SEPTEMBER 26 2015 BUILDING APPSAPPLICAI'IT'S IIA"IE:
DEVELOPER :
NEhI HANOVER COUNTY BUILDING PERMIT
APPLICATIO1I TYPE: RESfDE TIAL
PLEAsE AIIS}IER ATL QUESTIONS APPLICABLE TO YOJR PRO]ECT
-Project Responsibility"
ffi) touirzumu,<.-
Aot'-qlu
APPLICATIOT{
tlunber
(Offi.e use)
oorr', 8)c/rur
PHnE *: dg'zl >z
PRoJEcr ADoREss: lZt4 lA%9- UICH W,CrTtt1.t*lCtlul/CTU,t-/,<
EUAIL ADDRESS:PtOl'lE *:
SUNROOT4 5F STORAGE SHED
suu)rvrsro : !,lQ?a{. Errlo}t BLOCK #:_ LOT #:
PRoPERW ouNER,s 1{A E: C*fie SfJeOU)PHq{E *: 262'OqlZ
tZtI Q?qc+ tu*rt >L crtv:qttLctruv6O!.4 srt r,.-zrpl.aEVo?
cor{rRAcroR: ffi au>rnacnort LICENSE *:tl,os
1Yt 71Pr?818
zz? tt;Z-ArDREss: Z?oo fit (A? GA crwt El9U@ ST:
PRO]ECT CO{TACT PERSON:)aru 5"t*T yTzgaa Plu{E *: Zd Zl>?
Exrsrlr,rc co{srRucrror{: I alrrnrrrou ! nercverroH f] cerenal nrearns f] RELocArroN
NEt{ COI{STRUCTIONT ffrntCr EH RESIDET{CE or ! 4p,p1116X TO EXISTIT{G RESIDET{CE
T**PLEASE CHECX At{D ANST,ER BELOi, ALL THAT APPLY TO YOIrR PROJECT:
ffirr canrer L'tcl s, ! oer oanrce sr f] eoncx
-sF
tr SF I eoor-
zrPt &o?.zL ?lu></
fl cneerurouse @o EcK L-72 SF OTHER:SF
SF
SF
rorAL HEATED se Frt ZSDO rorAL sQ Fr uNDER noorz 78/L rorAL AREA sQ Fr3 16?)-
TOTAL PROJECT COST tres" roo t $ br,w.o" # OF STORIES: 3
Is Any ILECTRICAI-, PLUllEIilG or I,IECHA{ICAL Work Being Done to the Accessory Structure} [ V"s ff f'fo
If the project is a ReLocation, is there a Natural Gas Line on the Current Site? f] Ves [ ruo
Is there Electrical Power on this Building? l-l ves l-l ruo
ANCY: FSTNGLE FAr'lr L
kDr sNt4d
PROPERW USE / OCCUP
DESCRIPTIO OF }.IORK:
Y DUPL eX ! ro,{ruxOUSe
ebOe,r€funucl
6nd ordinances and regulalions. The NHC Dev€lopmefll Servjces Cenbr willt e notfied ofaoy changes in ho appo\€d plans and specificaiions or chanoe in
IS THE PROPERTY LOCATED II{ A FLOOOPLAII{?
EXISTII{G II'IPERVIOUS AREA:
-sQ
FT
NEI{ MPERVI(xTS AREA: _ SQ FT
conracbr anbrmaton. '-NoTE: Any work Performed wo he Appropriare PemiE$/i be in viotatjon oth€ Nc stab
OWNER/CONTRACTOR:SIGIIATURE:fi>
* *,*,r *,r*,*** + * + * * * * * * * ** * ** * *(IiTl Jil"J ,f,* )r,r** +,i++ rt,t *,** *,t *,* )t* *r:l rt+ + *,t*** * * +:i,t + + :t,t *,i ,t,t,* {. :} * + + ++fives Erc
TOTAL ACRES DTSTURBED:
EXIST LAND DISTURBING PERIiTIT:J-l vts fl no
MTER:
SEUER:E crrua I co]ruNrry svsreN I pRrvATE r,lELL f] crurnal well
creue f] cENTRAL sEprrc fl rnrvare seerrc ! cofil[rNrw sysrErrr
*+* SEPA'IATE PERNITS REQUIRED FOR ELECT, I{ECH, PL8G, 645 EqJIP, PREFABS & II{SERTS ***
pAyr{E]{r r,rEr]oo: I crsn I cxecK (PAYAELE ro r*rc) f] otrnrcAt{ ExpREss I ncTvrse ft orscwrn
*:a:i*+)i:i+ri:t+)t,t:|,r*{.**)r)i:a)i*t++++++ri)i,t*,t,},r,})htt+:}+*rt***,*,*,r,*,r,}ri,r*++**,*,t,**)***++:t,tt+**,*,r)i***:}*++
ZoNE: _OFFICER:
(FOR OFTICE UsE orr[y) REVTSEO DArE O4l11l12
SETBACKS: F:_ LH:_ RH:_ B:_
Approval:_ City:_ DATE:_ FL00D: _
Cdnent:
BFE+2ft=
N
PERI,IIT FEE: I
$--.-
&
OtiltlER'5 ADDRESS:
N\IU
PRO]ECT ADDRESS:
SUBDIVISION:
CONTRACTOR:
ADDRESS :
Qt "t -)t / - -l-ca(
NEW HANOVER COUNTY BUILDING PERMIT
APPLICA|ION IYPE: RESIDENTIAL
LEASE ANSWER AtL QUEST]ONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibility"
CITY:
BLOCK *:
L
CITY: _ST:_ZIP:_
?
APPLICATION
Number
(office use)
,orr,'f tJ- t7-APPLICANTJS NAIiIE:
DEVELOPER:PHONE S:
ZIP i
LOT #:
PHoNE #: q/2'r"/?/zZZ
Et TAIL ADDRESS:
.,2!G,,, Z ?az
q rt-zb-/- -"s77)-
l ta'z.z-tvt4
LICENSE
ST
PHONE f:
1/ nnne *:PRO]ECT CONTACT PERSON:
EXISTING CONSTRUCTION:TERATION R ENOVAIIO GENERAL REPAIRS RE LOCATION
NEW CONSTRUCTION:ERECT NEW RESIDENCE or ADDITION TO EXISTING RESIDENCE
**PLEASE CHECK AND ANSWER 8ELOI,{ ALL THAT APPLY TO YOUR PRO]ECT:
r GARAGE _ sF ! orr canace _ sr E PORCH SF
SUN ROOl"l
GREENHOUS E
TOTAL HEATED SQ FT:
conlractor inlormaton. "^NOTE: Any
OWNER/CONTRACTOR :
DECK.VD SF OTHE R:
wrl in Violation ol the NC
SIGNATURE
2a/SF SF 5F
5F
STORAGE SH
?OD
rorAl PRorEcr cosrrressrou , t /4mA2 f oF sroRrEs: Z
Is Any ELECTRICAL, PLUIIBIiIG or I{ECHTINICAL Work Being Done to the Accessory Structure}
a Natuna-tr Gas Line on the Current Site?
gr ffies ft Ho
flves [ ruoIf the project is a Relocation, is thene
Is there Electnical Power on this Buildin
TOTAL 5Q FT UNDER ROOF:TOTAL AREA SQ FT:
-Yes tr No
BFE+2ft= _
N
PERMIT FEE: $-
PROPERTY USE / OCCUP INGLE FAl"l DUPLE USE
DESCR ION WORK:/-//'4r<C.z
DISCLAIMER: rherebycer!tflatall inbrmation in this apphcaton is correci and a[ workwd compl ywrh ihe Stale Burlding Code and allolher appticabt€ Slale and tocattaws
and ordinances and regulaiions. The NHC De nl Servrces Cen ychanges in lhe appro!€d plans and speciljcations or change in contracloror
/o rhe ".""^*ffim'W;*:r*=
***)* ++* ***)r **** *** * *** **** *(I itli Jil"J * * **** *** * *r* ** *
rs rHE pRopERTy LocarED rN a rloooplarru? l--'l yrs
EXISTING IIVIPERVIoUS AREA:
-sQ
FT
NEW IIVIPERVIOUS AREA: _SQ FT
* ***,*+ )r * + * )i * )***,*,i *,i * ** )t ** *,* * * * *,t,i
NO
TOTAT ACRES DISTURBED:
EXIST LAND DISTURBING PERI,UT:l-'] vrs l-'] ruo
WATER:PUA ! conuururrv svsrrm ! pRrvATE wELL ! cerurnar wrrr
SEI,IER:creua I cENTRAL sEprrc I enrvnre srerrc COMMUNITY SYSTEi\4
ZONE: _ 0F FICE R:SETBACKS: F:_ LH:_ RH:_ B:_
Appnoval:_ City:_ DATE:_ FLOOD: _ _
AV
Coment:
*}* SEPARATE PERI1ITS REQUIRED FOR ELECT, INECH, PLBG, GAS EQUIP, PREFABS & INSERTS ***
pAyr,|EHr ritErHoD: I cas+r flcxecK (payaBLE ro trc; I anenr.* ,rr*ri, El nclvrsr ! orscoren)k*** + + * ** * * *,** * )t**)k ** * **+* ** )*)k:t*,*,**+)*,t* ** *+* )k )t:* )*,** ++ * )t** *+*,tx,i )t* * + + ,t,t * * ++* * ***,t*,f * ** *)* * )*
(FOR OFFICE UsE OIIIY) REVI5ED DATE O4l11l12
,-1-:'.,':' i. ''.'..
,l &--'\i-l
CITY:
tr
PROPERTY OWNER'S I,IAIi|E :
OWNER,S ADDRESS:
tr
\2,,,,
NEW HANOVER COTJNTY BUILDING PERMI
awLICAfidt rYPE: RESIDENTIAL
PLEASE ANSI,JER ALL OIJESTIONS APPLICABLE TO YO{JR PRO]ECT
"Project Responsibility"
AaFr-llzq
APPLICATION
Number
(Offi.e Use)
APPLICA T'S t,lAfiE:
DEVELOPER:
f\6(w gF
PRO]ECT ADDRESS:
SUBDIVISION:
CONTRACTOR:
ADDRESS:
EfilAIL ADDRESS:
PROPERTY OITNER' 5
O}INER'S ADDRESS:
rinr,lr: 3\euen {t{.r.i"-f,i Y\€)
i wr. Q.. C D^,\
t L,\-,r\\E
DATE :
PTONE *:l"
zrP:3B{OS
350
PHONE #:lto- 5a, -to
sr:u{:zrP: a8.tof
sriEzrpillsot
PI0NE *: q\q -&e8-tLtla-
proNE #:qq-&-g-\ql:
:
CIry:
U\e BLOCK f:LOT #:
,}c
l>
on.e
Lor
CITY:
LICENSE #:Gaq+q
CITY:eris€
PRO]ECT CONTACT PERSON:
EXISTING CONSTRUCTION:ALTERATION RENOVATION fl crnrnar nrearns ! RELocArroN
NEI.' CONSTRUCTIOH: f] ENECT NE}I RESIDE CE O" ! AOOTTTOI TO EXISTING RESIDE CE
*TPLEASE CHECK AI{D AI{sI{ER SELO}I ALL THAT APPLY TO YOUR PRO]ECT:
DSor co*e, 54-l sr I orr canace sr leoncr
I surunoom SF
PROPERW USE / OCCUPANCY:
DESCRIPTIOI{ OF HORK:
PooL _ sF
DECK SF
STORAGE SHED
t3i sF
SF
5FI eaeerunouse SF €flrt
TOTAL HEATED 5Q FT:qq rorAL sQ Fr UNDER noop:1323_ rorAL AREA sQ Fr3 +3J3
TOTAL PRoJ ECT €OST (ress ro0 : $ 3 (dC\ OC,I2" cO # oF STORIES: A
Is Any ELECTRICAL, PLUIIBIiIG or IIECHAIUCAL Work Being Done to the Accessory Structure? fl V"s IIf the project is a Relocation, is there a Natural Gas Line on the Cunrent Site? [ Ves
rs there Etectrical power on this Building? flves l--'l ro
E*o
t r*o* rar.rrr-v !
No
DUPLEX T0I4iNHOUSE
1momLl.)coo
m
DISCLAIMER lnercby certit that all inbmation in tiisapplicalion is correctand att
and ordioances and regulations. The NHC Development Services CenErwittbe noi,fied ofanychanges in he approved plans and sOecifcarions or
ZoNE: _OF FICE R:
ApprovaL:_ City:_ DATE: FLOOD: _
Coinment:
work will comply wiih the State Buitding Code and a[ orher appticabt€ Siaie and tocat taws
m conuacbror rtl
To S5O0 O.r '
BF E+ 2ft=
N
conlraclor inbrmalion.'r*NOTE Performed wo lhe Appropriaie Permits wi be in viotation oflhe NC state
o!\lNER/CONTRACToR 3 l-.^ E.\JE SIGNATURE :
(print Nane)*********+******)*******+*+*********+++**)t*****+*+++!t*****,**+)t*,k******+*******++*++******
rs rHE pRopERTy LocATED u{ a rlooonmrr? [ ves
Exrsrrt{G rr.rpERvrolrs aREA: O sQ FT
NE,,. rMPERvrous **,@ri .,
col4riluNrw sYsTErvl n PRIVATE bJELL CENTRAL WELLI{ATER:
SEWER:
CFPUA
CFPUA CENTRAL SEPTIC
ffirc
TOTAL ACRES DISTURBED: O'9i
ExIsT LAND DI5TURBING pERfirr: l-'] veS fl ruo
! enrvlrr srerrc tr COMMUNIW SYSTEM
(FOR OFFICE USE OiILY) REVIS€D DATE O4l11/12
SETBACKS: F:_ LH: RH:_ B:_
*** SEPARATE PERMITS REQUIRED FOR ELECT, IIECH, PLBG, GAS EQUIP, PREFABS & INSERTS ***
paylrEr{r rirErHoD: I casn I crrcK (payABLE ro 1rc1 [ uenr*n ,*r*ri, fi ncTvrsn I orscovrn)t:i*'t******:i:i*'******)r**********,i*:******+,t,*.****+:*jl::t*,*****:t,t*****:!:ajt'**:t*:t:t )i*,t ***+:a*,** * ** * +,*
PER IT FEE:
NEI{ HAIIOVER C(UNTY BUILDING PERIIIIT
aPPlrc,-rro rY"€: RESIDEI{TIAL
PTEASE AISTGR Alt Q[r€STloras APPLTCAaIE rO \qn PtolccT
-Proj.ct Responslbllitf
APPLICA T'S MIIE:
DEVELOPER:Oc een BIue Poola end SDaB of NC
PROIECT ADDRESS:531 Brookbend Dr cIw: wilnlnqton
}os 4tzq
APPIICTTI{}{
tLder
(Offlc. tl'. )
Plo E *: 9to -'t99 -3022
SUBDTVISIot{:
zIP:28{11
BLOCX *: LOT *:
910 -29't -0035PROPERW O'{ER'S M E:Liaa & Jo6h Xlcmner $
s
PIO{E
{ER'S AIX)RESS:531 Brookb.nd Dr
CO{TRACTOR r ocean Blue PooIE SDaa of NC
ADORE SS :30 Covil Ave
CITY: nilmiaqton T: g ZIP:l!3l]-
sT: Nc zIP: 28{03
LICEIISE l: ?3 ?Go
CITY: tlilrdngtoo
EIIAIL AIDRESS I oceaibluepoolsahdspesoyahoo. com
PROIEO COITACT PERS(I{: Pauline Dunne
Exrsrrrre coslmrcrror: fl rlrrurror I nercrrarror I e:ntur- nrrtns ! RELocArrot{
rEx cotsrnucrrqr, f] rnecr xEr rcsrDElGE or f] rmrrror ro ErtsT E iEsroEIrE
..PIEASE C'ECI Alo IffiI IELO' ALL IIiAT IDPLY M TUN FIO]ECI: AI rrr eaure
-
sF ! otr cruse sr ! nono
-sF
RECENED! zuntoo,r
-sF
@ roor.;3s- sr ! sroamr sHEo
-
t.iffi' ft ZO1S! eneelno.rsr
-
sr @ orcx 394 sr oTHER:
-
sF uuL" r ----
roTAL |{EATED SQ FT:
-
TOTAL SQ FT rtDEi Rq)F:
-
TOIAL AnEA SO rr, fu
TOT L Pf,OIECT CqST[-€rr0: t -4..29,q.9,!- * (tr STfiIES:
Is ArDr ELEC?IICAL, PUFtre o. ECI{IICAL raoik B.lng Done to th! Acc!5sory StructuEl I V"t ! ffo
If the proJect ls a Relocatloo, 1s th€r€ . t{atural Gas Lhe on the curpent sltel I ves [ rc
rs there Electrlcal Pfler on thls Bulldlnti I ves fl ro
pneERTy l,sE / occlp$cY: I srrcle rouLv ! ufl-ex E rouraousE
DESCRIPTIOII Of HOR(:
DBCLAxER I hoGby cortily tlat .t hbrrn.rbn h hi. at E.aon I co.r.cr !a worl*il coflfry rih tr! St l Boildhg Cod. rn .l oal.r eplc* Sbb in rrc.l bt .
,rd o.dhac.5 rtd ,lguLtrxi Thc l.tic or\i5p.rlGnl S.ryh.r C.llbr $[ b. mtt d ol try dslge. h ll. Tr.o\.d
conftor irbm.loo. "'tlofE: Ary$ro.r M WO tr. app.opr't ag.cnI!wllb€hvlobtonoft NC Sri dn slrbFl lc
CII{ER/COITRACTOR I oceaa BIue poota ar:d spag SIGMIURE :
r* r* *r*.r.. * r r r,r. r.... * r.. J!!!i,lEJ *a a'tat:ta*a *a+:aa,tt:t *a t a r * ta* al *'t, **raa *a*t*a:l *:tlr:t,|*1t i
** *{ 1:}* I tl'} * *** *:}l:}:}*:l1a'l***lt *** **,**all* * * *,1:l:t t:}:}:t t t *:t ****)t**1*+ta *****a***t* *:},t* ***+ +t
ZOfiE : _ OFFICER:
(fc ofFlct rr5! (n-Y) ttvlt@ uE oaltllu
SETBACKS: F: LH: RH: B:
Approyal:_ City: OATE: FL@O: _ _ 8FE+zft. _
^
--
Pr{nE t: .WJ22:J922_
PHr E *: 910-799-3022
Cdment;PER TT FEE:
,.
ocean Blue Poo16 and spas of Nc DAIET -91J2!E
rs rHE IRoPERW LOc ?O !X r rrOeUrrl ! ws E p
EXISTI'6 I,IPEiT'Iq'S AREA: LSQ FI IUTAL ACiCS D!iTUiAED:
xEI IpEm,IqrS AnE : L rQ FT ExtSI L rD DISIURTIF PEiirr: fl VeS E rO
rarER: fl crnn fl co rrrry svsren f] pRrvATE lrErL ! cerrmr- rrlr-
SEHER: fl crrur ! cErrRAL sEprrc I enrvrre srerrc fl co$r.nrry sysrE4
.*. sEpA,laTE pcx rls REqJTRED FOi Et-CCr,
't€CH,
PLB6, GlS EqrrP, piEFAAs & rirSEiTS ..r
p^yxErr rErHD; EI crrl E orrcr (payallE ro rr) Elrm:cr rpnrss ff xmsr Ef orsovra
a
A
0llftr33;?
:T JI'L
NEhI HAT{OVER CqJNTY BUILDING PERMIT
APPLICATI(N rvPr: RESIDENTIAL
PLEASE AIISIIER ALL QUESTIONS APPLICASLE TO YOUR PRO]ECI
"Prqject Respcrsiblllty"
e0|S qb7
APPLICATIOf{
,ftf,ber
(offi.. tk.)
APPLICAI{T'S TIAIIIE:
ITEVELOPER: N/A
New Leaf Buifdeis rnc OAfCt aa/ a9115
220 Qeekwood Road CIry: wilmingEon
PHONE fl: 910 .3 6a lo27
ZIP: 2a41tPTOIE CT ADORESS:
STBOIVISId{I NIA BLOCK H:
PS0PE RTY (}I ER'S l[tlE: Prank iL rard
OliER,S AoORESS: a936 Tilbury Road
q)NTRACTOR: Ne\4 Leaf Builders Inc
ADmE SS: 415 s 4Lh sL #1
LIcEr{SE S: 68e51
CITYi Carolina Beach
TOT H:
PHG{E H: 910 233 8oo0
ST: NC ZIP: 2 8411
ST! NC ZIPi 28428
CITYi wl lndnqLon
P ,, E H:
P}O E B:
910-354-1027
PfiO]ECT CO TACT PERSOI.I
EX IST IIG O)'ISTRTJCTIOiI:
Shane Keenan 910-364-1027
f] mrrnnrron I nenovarror'r !GTNERAL R,IPAI FS RE L OC ATI ON
flEr{ @t{sTRlrTlofi:
.+PLEASE CHECX AIID AI'sUR B ELOI{ ALL TfIAT APPLY IO YOUR PRO]ECT:
I rrr cnucr
-
sF f] orr crnrer rsg!-- sF
f] sur noo,nr
-sF
I eoor
-
sr
I cnrrrunorsr _ sF ! orcr
@,taro, !,rEr,r REsrDEr.rcc o. f] lmrr:ot* ro ExtrsrIts orurorr.r,!$p!rr3 lrt'r
SF
f] poncr
-
sF
! sronncr sHED
-
sF
OTHERT SF
TOTAL HEATED SQ FT: _ ToTAL SQ FT LI!DER R@F: _g3p_ TOTAL AREA SQ FT: 1680
TOTAL PROIECT COST(LessLoo : $ r:rooo.oo # OF STORIES:
Is Any ELECTRICAL, PLUllBIiG or !4ECHA ICAL rlork Eelng Oone to tie Accessor.y Structure?I ves I uo
If the project is a Relocatio.r, is there a tlatural Gas Line on the current site? [Ves [ ruo
Is there Electrical Pourer on this Building?[v.. ljil tlo
PRoPERW IJSE / occlpaircv, I sr*crr FAr,4r Ly fl DtpLEx E To HousE
DESCRIPTIOTI OF iIORX: L\eLached - Garaoe uoit 42x40 fooLprinL
O{SCI AllER therebycertv h d oll h lormarion in lhis €ppicslion is m@d ed dl wo& will .omplywi$ rhe Srare Bridinq Code ard dt olirer.pdic6be Stale ard t6d lall,s
€nd ordnd'es Rrd rcgula{ons. The l.lHC Devdogn€nt SeNic€s &nB \41llbe nolilied ol trych ges mthe spproved smd specricdbns orchE[]9e ir contrsatrror
conlreat r rniomsIG. ""$ETE:Anywo* turiomed WO fie r'.ppIopriaE Psmitswi be n Viotdion ot ihe NC Siab Code ar d Sr Lo{l{ER./colTRAcToR : shane Keera!,SIGMTURE:
(!rirt,rane)**r**rx*i:x***r,r*rx**x**x*i*rx:**:**r*:x*xx*xr****xr:i**r***xxr*:*****x***:**xx+***x*r*+
IS TI{T PROPERIY I.OCATED III A FLOODPIAIH? E YES I L
EXISTIIS IIIPERVIdTS AREA: 0 SQ FT
NE!{ II,IP ERIIIGIS AREA: 1680,oo sQ FT
hATER I creua f] com4t rry sysrEfi n pRrvarE t,lErr E CEiITRAL WELL
sEhEfi: fl cFpuA E cEr,tTRAL sEprrc pRrvATE sEprlc I comuur rw svsrrm
... sEpalaTE pERilITs REQUIRH) FOR ELECT, itEo{, PLAG, 6A5 EQrrIp, pREFAas & Ii6ERTS ...
payoEr,JT rur ETF(}0: E casn E crecx (PAYABLE To rtcl I emenrcor enness E rclvrro E orraour*
x* ** )k x* x,xxx **x x xx x,r x ** * ** x ** x * x* * ** ** i( xx * ** *** x* x xxx !*x* * ** x xx x x* ** x ** x*** * *)r xx * *)t * *x xx )i x
IOTA I. ACRES DISTI.RBEO: ,038
EXIST LAID DISTIRBIITre PERT.IIT: I VIS T-I M
(FOR OfFICE USE OTLY) R6/I5ED DATE O4lr1l12
SETBACKS: F:_ LH: Rlt:_ B:_Zolil E:OF FICE R:
Approval:_ City:_ DATE:_ FLOOD; _
A
B FE+2ft=
\C.Gnt:
e
g,lAll, ADORISS: shane -keenan@yahoo. ccm
0(f1 7Ot5-q1rt LNEW HANOVER COUNTY BUILDING PERMIT
APPLICATIo|t rYPf : RESIDENTIAL
PLEAsE llrsvER ALL QUEsTIOIs APFLIC_ABIE TO yqJB piOtCCT
"Project Responslbllttf'
ousH PtloNE f I
ST llLzrP I
?st 0rr
tl
/5o
APPLICATIOII
Number
(offica ure)
APPTICANT'S NAI4E:
DEVELOPEN I
tt)5r6tY $e\L;-o .V-t,tL6-4 t-Lc
PRO]ECI ADORESS:
SUBDIVISION:
?tt\ CB6S|VJ lKWf crrtl
OATE:
q()
ZLP | _
PROPERW OI{NERJ S iI,AME:
OLINER'S AODRESS:
sr
.)P Utc tJ
ITY:/L
(
CONTRACTOR:
ADDRESS:
Ef,gsE #:
C ITY:sr | _!qll? |
EI4AIL ADORESS r )- . C-gt'/.,^- P[0NE *:D 1a
PRO]ECT CONTACT PERSON:Ja eo bV 4tps PHONE *: t4
EXrsTrNG CO}TSTRUCTTON: E ALTERATTON @4eruOVArrOn IeerVrRAr neearns I RElocaTror,l
r,tE|l.] coNsTRUcTroN: fl enecr NEt.] RESroEr{cE o" I aoorrrol To ExrsTrrc RESrDEt{cE
rrPIEASE CHECX AND AflSlilER BEL(},{ ALI- THAT APPLY T0 VoUR PROIECT:
! nrr camcr _ sF DET GARAGE
-
SF ! poncr
-
sr
SUNROOT4 SF SToRAGE SHED _ 5F
f)
! cneeuous: _ sr
! eooi
-
sr
DECX SF OTHER:I 5F
ToTAL HEATED SQ FT: _ ToTAL SQ Fr [r DER R00F:
-.-
ToTAL AREA SQ FT: _
T0TAL PROIECT COSTrss6Lor) : $* OF STORIEs:
Is Any ELECTRICALj PLUIiIBING or IIECHA!'IICAL lro.k Being Done to the Accessory St.ucturel ! VeS I HO
If the project is a Relocationr is there a Natunal Gas Llne on the Current Sjtel IV.t [ ruo
Is there €lectrlcaL Por,{er on this Building? [-lves Eruo
,?
PROPERW UsE / OCCUPAiICY: ffsrnere rnmrlV ! oUnrex ! TOWI,/HOUSE
DESCRIPTIO OF 11OR(: R,J,^,'O UI *.t:e K \YLHku
^9€L) CX S / !r €TS a- T'ws -/l,Lt c4)
^-
f- rs*,b til6 tlo"l.-t(+u €t€c-TLtoAL <-t+ 4',,i Ct4
6nd ordhonces and r.gollrbrs.Ihe NHC tr6v€Ioprnanr S€rvic€s Cenler witT b€ m01t.d ot any.hmqes tn Ue sp
contacb. ln b rms0on "'NorE:Anywort Pe.romed w,o tEtppropriac pem rs wil bctnvtotJbn ollhe Nc
Dlrns and specifaalons o- Errange in .ontccrf ol
s ro55@C{ .
OI,INE R,/ CONTRACTOR :Jn lf(dv*<>s SIGi'IATURE r
,*** **r,la1* * * i * **...----.- -(!l'I l,l ir,l* r,x,r +* **++ +*
rs rHE pRopERry LocaTEo rN a rroooelarrr fl ves
EXISTIIIG IIpERVIoUS AREA:
--SQ
FT
tlEtt IMPERVI0{JS AREA: _SQ FT
TOTAL ACRES DISTURBED:
*ffK*****.r
cE,rRAeft/$qnscri0f, frww,
p I
** **r****** *+]t *** **,f ***
€RTs ***FABS & -INsM,,,tr DISCOVEfl
til54"twl
WAIER; E.CFPUA
SENER: WFqUA
*r* s
PAYI,IEI'TT I'IETHOD:
zorr; fLif orrrcrn:
AoDroval: Citv:
Exrsr LAND DrstuRBrNG ernnrr: I vrs f] Ho
A
f** * * *a ** i r* t ** r*** *** **** *** * ', '***,r+* **** *rr** *** * *,1,k ***,N *** ***+r+i+ * )t* * * *.* +** **r* s*s* *r
c0r'1l4uNI ry 5Y5TE!1 PRIVATE },JE t L tr! cerurnal srnrrc I PRIVATE SEPTIC
TI"CRATE PERJ4ITS RTQUIREO TOR ELECT, MECHJ PI'8G' GAS E QUIPI PRE
Ecqsn EcHrc* (PAYAsLE ro r/Hc)tr AI,IERICAN EXPRESS
SETB
I(E usE q!LY) t I I t q(vIsED DAri g'lll/12
ACKS : F: lar- tq:.i! Aa: _yl O: _y!_
FLmD:
-
_ J BFE+2ft- _A v -;- -
brr,. onrr q
Comnent:ND gzPur 5,a,)
r{
PERHIT FEE: ,-
BLoC( f: _ LoT fl: _
P}ONE f:
PRO]ECT ADDRESS:
SUBDIVTSIO : BLUE PO\NTT
NEW HANOVER COUNTY BUILDING PERMIT
APPLIcATIott rvPE; RESIDE TIAL
PIEA5E AIISWER ALT QUESTIOI{S APPLICABTE TO YO('R PRO]ECI
"PrcJect Responslbilit!d,
N\\r-r oR(
\Jr€R-CIry: W iLM rN €,'T ONJ zLPtT=jltJL
BLOCK *: LoT #:
PHO{E f:to (16 Bbsl
sr: I).ll zIP: ZUq l/
lors- Qtz4
APPLI CATIO
ltu[lber
(office Use)
APPLICAI{T'S tJA E:
DEVELOPER:
DArE: q-q- l5
PHO E *:
PHOt'tE *:
PHo{E *: q1q79591 ty
'14txe aR<LIcEtlsE *: !/A
ClfY: \!lt yt ,t, ( -r>t nJ Sf I i!_aZIP,: Z Zf '.
CO TRACTOR:
ADDRESS:-7 t1 BLU8 &.l.)7t DR
EIiiAIL ADDRESS:tt (L*€AN@ |^sN coM
PRo]EcT co.ITAcT PERso : DEUE B CC(EL
EXTSTI|€ Cd{SrRUcTrOit: ! llreanrroru fi nerllornrron Icerrnar neelrns ! RELocATrc[,I
t{E}r cor{sTRucTrot{, ! enrcr Er.t REsIDEiIcE o" fi aoorrr* To ExIsTIitG RESID€i|CE
..PLEASE CHEO( AI{D A'{S}GR EELO{ ALL THAT APPLY TO Y(l,R PROJECT:
f] nrr caRacr _ sF
I surunocx'r _ sF
! cre +uo.rse _ sF
DET GARAGE
-
SF
P@r _ sF
otcx 316 sF
! coaor
-
sF
! sronncr sHED _ sF
OTHE R:SF
TOWNHOUSE
trn
X
TOTAL HEATED SQ Fr: N/A TOTAL 5Q Fr UI{DER ROOF: _ TOTAL AREA 5Q rr: 136
TOTAL PROIECT CoST lress ror) t $ A qo # oF SToRIES:
Is Any ELECTRfCAL, PLuttBItG or nECHA[{ICAL work Being Done to the Accessory Structunel I V"a (fo
If the project is a Relocation, is there a Natural Gas Line on the Current Site? [Ves ItoIs there Electrical Porer on this Building? [lv"r !Ho
PRopERry usE / occupAr{cy, frrrNcte rmrrv [ rurlrx
p
fI
A,)AuD ADD APrRox 5o/r lDrDESCRIPTIOI{ OF hIOR(: PEMOV AL CE
becu-ND PZRL2LA 'ln (trAR cf Hottz , oeLY llett, q1 L6sr IHAN ,0,, Fz"H 6EAA€ ,
DNSCIAIER I her6by c€nify fiat all
and ordinances 5d regulalions. Th€
contacttr iflt ma*xl. '-|{OTE I Any
OTJNER/CoNTRACTOR :
inbnnalirn in his applicrlkr. b corcct rnd an $lork wifl compty wifi
'l€
Sbr6 Euihng Codo and a{ oha applaabb Sbb and rccall s
NHC Dewlopmont S€ryis Conta, wiI bo notfiad of *ry changes it il6 appDr€d pbns g|d or chango in conlra.t r o.Wo.i l]6mEd w/O h6 Appropriab P6mi6wltb€ it Vbbtb. ot !t€ NC Stab p To1500.0o"
r\du-'(.) N.O-,SIGNATURE :
+r,i+,i*,i * !r + *,i,i r(,( - *** *..,',*.. JliTl JiSJ ,|*,i*** **lt**** + )t * * ,* )*,*,* r*,1)t*,1,i,i,:+***r():***,i*,*,***t,i ***i! +*
rs rHE pRopERTy LocATED rr a rlooorlarrt fl vrs f] no
EXISTIIG II.TPERVIOUS AREA:
-
l{E}/ IMPERVIOUS AREA: _
TOTAL ACRES DISTURBED:
EXIST LAND DISTURBI G PER IT:l_l vrs l--I no
ttlATER: Ef cFpuA I cor.tr'rulrrw svsrem I pRrvATE u,ELL I cerrml t.le ll
s:urR: [J creua I CENTRAL sEprrc I cnrvlre srerrc I ccHrur{rTy sysTEr4
,I, SEPARATE PERIiIITS REQUIRED FoR ELECT, I,IECH, PLB6, GAs EQUIP, PREFAES & INSERTS iiI.
pAyr.rEl{r rErlrco: fl cm'r I cr=o< ( PAYABLE ro n*.1 [ or,.*r.* .ir*.i, E -rr*
' -
E rrr.*a^**'a*:**'*****jtrt!*!t,|*,***r*,***)t*******,t***,*,**,t*+,4,i***!* *,t,f,,* * +,t,i,t,t* + *,t,t t *,t * ,i,i + * *,*:* ,t * *,t *r*,t,t,l*,t**
(Foi oFFrcE ust oflty) ffEVrsrD DAIE O4l11/12
SETBACKS: F:_ LH:_ RH:_ B:_
SQ FT
SQ FT
ZONE:OFFICER:
Approval:_ City:_ DATE:_ FLmD: _ BFE+2ft= _AVCotuent: pFRltTT FFF: (
v
PROPERTY OI {ER'S tIAttIE: B ITZ + JU I.\ E O&A-
O {ER'S ADORESS: .] I? BLV6 R)INTF bA CIIY:
NEW HANOVER COUNTY BUILDING PERI'IIT
APPLICA|ION IYPF: R ESIDENTIAL
PL€AS€ AIISXER ALT q]E5TIONS APPI]CA8LE TO YOUR PROJECI
(.,
)C..5-a1v5
APPLTCATION
l&rmb€r
(oFfice us€ )
t
APPLICANI'S I.IAI'IE I
DEVELOPERI
PRO]ECT ADDRESS:
SUBDIVISION:
CONTRACTOR:
!ODRESS:
PHONE f:
t5
zrP: !-6Y 0 J
DATE;
PROPERTY ORNER'S ill'I!'IE :('-rL PHONE #;
O,JtlER'S ADDRESS:sr:ryf zrr: A8 Y oj
sr: NlcrrP 4.191 Oi
LICETISE *:
ElttAIL ADDRESS r ooD NE *:
LPRO]ECT CONTACT PERSON:
EXI5TIM CONSTRUCTION:ffirrnarror RENOVATION I ccnrnal nrnaras f] RELocArroN
t!EI,{ CONSTRUCTION. ! ENTCT NEW RESIDENCE Or ! AOOTTTOT TO EXISTING RESIDE
'I*PLEASE CHECI( AND ANSITIER 8EL0N ALL THAT APPI-Y T0 YOUR PRoJECT:
ff:f"sti-:r'' -
ITY: L!) , c nr -
. CITY: (,rl iurz .
I arr caRace _ sF f] orr cannee _ sF
! sunnoom
-sF
! eoor _ sr
! enrenHarse _ sr I oecx
ToTAL HEATED SQ FTr _ ToTAL
PORCH s';P 2 2 i:li! sroue r sreo 5F
5F OTHER:5F
s%!r UNDER R00F:?itc,TOTAL AREA SQ FT:
-
BY:
Flr
r;ru
M
TOTAL PROJECT COST ruess r-orl : $ooo * OF STORIES;
ot,lri ERlc0 SIGNATU
**tt **t *** + )t,t** ** * *,i t* +**,t **t ***..t t**,1*,arr,**r,* r,*
rs rHE pRopERTy LoGATED rN l rloooelarrl I vrs NO
EXISTIiIG II,IPERVIOI S AREA: _SQ FT TOTAL ACRES D
NEW II1PE
llATER:c
SEWER:CF PUA n
(Fon 0FFIaE USa O L
Subiecr lo Fines up ro9500.00'"
*+ +**i**r * r,frt**,* *,i *rr *** * **** I *
d(",Is Any EI-ECTRICAL, PLUHBnIG or lro.k Seing Done to the Accessory st.u(tu.e?
If the project is a Relocati.on,s there a Natunal Gas Llne on the curnent Site?Yes
No
EHo
Is thene Electrical Po$rer on t is Euildlngl [-'] v". I no
PROPERIY USE / OCCUPANCY:SIN6LE FAIUIILY ouerrx I TouNHousE
DESCRIPTION OF I,IORK:ov k o
DISCIAIMER I ce.tit lnrl alr hfrrmalion is corcclond allwo!twlllcomplywit' he Sl.k euiEing Cod6 snd atlohe, appta
and ordlnsncas and .eoularons. Tho NHC Deveropm€nl Se fllces Cenlar will be noliied ol an y changes in 6e appoved ptan s and spoclfEations o. change in con
conrsctor l,1bmalion.''NOTE:Pe{omed WIO hs Approprl.b Psmils wllr be in Viotdion olthe NC
soD.
,!,*Jp$pgrrrewr,n&flffw0,
l-'1 ve sAREA:
-SQ
FT EXIST LAI{D DISTURSIiIG PERI4IT:
colt'ruNrry svsrrr ! pRrvATE wELL I celru- well
cENrRAr sEprrc E pnrvarE srnrrc ! comr4ulrry sysrEtl
.l,* SEPARATE PEMITS REQUIRED FOR ELICT, I\ECH, PI.B6, 6A5 EQUIP, PREFABS & INSEflTS I'**
payMENr ilErHoDi flclsH f]crrcx (pAyaBLE ro rwcl I erenrcaru exeness E r.lrrro fiorscwrr,i* ** t*l} **** **)r * *******+*,;*,f*'* t **,a* )t * * ri* *,t * *+ * ++ * * * * * *,i*:r 'i,* **,t ** t r)i *,t x * *,r* +,i *,t *,t * *,t,i ir r. !r*
Appnoval:- ctty: []rLA DATE
itvtslD DAr! 0!/1r/12,L e, ,+
V BFE+2ft=-;r- -----.
PERrrr FEEi $___!!c
sETBACKS: F:
conmentr (6 ey i(* :l ra rl
FLOOD:
Y)IrI- LH',!-- nn'
-^ t
.) "Projcct ResPonsibtltty"
15r.c^.rF^- 1 Flo,.r,c ro^J G^r srre,. cr inr,.-,
BLOCK S: _ l-0T $r _
(Y..{5J
PHoNE *:2L8JL !L1 'o
t,rn, {.
zorr: Q(orrrcen:
.rOlS-?/93
NEId HANOVER COUNTY BUILDING PERMIT
APPLTCATIOIJ TYPE: CC.IiIERCIAL
PLEASE AI{SI'ER AL. QUESTIOIJS APPTICABLT TO YA,'R PRO]FCT
-ProJect ResponsibilitY'
15-563
APPLICATIOI{
Number
(offtce t se)
DEVELOPER:PHO E #:91o-2i3-s3s1
PROJECT ADDRESS: 3132 Kirt,, Ha.rk Road
OCCUPANT/BUSI ESS alAIi{E 3 flan,nelheacls yourh Leaqu F'C
pROpERW OIfIER'S tlAltE: Dor Harrew adenr for hretl
o}f ER'S ADITRESS: 420 N. 20th sr. 7rh Ftoor
CO TRACTOR: f,4t r.t (-e itZ-
ADORESS:
EIAIL ADORESS:
pROIECT CONTACT PERSON: 'Ep
{ r.j -nP-l
qITY:ZIP: >ear',;
CITY: Bi rmin(,ham
Frrd6 A,nk- N A
ST: AL_ zIP: jlzgl-
sT3 zI.Pl
LICEiISE f: n/a
CITY:
(2-
P}rc E :
PtlO'lE f,:
(Cte.k All th.t Apply)
Exrsr c$rsrRrrcrrolt: n ATTERATToT n RENovAEo E3grcmr REpArRs fl RELocATrq{
lf Fblocdon, h there a Na ;rGas Line on the cunent site? flves firuo ls BLDG SPRINKLERED? ElYes ENo
ltEr cclsrfiucTr$t: f] EnEcT ,{Er{ sTRUcruRE ! rasr rnncx I srier-r- ! urrrr I Aoo ro ExrsT srRUcruRE
ACCESSORY sTRI.'CTURE:
If UPFIT - The Shell Pernit *:Is Elect Poler on this Building [E Yes E to
r...* Js THrs A GUtr{GE OF OcclrpArry USEI llyEs [tD ..*..
IF Y€s, r$at ras the Previous Occupancy Typei
-
lfiat is thc ilerr (kcupancy-Typ.? AZ
ARCII DCSIOI PROFESSIOAL: L. Mark toudermilk, AlA PH
Ptt
910.341.7600 NC REG *: i0776
ENGR DCSIGN PROF€SSIOML:itc RE6 *:
DESCRIPTION OF hORK:
ls lbod or bovo.ag6 prepd€d a s€rrcd h trb stuare? [Yes firuo r me eroperty Locatod ln Ttc Floodd.in? EIYes l3 No
will with lhe Stale Arilding Cod6 and ail olher aFpljcdle State
b.ad
al,d
OWNERICONTRACTOR:L" Mark roudernilk (aoant )SIGNATURE:(O,.lllL) (Prh l{.'r.)
Noa€r Mlton ndltcstorB a s.b6ob. nmorol p.lrit.pClcdrdr .! b bo .dtnll6d u.tE h. opdhd(ir ltrm (DHHS-Cr88) n,tl dr. t$ Hnt o. bdld.o wa lbqd to
co rh Ar6odo. or rrot. Yqr q! ltqdttd b Gdl tE .dard Enlshn S!ftffi t Hurtll. At FolubnE (I{ESHAP) rt (910)707*5t50 !i b.!l t0 &yr pdq b dr.
(*mltloo oa
'ry
hralty or hildtt. 8€o r.e.fryh6 tu her/*ry..pl.&.ncdlo0lb.bqto.ibh.np.fnl
TOIA PROJECTCOST; s.r, ooo BUILDING HEIGHT: 1s'# OF UNITS: 1
TOTAL AREA SQ FT: 14- ?33
TOTAT SQ FT UNDER ROOF: ra rlr # OF STRI,,CTU RES:
ACRES DISTURBED:
SQ FT PER FLR:
-
# OF STORIES: r
# OF FLOORS:
EXST rAND DTSTURBTNG pERMm IIYES E NoI
pRopERryUSE: Eornce EnesrauRmn f]uencnrnu Eeouc [err flcoruoo ffiERe^l_*_.
WATER: ECFPUA fl@MirUNnYsYsTEM flwELl flailNGUsEG[AsslFlcATloN:_
sEwER: E CFPUA flCEinRA[ SEP-[!C Ll PRVATE SEPTC f]COrrrMU rry SYSTEM
* SEPARA]E PERMITS REOUriEO FOR EIECT, MECH, PLSG, GAS EOUIP. PREFAAS & IiISERTS '',o*.*u Elorscowa
(FOR OFFrcE U6E OIILY) nEl/laED OATE.i11^2
ZONE:_OFFICER:
NEW IMPERVIOUS AREA: o SQ FT EXISTING |MPER|I/IOUS AREA: SQ FT
SETBACKS: F:-LH: RH:- B:_
ADflo\ral: Cttv: DATE: FLOOD: BFE+2fi=
AVN
Comnpnt PERMIT FEE:
ApPLICAI\IT'S NAIIE: wirr r.".,n"'a OATEi 2/24/2a7s
PIOflE #: _g.L9-=2g&frj3_
a o ts-3l<)
L)NEW HANOVER COUNTY BUILDING PERMIT
APPLICArI0N rrPs j COI4IIERCIAL
PL€ASE ANSI{ER ALL QUE5TIONS APPLICABLE TO YOUR PRO]ECT
.,proJect Responslbility,,
?sztt-)3?3
APPLICATION
Number
(0ff1(. !se)
APPLICANT' 5 NAIIE: Thomas Constlucrion Group
DEVELOPER:
PROJECT ADDRESS: 5553 old Garden Road tr^:t.?o CfTY: ri i rni:1
OCCUPANT/BUSINESS ilAfilE: Ca ollna Bay Garden EIATS
C0 TRACToR; Thomas Construction cro up
PHONE {r
zIP:28.403
5T: nc ZIP; 28405
PHONE #: ?99.22es
PHONE S: ?99.229s
ADDRESS: 1111 MiI:tary curoff Rd , s uice 19I
EI|AIL AoDRESS: l!/iIliams0 thonasconstructiond
PR0IECT CONTACT PERS0N: Laura l,riIliams
NEr,{ CONSTRUcrro.l: I enrcr r{EU STRUCTURE fl raSr rnacr ! sxrr.r.
ACCESS0RY STRUCTURE: Hardi Boerd
Exrsr coNsrRucrroN; D ALrERArro* I *rnJifiilSii 'iiTtth^. nrprrns fl RElocarroN
lf Rslocatdr, is the's a NaturalGas Line on the current str€? [ves-filr'ro ts aLoc spa-ttxrenEgrz flv"" f]uo
LICENSE *; 51620
CITY: flihnqLor
urrrr ! ADD To Exrsr srRucTURE
If UPFIT - The She11 pernlt #i 1i-235s
.*T'r IS THIS A CHANGE
IF Yes, what Bas the prevlous Occupan<y Type?
ARCH DESIGN PROFESSIONAL I Ls3P
Is Elect Powe. on this Building El ves E lo
r flvrs fltno -"..'
l,lhat ls the Uew Occupancy Type )
OF OCCUPAXCY US€
EiIGR oESIGN PROFESSIONAL: McEadve. En
le fuod or barerages propaed or ruvod in U{s drunrs? fives fii]rvo b Tho propaly l-ocet d tn Th6 [v"" Ir,ro
PH:910.?90.990r
PHi 910.399.1125
NC REG *: 50417
NC REG S: 8433
DISCU ER: hereby c€nly lhat atthto.rnaron in
and locsllaws andoroinancos ard reoutanons Th6(rcianQo,n conl.aclor or conlractor iifematd .-
subjgcrro FineE UD To 3500 00.-
wilh lhe Stat€l!all olrr€r applica bl6 Sare
olans and sD€ciricalrms
NC Stale Bldg Code and
OWNER/CONTRAQTQfiI; r,aura uir r iams SIGNATURE:
Not6: Lr.mo0ddl mt ficstons A ssbGfrs snoval paflnlt Ddlcrdo.B ar. b b. sr.tnltbd ultng rh. .pCtcdifi lonraon6ln A!D66lo6 or Dot. Yq, aro rEqrllEd b.rll tE Na{on l EJnlltoi Si6idar6 ttf HE rdou! A} polt ian!INESIIAP)(b.mlifoo ol arv tudllty or buttdlJrg, 566 Atb{l6 Wlb Slbi hiprn w*..pt.ttrt .nc.us/opfiErb.stoc/ohmp.html
TOTAL PROJECT COST: ,15, Ooo BUILDING HEIGHT:45'
d l6a! l0 tbF Fhf to tlc
AUG 13 2015
foF
*oF
#oF
TOTAI. AREA SQ FT 5C SQ FT PER FLR: 14s o
TOTAI SQ FT UNDER ROOF: a2. oio f OF STRUCTURES: 1
ACRES DISTURBED: O EGT LAND DISTURBI EvesPERMIT?
8FE+m=
1
NEW IMPERVIOUS AREA:O SQ FT EXISTING IM
SETBACKS:
SO FTpRopERryusE: EoFFtcE EnesreuRANr luencm.rrLE leouc lAPr
y$,EE;utrffi UIESSIHXIILH"A,Fffi..".*trB'^ff liiffi .y:.N+ff ,F'cA'oN:
.,. SEOARATE P€RMITS REQUIREO FOR ELECT. MECI-], PI8O. GAS EOU P, PFEF
PAYMENT METHOD: fiCasn ! cxecK pAyABr.E ro NHc) fleuenrcll
AAS &INSERIS ''
DGRESS EMcMse I oscor,en
(FOR OFFTCE UsE f-4-.*,-4RH: t4.B: ,,(
Commont
FLOOD:
REV'AEO OATE 4T 1N 2
DATE: 8/12l15
PRoPERTV ol{i,lER's NAitE: carorina Bav properties of reitminqton, r,Lc pHoNE f: a10.5sz.s40o
ol$lER,S ADDRESS: 2334 s. 41sr. srreer CITY: wi]mlnoton ST: rc ZIp;28403
DESCRIPTIoN 0F WORK,
t
E]nro
PEBMIT FEE: g-_