MARCH 31 2016 BUILDING APPS-\
\<
e
DEVELOPER:
CONTRACTOR :
ls food or
OWN
WATER:
SEWER:
ZONE:
\J+
_\
..J
\)--=)
Comrnent PERMIT FEE:
NEhI HA ER COUNTY BUILDING
;)r /u-,](),nrrmripgS t;S-4gE
APPLICATION
Number
(office Use )
I tk
PL€ASE
APPLICANT'S NAritE: crov,/n cast fe outh LLC
PROIECT ADDRESS: 37se Norrheasr
oCCUPANT/BUSINESS NAIiIE: Ar&r Mo ilir
PROPERTY O}'INER'S f,lAllE: rrene r,
oWNER'S ADDRESS: 3 719 Northeast
N work sofu 10ns LLC
ADDRESS: looo centre creen wa suire 300
beveragos
APPLICArIoN |YPE: COItllilE RCIAL
ANSWER ALL QUESTIONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibility"
CITYI Castle ttatme
CIry: castle Hayne
PHONE *: 91o G'7s 2568
ST: I!_ ZIP: ::jl1
l'lo
PHol,lE #:
ZIP I za+zo
LICENSE #:
CITY: cary
70037
EMAIL ADDRESS: brad. connomastec com PHo E #: 678-99s-6314
PROJECT CONTACT PERSON: Je athers PHO E #: 704 4as 6s49
(Ch€ck AII Ihat Apply)
EXrST CONSTRUCTTON: I ALTERATT RENOVATION 6ENERAL REPAIRS RELOCATION
lf Relocation, is there a Natural Gas Line the Current Site?tr Yes fl*o IS BLDG SPRINKLERED?[v". fltto
iNEIT,I CONSTRUCTION: E ERECT NEt.l
ACCESSORY STRUCTURE:
TRUCTURE I rrsr rmcr I sxer-r- ! uerrr f]ADD TO EXIST STRUCTURE
If UPFIT - The SheII Permit #:Is Elect Powe!' on this Building E Yes E *O
,**,1** Is A cHATGE oF occupANcy ustl Ivrs INo *****
IF Yes, what was the Previous Occu ncy Type?What is the Neu Occupancy Type?
ARCH DESIGN PROFESSIOTIAL:PH:NC REG #:
ENGR DESIGN PROFESSIONAL: TeT ich AC&S En inee ri n PH:864-288-0ss NC REG *: 029239
DESCRIPTION OF WORK: remove and re lace 3 exist i.tnter.nag ?:th I n.w an!ennas ; r lace 3 RRU'S
preparod of sgrvad m sruaure? lYes I No ls The Prop€rty Located ln The Floodplain? [ ves I
isa
HC
ica tion lding and eIa
a
ble State
5
ndol th
ER/CONTRACTOR: ;e
TOTAL PROJECT COST:15 000
TOTAL AREA SQ FT
TOTAL SQ FT UNDER ROOF
ACRES DISTURBED:
NEW IMPERVIOUS AREA:
OFFICER:
Approval:_ City:-
BUILDING HEIGHT: 230'
# OF STRUCTURES:
F !.her s SIGNATURE:stfe
(o|d16€r)
Note: Demolilion notific6tions & asbesbs rsnoval applicalioos are
conlain Asb€sios o( not You ar€ roquired !o call th6
demolitjon of any facility or building. See Asbestos
to be submitbd using the apdicalion fom (SHHS-3768)wh€thor fie fucility or building was found to
Emissloo Sbndards tor Haz6rdous Air Pollutants (NESHAP) at (919)707-5950 at lesst 10 days rior to dl6
htFJ flu/w. epi. stale. nc- ust/epi/asbestos/ahm p. htn I
# OF UNITS:
# OF STORIES:
# OF FLOORS:
Exsr LAND Drsrunane eeRurrr Ives I r.ro
SO FT EXISTING II!,IPERVIOUS AREA:SQ FT
PROPERWUSE: flOrrrCe E flr,rencmrrrue leouc lner lcoruoo orHER:
ECFPUA
CFPUA cfl flWELL flzoNrNc usE cr-ASSrFrcAroN:
PRTVATE SEPTTC ECOMMUNTTY SYSTEM
COMMUNIry
CENTRAL
"'SEPARATE PERMITS RE IRED FOR ELECT, MECH, PLBG, GAS EOUIP, PREFABS E INSERTS *'
PAWIENT METHOD:ficnsn I (pAyABLETo NHcy flnueRtceru ExpREss flucnnse I otscoven
(FOR OFFICE UsE oNLY) REvrsED DA]E 4/11/12
SETBACKS: F:-LH:- RH:- B:
FLOOD: _ BFE+2fr_
AVN
)
oarlt 4 ,/) q
5T: Ie_ zIP:2!3?2_
n tr
SQ FT PER FLR:
-
{
.r
=E,),
DEVELOPER: s
ZONE
-f\
s
Comment
N
PERMIT FEE: $
ER COUNTY BUILDING
APPLICATION rYPEr COMMERCIAL
ANSWER ALI QUESIIONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibility"
CITY: wi Iminqron
Col1e
CITY: wi- tl imsr.on
LICENSE f: 70037
CITY: cary
. /! 1./ -i,.
PERMIT PE?IU-583
APPLICATION
Number
(Office Use)
PL EA
APPLICANT',5 NAIIE: cro$'r cast 1e South LLC
A
PROIECT ADDRESS: egoq sidttru d
OCCUPANT/BUSINESS NA!'IE: Ar&r ilir
PROPERTY OI,JNER'S tlAf{E: ca r Communit
oWNER'S ADORESS: 411 North F t st.
CoNTRACTOR: Mastec lletwork So1 E 10ns
ADDRESS: looo centre Green wa Sulte 300
EI'IAIL ADDRESS: brad. conn@maste . com
PROIECT CONTACT PERSON: ,re r eathers
***** IS T
IF Yes, what was the Previous Occ ncy Type?
NEhJa
(check All that Apply)
DAT E
PHONE *:
PHONE S:
ST: NC ZIP:28401
ST: NC ZIP: 27s13
2 /z!
' lf Relocation, is there a Natural Gas Line the Current Site?Yes
NEH CONSTRUCTIO I:ERECT NEl,l STRUCTURE FAST TRACK
ACCESSORY STRUCTURE:
If UPFIT - The Shell Penmit #:
No IS BLDG SPRIN
RELOCATION
KLERED? fl ves I no
! sxelr- n uprrr E ADD TO EXIST STRUCTURE
Is Elect Powen on this Building E Yes E ruO
A CHANGE oF occUPANcY UsE? EYES [rc .***.
What is the ileu Occupancy Type?
co
Center will be notilled of anv che
W/O the Appropriate Permits wil
nqes ilbe n
lding Code and
Vrolation of the
all other applicable Stiale
Dlans and sDecifications
NC Stare Bldg Code and
Exrsr coNsTRUcTroN: [l ALTERAT ON RENOVATION GENERAL REPAIRS
ARCH DESIGIiI PROFESSIONAL :
EiIGR DESIGN PROFESSIONAL:
PH NC REG #:
Ter A drich AC&S lneer
DESCRIPTION 0F WORK: renowe dri l-ace 3 exist in antennas with 3 new antennas &lace 3 RRU' s
is wi thrhiSappicalionrrectandacoplv th State 8ui
ls food or b€veragos prepared or servod this sruaure? flves I No ls Tho Propafiy Lccatod ln The Floodplain? E Yes I No
N
OWNER/CONTRACTOR: ;.,F athe rs Cro n Castl SIGNATURE:
(Pritrl Nrn€)(oualn..)
Noter Demoliton nolifcalions & asbestos rernoval il applk=lions ar6lo be submitl€d using lhe applicalion form (DHHS-3768) rvhether ths facility or building was found to
contain Asbestos or not You are r€quirod tc callthe Emission Standa!'ds br Hazardous Air Pollutants (NESHAP) at (919)707-5950 at l6ss! 10 days prior to th€
d€molitiJh of any lacility or building. 56€ Asbostos Site: htP:/i,t/x/w.epi. slate. nc. usi/€pi/asb€stos/ahm p. hun I
TOTAL PROJECT COST:BUILDING HEIGHT: 230,15 000
TOTAL AREA SO FT SO FT PER FLR:# OF STORIES
# OF FLOORS:TOTAL SO FT UNOER ROOF:# OF STRUCTURES:
EXST LAND DTSTURBTNG PERMTT? nyES E NO
NEW lN'IPERVIOUS AREA:SQ FT EXISTING IMPERVICUS AREA:SQ FT
PROPERry USE: [OrrrCe !REST RANr fIMERcANTLE EEDUc flaer flcoNoo orHER:
COMMUNITY flwELL fIZONTNG USE CLASSTFTCATON
PRTVATE SEPTTC DCOMMUNTTY SYSTEMCENTRALlcn
.' SEPARAIE PERMITS RE IRED FOR ELECT, MECH, PLBG, GAS EQUIP, PREFABS & INSERTS "'
PAYIVIENT METHOD: ECASH ECH (PAYABLETO NHC) EAMERTCAN EXPRESS EMCA/|SA EOTSCOVeA
(FOR OFFTCE USE ONLY)REVISED OATE #11/12
OFFICER:SETBACKS: F:_LH:_ RH:_ B:
FLOOD: BFE+m=Approval:_ City:_
tr
ACRES DISTURBED:
-
PH: 864-288-055 NC REG *: 029239
informalion
# OF UNITS:
7IP'. zaaos
PHONE f: 61a-995 G3r4
PHOl,lE #: ia4-Aas 5s4e
tr
Y$ER:B3HUi Lr
$RECEIVET I'lLl
NEW H
PL
APPLICAT.IT'5
DEVELOPER:
*-., ftlrl5 finu
v{r
PROJECT ADDRESS: 52
SUBDIVISION l\
PROPERry OUNER,S M}tE:t,J0n5
O},IER'5 ADDRESS:
A 1(o o
COT,ITRACTOR:t tr'/I
ADDRESS:1 0
EIIATL ADDRESS: 5 i
PRO]ECT CO{TACT PERSO :
EXISTTiTG COiTSTRUCTTO : EALrE
ItlEI.l CONSTRUCTION:d ERECT NEl4l
'*i'PLEASE CHECK AND At'lsWER BELOI{ AL
@ rrr eeme e Slrb SF
! surnoom
-
sF
! cnrrrurousr
-
sr
TOTAL HEATED 5Q FT:1tfi
TOTAL PROIECT COST tr-ess rat : $
Is Any ELECTRICAL, PLUiIBING o. H
If the pnoject is a Relocation,
Is thene Electrical Power on th
PROPERTY UsE / OCCUPAI.ICY:d SI
DESCRIPTION OF }'IOR(:tlsbl 2'i
DISCLAIMER lhereby cerlit halallinbrmatbn in this
and odinances and regulalions, The NHC
conE#br inbrmaton. '-NOTE: Any Work Perfonned
Ol{NER/CONTRACTOR :fa't 5
**++ ++tr + +)**,**,t*+1.+******,** +
IS THE PROPERTY LOCATED I
EXISTII{G II.IPERVIO{Js AREA:
NEIJ IiIPERVIqJS AREA:
t'lAF
L9 I
')
[tlATER:
SEUIER:
g
m
creun ! colr/vruNrry
creul ! CENTRAL sE
i!*i. 5EPARATE PERI.|ITS R
PAY|E T [|ETHOO; E CaSn E
+,* *,f ,r *,* ++* )* ***+ {.++)i *** {<*+:i +
zoNE: _ OF FICE R:
Appnoval:- City:
Coment:
milErlfr r[EE trmw
aft!trff
0 2016
VER COUNTY BUILDING PERMIT
APPLICATIfiI TYPE: RESIDENTIAL
A}ISI{ER ALL QUESTIONS APPI-ICABLE TO YOUR PRO]ECT
"Project Responsibilit/
lh tlcns 0r,t4i C,oo a
crw:
BLOCK
4itli
Aott, - A]12
0orvr 6/1
CITY:
LICEI{SE.
CIw: $rr r!\o
*i
APPLICATIOfiI
Itnber
(OFfi(e Use)
DATE :20t h
PIIONE *:0
ztP I
LOT *:
plorE *: $tilfit.Abqol
sr: {!zrri 0.0@
Accout{T #: 11e
stzttL z1q.; At101
:a56
0fl
ao
Plo E #: 1qq-$hqq
fJ h 0 Xo P}PNE #:
rror'r ! RENovATToN ! eelrrnar ntenrns ! RELocATToN
RESTDENCE o" ! mOrrrOt TO EXrSTrt{G RESTDENCE
THAT APPLY TO YOUR PROJECT:
DET 6ARAGE SF fieonc,r bo SF
POOL SF ! srome r SHED _ sF
DECK SF OTHER:
ICAL work B€ing
is there a Natu
s Bu ilding? [
LE FAMILY
t
L
fieAppopriab Pemilswillbe in Violation of lhe NC StaE Bbg
rorAL sQ Fr u DER R@F, ?0q4 rorAL AREA sq fi, 903(
a0 000 # OF STORIES:
^Done to the Accessory structure? [ Ves fffo
ral Gas[ine on the curnent Sitel !ves fi no
v", llii ro
e
E x TOWNHOUSE
0.
aton is correct and all work will comply wih the Siate Bxilding Code and all oher applicable $aE and local laws
rvices C€nEr willbe noliied of ahy cianges in lhe approved plans and specifcations orchange in contracbr orYW"tr Fines lJp To $5,00.0cr"
0 SIGI'IATURE :
* * *** *,t** *,i** ***,* ++
LAIN ?l-l vrs
,* ** ** **** *)t + + + + Id*6*{K*********** **
SQ FT
SQ FT
TOTAL ACRES DISTURBED:'13
EXIST LAI{D DISTURBIi.IG PERI'IIT :I ves d NO
rrr-r E PRTvATE uELL I crrurnal uell
I commuurw svsremc l-l pnrvare seprrc
ED FOR ELECT, MECH,.PLBG, GAS EQUIP, PREFABS & INSERTS ***
(eAvABLE ro n*c; f,rr.. *.*nt E tc/rrsr I orscoven
QUIR
** )r )r )i *,t,* + ,t +:l + ,i rr i. * * *,t,* +:Bil. *** r( *,i * + + + rt +i,i * ++,t,* *** )t***,**,****++ *,t
(FOR OFFICE USE ONLY)REVTSED DATE 04l11l12
SETBACKS: F:_ LH: RH:- B:-
DATE: FLOOD: BFE+2ft=
AVN'
PERIIIT FEE: $,rc2
lk g=k
SF
tr
Itoodcr
CouNl-1 ffi''irLat
APPLICATIOI{
Number
(Offlce Use)
PL EA
.ti lat
LI
NEW H
RECEtVET itAR 02 ?010
VER COUNTY BUILDING PERMIT
aPPLIcarIoN rvPr: RESIDENTIAL
ANSWER ALL QUESTIONS APPLICABLE TO YOUR PRO]ECT
"Project Res ponsibil ity''
llir c hae I ir StrvrnE
DEVELOPER: N It
PRO]ECT ADDRESS:
SUBDIVISION: ZO
DA atv1-TE
PHONE #:,l
BLOCK #
ZIP i
LoT #: LA
U
L ft
PROPERW OUNER'S t.IAT.tE :lhrcha L l4l i ? v'0 t19
Olf{ER'S ADDRESS: 5ri L^5 ?i
COT'ITRACTOR:
ADDRESS: 5
,l€fl9 0r,r,ld'rn Co',n c,rl
CITY: _ST:_ZIP:_
LICENSE #:lltaZt,
sr. NL :Z:IP. x$|a1CITY:\v,l
PHONE #:Tu-*vT-
PHot{E #: h'lL"fitv
GENERAL RE PAIRS ! nr rocarrol
5F ! eoncu Nt ,,
I srouce sHeo N& 5p
SF
TOTAL AREA SQ FT:z'!u c
S OF STORIES: A
e to the Accessory Structure?
DUPLEX TOWNHOUSE
€t /ovA
l0 6
PHONE #:
fi,",
PROJECT CONTACT PERSOI'I :
EXISTING CONSTRUCTION:
EAIAIL ADDRESS:
! surunoor.r
ri t 1ot.o$t6 Ct)
ALTE
NEI{ CONSTRUCTION: E ERECT NEH
*'PLEASE CHECI( AND AI{SWER BELOW AI-
ESIDENCE o" I aOOrrrOH TO EXISTING RESIDENCE
THAT APPLY TO YOJR PROJECT:
f] arr eauce N A tt ,r, uo*on, Nk
rC ho lso
d rroru ! neruovrrroru !
Ni 5t-POO L
GREENHOUSE r,,l I SF DEcK N&SF OTHE R:
TOTAL HEATED 5Q FT:L TOTAL SQ FT UNDER ROOF:
TOTAL PROIECT COST (ress rori : $,0(]0
ft k sF
Is Any ELECTRICAL, PLUiIBII{G or iIECH
If the project is a Relocation,
Is there Electrical Powen on th
ICAL l.Jork Being Don
PROPERTY UsE / OCCUPANCY:d 5I LE FAMILY
DESCRIPTION 0F ltlORK:0ta 5co to
is there a Nat-ural Gas Line on the Current Site? fl Ves
s Building? fr v", Iro tr ruo NrA
t^
No
i( * * )t r* * * * * **** * )*
DISCLAIMER: lhereby cert, fiatall inbrmation in his
and ordinances and rcgulalions, The NHC Developmenl
contacbr inbrmaton. "'NOTE: Any he
OWN ER/CONTRACTOR :i0fl5 h,l r4 {n rt
h
0
in*,*,*,* ** )* **,** *** rt +*** *** ****,*
IS THE PROPERTY LOCATED IN A FL LAIN?
plicalcn is conectand all work will comply wih he State Building Code and alloh able Srab and local les
ruices CenEr will be nolified of any changes in he approved plans and speci or change in contracbr or
its I Violation of the NC State
SIGNATURE:
Bdg Cod t b Fines Up To $500.00"'
** **** * * )* *,* * * +** * *,t * * * * * *d EuoYES
tuk
EXISTING IIiIPERW(US AREA:
NE}'I IitP ERVIOI'S AREA:
tr !{ cor,l*lururrv s
SQ FT
SQ FT
TOTAL ACRES DISTURBED:
EXIST LAND DISTURBING PERi{IT:
SETBACKS: F:_ LH:_ RH:_ B:_
5vesl,F
511.*
NO
hIATER :
SEWER:
CFPUA
CFPUA ! cenrRar see c PR
PRIVATE WELL
IVATE SE PTIC
CENTRAL WELL
COI'II'IUN ITY SYSTEM
*** SEPARATE PERI4ITS RE
PAYIENr t4ErHOo: I CrSr I Cx cK ( PAYABLE TO r{frc )
IRED FOR ELECT, MECH, PL8G, GAS EQUIP, PREFABS & INSERTS ***
I ncTvrsr
T EM
AIiIERICAN EXPRESS
,t,t x x x * * ***t **** + +:t + + + + + 1. + t ++ + * + * + + * :t :t :t + + + + + + * l. ,t ,t + + ,* 1. 1. + * 1. + * * * + ,t + r. ,r ,k * x * * * * * + + + * + * * * * * * * *
(F0R 0FFTCE USE oir LY)REVISED DATE O4l11l12
Approva I i_ City:_
{ 0(t(a
fl m flt
EWl
@
TE:_ FLoOD: _
A
BF E+2ft=
N
/:. ri, ': .
\ry
CITY:
APPLICANT'S t,IA E:
a4^n"r"
tr
tr
I orscorr*
ZONE: _ 0FFICER:
APPLICA}'TJ S I{A,IIE
DEVELOPER:
\J \\
#
PRoIECT AoDRtSS i
SUBDIVISIOfl:
DESC
(
fr/o t \t+
NE HANOVER COUNTY BUIL ING PERMIT
APP LIcArI otl rYP€ ; RESf DENTIAL
PIEASI AIISYIE AtL qJE5IIOIIS APPLI(AALE IO YOJN PRO]E(I
"P.oJ€<t Res pon s i,bi 1ity''
.-)e wl;-'rr--fi
)oiL -2721f
t(,'k)8
pTl r clrro-clrrolr
llulnber
(orfl(. ur.)
sgs,, 3/'{/r d
CITY: ; /-,-1
PFONE it ?/; - 2
ptgjtE $.t <//;t -',t?l'h a s \.
RELOCATION
PROPERTY O}T ER'S tIAItC:
q{NER,5 AOORESS: ?CITY:
cotfiRAgTon: ';' a *ty' S'P'<c'ken,'5 z f[,*, o
g/c,t-,e3 ILL n{,|le *: e, o- J?-r-b, t jv.
-E z- z*1
zrP | 2ZI; ,
ELOCX [: _ LOT t: _
sf I E_ztP| ) t-'1 t t
7>'bta accol-NT *:
sr 2!i:al-V-. i2y, , tADDRESS) I -f +<e--r
EIIAIL ATDRESS:
RIPTIOI OF K)RK:
CITY:;A: LA
C PaR'71('S
b - 'rr-u a/PRO]ECT CO TACT PERSON:
EXISTIT.E COT{STRUCTIOI{ :
c/e
LTERATION [} temreuoru [l e eneul nrearns
ERECT tlEU RESIoENCE or ADOIlION TO EXISTII'IG RESID€I'ICE
..PLEAsI CHECX AID AtiSH€R BE
! err elmcr
-
sF
I surnoox
-
sF
I cReruoust
-
sr
Is Any EIECTRICAL, PLUl,lBItlG
rf the project is a ReJoc
Is there Electr ical Power
PROPERTY USE / OCCUPANCY:s N6L
AIL TIIAT APPIY TO YOT'[ PRO)ECT:
! orr cauce sr D poncH
-
sF
f) eoor-
-
sr f] sroneee sHED _ sr
SFDECK _ SF oTHER i
T
TOTAL HEATED SQ n: 2'IOTAT 5Q FT UI{DER x696; Ja;r- IOTAL AREA 5Q FI: _
I0TAI PROJECT C05T tt-cssroo I .l5l; cl. '-: r oF sroRrEs: .n
xECHlr{tCAL liork B€ing Don€ to the Accesso.y Stru.turc? [ Ves !No EA 45 i/.?h'D
E,roon, is there a Natural Gas Line on the Current sitel Eyes
this Buildiog? El.ves I Ho
E I L n OUP E x tr oiJNH0US
5r f i'/!(E'eFtn/,st-t trLaqeSr K'l(tP/
(Ca fr{iler5
DISCLAIUER lhe,ct y cenily t'.rrl nbms|ion cdrecl 3.d .I rsr ril .ohpt wrh rl. Sbb Bu'lng Codr trd a! otr€r d{rt .bb Stlr .nd tocal I'!
,d ordnarEei e.d ocdrbns rno NHC l S.r'ces CanE vi! b€ mtLd ol'lt cna96 h te applolod !u,
Eo.r,.cbr nbm.bn "1NOT€ any Wdk WrO t'c ApproprEr PlDirs w.l b! . vo]alon ol rhe NC Sr.e s5cc 0!'
ohtNER/coNTRACTOR:
MTER: E CFPUA
sEr,rER: El CFPUA
P5 Pocvl
s TBACXS: F
DAT€r1000:
fi U €1,te Fte,z5 at,-Un a 7',)LD
tS THE PROPERTY LOCATEO I}I ruooortarrr I ves W ra U,rf\
t?J-rr-- n/ 5T6NATURE:
SQ FT
5Q Ft
TOTAL ACRES OISTUREEO:
EXIST LAI{D OTSTURBI'.IG PERI,IIT:l-l ves l-l ap
svsrrr,r ! pRrvArE T,JELL I cemnar wtr,r-
srlrrc fl pnrvArE sEpTrc f] commrrrrv svsrrr
s RTQUTRED foi ELECT, ECH, plg6, GAS EQlJIp, PR€FA8S 8 IflsERrs "'
clEcx (pay^BLE ro mrcl I arrl rccorrr @rcTvrsl I orscoren
EXISTIIIC !,IPERVIOUS AREA i
NEH I}TPERVIOUS AREA:
PAYMEMI TET'IOO:CASH
*r.a a* * r 1r,a ra ** l l ra* )}*t}r r *. 't. rrr *** t,l*,r a * i * rr* 3 *1ri,
fl comunr
I cemaal
.T'SEPARATT PERXI
(ue)
zorE: R 5 orrrctn:
npp"ouat:-!f.- ci.ty
lil/+,.,,nyh
. itvIlE0 D Tr salrr,,12
{A
BtE+2ft=
Connent:
Cily REuneo, 91[254.0yi0
PERI'II T FEE LL{S2re
Pll0,lE *; ')t:-,?7 - v, r- J L,
NEl{ CONSTRUCTION; !
N
L/\/.S-r,J\/ n-
)ctb ,/-Tl
ffi
APPLICANT'S NAME:
DEVELOPER:
PRO]ECT ADDRESS:
SUBDIVI5ION:
tNEWHANOVER COUNTY BUIL ING PERMIT
APPLICATION TYPE I RESIDENTIAL
LEASE ANSIIER ALL QUESIIONS APPLICAELE TO YOUR PRO]ECT
"Project Responsibility"
/e
fr/<,\,b lL --
APPLICATION
Number
(office Use)
- t- --,/, .oatt: 5/t > /' 6J rtcl(
{69 ffi
p Peene PtoNE #: ?rl- ?21- t<. 3 3 L,
a CITY:t:z-A zfit ,?A'Z c >
g/erQrre3 l/L pwne *t ?ro-J?l-to=3ta
6OiITRACTSR: J"/+ *P'P\kenes ''tfrrr* o,e-6AL
PROPERTY OWNERJS NAME:
ONNER,S ADDRESS: 2
ADDRESS:al 57
EMAIL ADDRE5S:
DESCRIPTION OF l^JoRK:vl
0tilers
G
,,/3
/e
CITY: --= z-.'^sr t !9zrP.: >-rZ r I
ACCOUNT $:
Sr,lgzIPt 2r'A t I
PHONE *: ?/,2 -)2a-t- "3 k,
PHoIE #: ?/A-J?t-b ? 3 k
CITY:
b -.1 -rro "/
)= 2/r4
,v eaPe/?T(e-9
rnnrron $ nrnovlrroru pGENERAL REpArRs I Rerocnrron
**PLEASE CHECK AND ANSI.IER 8EL
EW RESIDENCE or ! aOOrrrOH TO EXTSTTNG RESIDENCE
ALL THAT APPLY TO YOUR PROJECT:
PRO]ECT CONTACT PERSON:7a
ATT GARAGE
-
SF
suNRoor,l _ sF
GREENHOUSE SF
If the project is a Relocati
Is thene Electrical Por./er on
PROPERTY USE / OCCUPANCY:E INGLE FA[,IILY
DET cARAGE sr I eoncu
-sF
PooL _ sF I sronacr sHED _ sF
DECK 5F OTHER: SF
n, is there a Natunal Gas Line on the Current Site? nyes
this Building? @v"s I r,ro
TOTAL HEATED 5Q fi: ?aca
TOTAL PROIECT COST iress rory :$ )5, J:?-':- # oF STORrES: J
]5 Any ELECTRICAL, PLUI4BING ON HANICAL Wonk Being Done to the Accessory Structure? [ V"r f]11o p. 45 uectuD
Eruo
DUPLEX TOWNHOUS E
tc ?sropAf/ od tr! \'eFtn/ t'r./ FLcoP5:, K t tCl{c 'r'
a pt Th eocvl I / X1 U BC Ttte Fbc,{25 CRcul nr a ol LD
REVISED DAiE 04111/12
DISCLAIMERT I hereby cerii, rhat all intrrmarion in is applicaton is correcl and allworkwillcomplywih he Sbte Bu ilding Code and alroher appli{abb Srab and tocat taws
and ordinances and regulalions The NHC Dev€ni Serylces Cenier willb€ notfred ofany changes in he approved phn
conuaclor 'nlorrarcn "1,,lOTE Any worl Perlom /o N c SG b Bldg o Ss00 00:
OWNER/CONTRACTOR: ..,'-f.D f/c,.)s I G NA T U R E
* * *,f ** * * * )k * ** **** * * ** *:f x * * )* ** * * * **** * * * * *'** * *,r **,r)r*,r )r,r,* )* *)*** * )*,r * **
I5 THE PROPERTY LOCATED IN A LooDPLATN? f] YEs El *o
EXISTING IMPERVIOUS AREA;
NEW IMPERVIOUS AREA:
WATER: E CFPUA
sEwER: EI cFPUA
TOTAL ACRES DISTURBED:
EXrST LAND DTSTURBTNG ernurr, I ves I--] m
5Q FT
5Q FT
COIYMUN I SYSTEJ\,1 PRIVATE WELL CENTRAL t^lE L L
fl cerurnar s PTIC
*** SEPARATE PERA1ITS REQUIRED FOR ELECT, T1ECH, PLB6, GAs EQUIPJ PREFABS & INSERTS ***tr tr HECK (payaBLE ro xHc; Iarll rccouxr ftlrlcuvrsa I orscovrnPAYT1ENT METHOO CASH
****,* *,* ***,* *** * * *,* * ,r,r,* * **
ZONE: _ OFFICE R:
Approval:_ City
Comnent:
(FoR 0FFICE USE o{LY)
SETBACKS: F: LH: RH _ 8:_
_ BF E+2ft=
N
PERMIT FEE:
'
,r,r * )*,*** )k *,f,f ****,r,r,t* *** ** * )k )r,k** ** * * )** ** )t,*,* x*,k * *,F * **** ** )t )k x:i** * *
DATE: FLooD:
A
s\\
BLOC( f: LOT s:
EXISTING CONSTRUCTION: n
NEW CONSTRUCTTOT' ! rnrCr
TOTAL 5Q FT UNDER PogP. t.'3O TOTAL AREA SQ FT:
I enrvnre seerrc ! cor4ryuNrry sysrEM
PRoIECT ADOR!S5i
co TRACToR I
ADORESST
ETTAIL ADDiESS:
DESCRIPTIOTI OF
0l SCLATUER
Subilcl to
TOT
\,VATER:
SE\YER:
Comm6nt
T
orc
City lnpeclron flcturco, 91S254{}:l
REqErvES Hr* I
APPLICA'fi'S iIA'IE:
OEVELOPER:
)tottr )1'tL
HANOVER COUNW BUILDING PERI4IT
APP L T CAT I@,1 TY"E J COIi{'1ERCIAL
PLTAs! A,.'IEi A!! QIJISTIOII5 APPTI(A8I"E TO \rc{'N PROJE'T
"ProJect Responsibilr.ty"
J r?-ta
ocauPArr/Busrt{EsS flA}rE :
PROPEnTY OfilFJS MXE I vri)
owtttR'5 AOOnaSS:
!EG€,
i"'c r J d. (Y AUT LE 'LA(,,
LL
* t , C./t\
:{. n,t!{'ud,r
RE N'VA'
ne Current Sita ?Yes
CITY: lvrql\-p c ?!ru Z1?
tl a r PIIONE *:
CI'Y:
LICEIISE sl toLY -t 't- accou{r r:
CITY: 1- r ir..r,ia-ui.!.r;
JI ,'l'
sT: ZlP 1
S 1: c,a4 t 2:
PROJECT CONTACT PETSO'I:'t
EXrST COXSTnUcTlotl: m
ll Relocatlon, is lhera a Nstwal Li
IAT
on
loN
lhe
T
c t2 ?sr' tLzrPt ?LLt
PloxE r: _L:i_lL:8
PK)tlE Sr qli.t'il 1i-t/t?t
r{Er{ cor{sTRt cTro r fl ERE lEll sTRTKURE flrsr rmcr f] sner'r' I uerrr I ADo ro rxrsr srRt €ruRE
ACCESSORY 5TRIICTURE I
If UPfIT - ThE ,hEII t f:
rs THrs A clrrr{68 or occuplrcy use r Slves E ro *..'
oc(up.ncy iy?c? CaF, ba\*ap l&at t! th! iltt occup.n.y Type
ION tr GEN E R E p At RS u R ATION
tr D NO B L DG SPR NKL EREO'tr YBS E NO
Is Elect Porer on thts Euilding EI Yes E m
IF Yes, Ltat ras the P
ancx oEsIOI PRoFESSrOtlAl!
EHGR DESIGIJ PROFESSIOTTAL:
LloRk: Rt
O!VhIER/CONTRACTOR
(a!6,,..,
ACRES DISTURBEDT l,
NEW IMPERVIOUS ARE,u
zoNE: R (3 OFFICER:
Appr$€l:- Ot)r
r *(..,a.
4l:1.
ls food or brvqa!€3 lroprasd o.tn ft18 !'rrm{E? tr Yes frt uo r lr e-pcty Locded In Tbs Fboqah? n Yes El No
sralc Buil(sig code rrd(tunl€s itr rt'€ aDorcvodwii t,G n Y'olal'on o, $E l,JC Srar.Bldg C.ae.nd
Slaleall
t5@.00"'
@."LSIGT'IATURE:
Nor.: D.moll&n iatiiadclrr I alb6roa
(,nr.h arb.$t o. llot You .,r 'tq&td nl. N.!o.l,l EmEtho 9and.r6 brlE r{orE Ar troIsE.s {NESHAP) .l {91qm7{5'$) d b.n 10 dlyr ![to, b 0r.
!.int.?dk r,'rfl $, $ b. rt&nh.d utl4 t'. .rdl€.lhn lb,m (0Hl1S-3?88) 'rn'tl.r 0t. hd[ry or Mldlll| }rr hl,{ i]o
deio&on ol .n, h€iiy or hrtsl!'. S..vt.b sli.r ht!p/w.s9l.ei!r..trcJsr.9u!rb€616,hhmp.htnl
AL PROJECI COST: J9
TOTAL AREA SQ FT :SO FT PER FLR;- tot STORIES
TOT,trL SO FI UNDER ROOF:f OF STRUCTURES: _ #oFFLOORS;_
E(sr L{ND DtsruRBrNe eenurn fives ffi ruo
SOFT E(IS]]NG IMPERVIOUS AREA
PROPERTY USE: I]OFFICE RESTAURANT $uencervnr-e [eorc f, err lcoxoo orxe*
EIrr1
CFPUA
CFPUA E SEPTIC
SYSTEMu -!r'EII
PRVATE SEPNC
r t ji[ctir'l() f on e)-Eal. r,{t clr. Pi&c. c,q LcvEr,.aiiFAS$ I lf rtl i} :1} f ,
SO FI
orEcK (pAyAaLE ro xxcl fieulmuur filuouse f]orsc-,oven
(FOROirrcE USE O tY)
N
PEqMiT FEE: 0
It ' {b-
APPL ICAT IOI{
t{llfibcr
(otfl(. Ut?)
DAr!:-f;./ls;i.f
PtloflE t:
,'' ! :\
.,,&l
PAY'IUENTMET}IOD: I]CASH
PH: IC RE6 t:
P+I: NC REG *:
f OF UNI'lSr
Dzor{lNc usE cusstnc^TtoN:
E cofrrMuNrrY sYsTEtr
B€!.6EDO lE,lfl1at2
u\
DEVE LOPER:
PRO]ECT ADDRESS:
OWNER,S ADDRESS:
CONTRACTOR :
ADDRESS:
EI'IAIL ADDRESS:
DI s IMER
nd local
S
r change
ubiect lo
WATER:
SEWER:
Appro\ral:-
Comment:
APPLICANT'S t,IAflE:AT L)n-
PROPERTY o[',NER'S t'lAlilE :Drv ,B U,rCrr !t rL A)
A,cruoor L
or contraclo
$500.00*'
ANOVER COUNTY BUILDING PERMIT
aPPLI'ATI,N TYPE: COliilllERC IAL
E AI'ISI,JIR ALL QUESTIONS APPLICABLE TO YOUR PRO]ECT
"Project ResPonsibility"
ruDe
lr rY CITy: tJ r ua,a: c 7lral
ak 3ee
omt:.P!--l!2
ZIP:_
P$NE *t q)0't t2 317 ?
vED n4fi 1&t\frEgl
Aolto )+1L
APPLICATION
Number
(Offt<e Use)
Lr EGe D
OCCUPANT/BUSINESS t,IA E:U F :Jea(ou LE.T
2)LLL LrcEr{sE *:t tY I 2- AccouNr *:
sIt LLztPt Z!!/oS
t
CITY:L \ -rl..t ^) t 7'D ^)o lZtL
&e,uv\
PRO]ECT COT'ITACT PERSON:o .*LDe D6.,/L
c all That apPlv
EXIST CONSTRUCTION: E ALrE I ON n R ENOVAT ION tr G ENE RAL
lf Relocation, is there a Natural Gas L e on the Current Site tr n
th at al inlorm
AI R5 n R E LOCATI ON
Yes tr
s: llt)- z-t? -
N o
Staie
PHONE
PHONE
RE
PH:
PH:
P
?Yes No
NEW CONSTRUCTTOfl, I enrcr srRUcruRE ! rasr rmcr I sxeur- [ urrrr I aoo ro Exrsr srRUcruRE
ACCESSORY STRUCTURE:
Is Elect Pouer on this Building E Yes E l,lo
rHrs a cHAI,TGE oF occupANcy usE? EIYES flto *****
upancy Type? CoFF Lr, Sts.oP what is the Ner', occupancy Type?At"i )a rt_
NC REG #:
NC RE6 #:
BL S P R NK LE E D?BDGR
rf UPFIT - The Shell Permit
*,r*** I
IF Yes, what was the PrevLous
ARCH DESIGN PROFESSIOIIAL:
€NGR DESIGN PROFESSIOML:
DESCRIPTION OF h]ORK:ato p€A rla,l-rl Fo.s,ur
ls food or bsverages Prepared or tn $ts shtdure? n ves frl No b rhe Propeny Located ln The Flooddaln? fi v". ffil r.ro
I hereby ce fy
and ordinances nd
lding Code a d olher appli Slate
n the aooroved
Vrolatioi of the
olan
hrc
nd
Bldg Code andconlraclor
Fines Up T
OWNEF/CONTRACTOR:D crr asE- O 0-SIGNATURE:
(Pnnr Nrrn€)tqual 16r)
Note: D.molltlon notfcadons e asMs permh appllcadons 6lr to b€ subnltlod uslng the 6pplicatJon brm (DHHS-3768) whetEr tho fedliv or bulldlnC wss bund !o
contaln Asb€stos or not You sre r€qullDd to call NstonslEmlrslon Standsrds br Hazardous AlrPollubnts (NESHAP)et (919)707-5950 ai l63s110 days p.lor b th€
d€molhion ot 6ny fadllty or bulldlnC. S€o Web Sho: hiF Jr!'/wv..epi.slst6. nc.uJepi/asb€slorahmp.hltnl
TOTAL PROJECT COST:J U BUILDING HEIGHT:# OF UNITS:
TOTAL AREA SO FT :SQ FT PER FLR:# OF STORIES:
TOTAL SQ FT UNOER ROOF:# OF STRUCTURES:# OF FLOORS:_
ACRES DISTURBED o EXST I-AND DTSTURBTNG pERMrr? - yES El NO
NEW IMPERVIOUS AREA:SQ FT EXISTING IMPERVIOUS AREA:SQ FT
PROPERTY USE: flOrrrce !R$rT EIMERC,ANflLE EEDUC flenr lcoxoo OTHER
CFPUA
CFPUA
tr USE CLASSI FICATION
PRMATE SEPTIC coM MUN ITY SYSTEM
"'SEPARATE FERI'II'J ITECUIRED FOR ELECT, MECH, PLBG. GAS EOU{P. PAEFABS 8 IIJSERTS ''
PAYMENT METHOD: flcAsn oHECK (PAYABTE ro NHC) EBIII ACCoUNT EMCMSA B orScOwn
(FOR OFFTCE USE ONLY)REVISED DAIE {/I 1/12
ZONE: OFFICER:SETBACKS: F:-LH:- RH:- B:
FLOOD:- BFE+2fr-
N
o
EIE trE COMM
SEPTIC
SYSTEM tr WELL zoN ING
PTONE *:
CITY:
-
ST:
-
zIP:-
I
,,L
r\Eh
PERMIT FEE: $_