVISIoT:
PROPERTY
OhNER'S llAfiE:
OT{ER,5 ADORESS:
0
n'
6[i\A(r5,
LLC
T{EW
HAITOVER
Cq'NTY BUILDING PERIIIIT
APPLICATIOII TYPE.. RESIDE TIAL
PI.EASE A}ISX€R ALL qJESTIO}{S APPLICAALE TO YOI'R PRO]ECT
"Project Responstbtlity"
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Et'tATL ADDRESS:
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f| alreurrol ! *rslrron I GEI{ERAL REpArRs
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r{Et{ coiETRUCTIoll . {r*rr, NEx RESTDEI(E
or [ ruDl11or To EXISTIiE RESIDENCE
STORAGE SHED5F
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5F ofHER: AZ1-SF
rorAl HEATED
sa ctz 40cl.l TOTAL SQ FT U DER ROOF:
faz< rorAl AREA
sqer,
55o{
TOTAL PROI ECT COST lr-u"' rar
: i oA* OF STORIES:
A
fs Any ELECTRICAI-, PLIFIEI G
or iTECHAUCAL tdork Being Done to the Accesso
ry Structure?
[ Yes No
If the project
is a Relocation,
is there a Natural 6asine on the Current Site?
I ves No
fs there Electrical Porrer
on this Building?.fiYes No
dPROPERW
t,sE
/ OCCUPAICY:
SIIIGLE FAI4ILY
fl oueLrx
!TOtINIIOUSE
DESCRIPTIO'{ OF hIORl(:
DlgCLAll/Eft I horoby
c8nit t!616n hbflna@n ir hls Opkalofl !i conecr and al wofi wil c:o npty yrih tr€ Sta!6 tuitdhg Cod€S'taE ald bcal taws
and ordinances 6lld rEgulalbns The NHC De\iebpr,rEnt Servbes CenE( win b€ noti€d ol any chEtgos h fie appaoled pbn
cont,rlor inbrmaton. '"NOTE: Any Work P€rfomed w/0 tle Appropriae Fbmls u,lt b€ h Vbbrirn of dta NC Stat To 350O.0Oit
0t{{ER/CONTRACTOR t SIO'IATURE
..ptt{se cxecx AiD arsxER SELot{ aLL IHAT appLy ro yolrR p*orEcr:
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ROPERTY LOCATED I
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IiPERVIOT'5 AREA:TOTAL ACRES DISTURBED:
IlitPOUS AREA:
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COI'}TUNITY SYSTEM
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SEPARATE PEn,IITS
I EDFOn ELECT, r'tEcl{, pLBG, GAS EQUIp, PR€FABS
& IiEERTS ***
PAY ET{T NETHOD:
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PAYABLE
IO M{c)
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(FOR
OffrCE UsE O[y) REVTsED
DAT! O4l11/12
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