MAY 13 2016 BUILDING APPSNEW NOVER COUNTY BUILDING PERMIT
APPLICA|ION TYPE: RESIDENTIAL
EASE ANSWER ALL QUESTIOTIS APPIICABLE TO YOUR PRO]ECI
"Project Responsibility"
CITY:)
BLOCK *: _ LOT *:
&b-rc6
APPLICATION
Number
(Office Us€)
,ry/\zo
tu
APPLICANT'S T.IA'4E:
DEVELOPER:
J
PRO]ECT ADDRESS:
SUBDIVISION:
DATE tc
PHONE #:
ZIP I I
PHONE #:-g
ST:_&zIP:
ST: ZIP i
PHONE #:
PROPERTY OHNER,S NAI'IE:
Ot'lNER'S ADDRESS: I
.rJ a-
CITY:t
CONTRACTOR:
ADDRESS:
LICENSE f:
CITY:
EIIAI L ADDRESS:
s{
AL E RATION
NEW CONSTRUCTTON: ! enrCr r
*,}PLEASE CHECK AND ANSWER BELOW
W RESIDENCE OT ADDITION TO EXISTING RESIDENCE
PRO]ECT CONTACT PERSON:
EXISTING CONSTRUCTION:p*erororro* ! eerurnal nrcarns ! RELocArroN
ATT GARAGE
-
ST
suNRooM _sF
GREENHOUSE SF
LL THAT APPLY TO YOUR PRO]ECT:
I orr canree sr ! eoncr
-sF
I noor-
-
sr STORAGE SHED
5 F OTHE R:
SF
5F
TOTAL HEATED SQ FT:
TOTAL PROIECT COST lress ro9 :
Is Any CI-ECTRICAL, PLUiIBING or
If the project is a Relocati
Is there Electri.cal Power on
ZONE: _ OFFICER:
Approval :_ City:
Comment:
DECK
z{ooo # oF sroRrEs:
HA'IICAL Work Being Done to the Accessory Structure?
his Building? ! v"r Ino
PROPERTY USE / OCCUPANCY:
DESCRIPTION OF WORK:
&rNGLE FAMTLY ! ouelrx ! rowruHousr
er appllcable SlaE and locallaws
ns o.change i. conl.acbr or
lect b Fines Up 1o $500 0O"
Yes No
* * + * * * * *rr* * * * ,f * * *
DISCLAIMER: lherebyceriit tiai all inbnnarion in is applicaiion is corecr and all work will comply witl t'e Stare Build
and ordinances and regulalions. The NHC Develo I Services Cenler willbe nolilied olany changes in lhe apprcv€d
conracior inbrmaton '_NOTE AnyWork Per,orm W/O t'e Appropriab Peffiilswillbe in Violation of lhe NC Srats
O!'INER/CONTRACTOR:1.?..SIGNATURE:
**** * * t +rtt**!t+rt*+trt,t****rtrt t*** !t* **+ * rt
SQ FT
5Q FT
waren' ! creua I coMMUNrrY SYSTEM PRIVATE WELL
* * *,t *)t* * ** * * * *rt ***)*,**)*,r)*,t
IS THE PROPERTY LOCATED IN A
EXISTII{G IT.IPERVIOUS AREA :
NEW IMPERVIOUS AREA:
SE[',ER: E creua ! CENTFTL s
*'+ SEPTAATE PERI'1II5
PAYIiTENT I.IETHOD: E 'OSX E
* * * * **,t** )** )** )t* )* r*,* + * !i:t !t,t *
LOODPLAIN?
PT IC PRTVATE SEPTIC
I-l vrs [--l ro
TOTAL ACRES DISTURBED:
EXIST LAND DISTURBING PERMIT:
! certnnl wrrr
I comr,rurrrv svsrnr
YES l-_] ro
I orscoven
_ BFE+2ft= _
N
PERIIIT FEE: $-
EQUIRED TOR ELECT, MECH, PLBG, 6A5 EQUIP, PRTFAES 8 INSERTS *''
CK (PAYABLE TO NHC)flarrnrcan exnnrss fl ,.rrrro
+**,i *,I*,r * * * *** * **,** ** * !F * * * rr,r,*,f * )* * ,*,r *,r*,r* * *** * *,t * * * **,f * * * * * * * * *
(F0R OFrr(E USf OriL Y)REVTSED oArf 04l1rl1?
DATE:_ FLOoD: _
A
PHoNE *:610) st'l -€tlt
SETBACKS: F:_ LH:_ RH:_ B:_
TOTAL SQ FT UNDER ROOF:
-
TOTAL AREA SQ FT:
is thene a Natunal Gas Line on the Current Site? [Ves ! ruo
Y${A Ir\:+s
$:S:"f\
P,E, d
c-
*=
q
3 or b -13ta
($.)
, RECEIVEO APR 21 ztrS
i{ HA'iIOVER COUIITY BUILDII$G PERI,IIT
tPpt ICATIOi| naf: Cot{r{E R€IAI_
P[&5! Ar5lrt a]"! Qut-sT:aag Apptrc ELE To youR piolfct
"pmJcct tespollslblllq/
r v1 / (-t )
APP L TCATlOIl
Lunb.r
(Ofrl<! Ur.)
A'PLICAXT' S IAIiE: IAi:i:DAIE:4120/2016DEVEIOPIIi:PHOITE 3:PtolECT ADORISS: t43o c CITY: w11 zrP:28403
o(cuPt.trlBt]s !uES9 t{.}"r{f :id{e:j:r?i:k!r r:.rl Suncoas! Pa.trers
PROPEnIY O|**ER, S l,tttr: I 30 Cd:sxirl.ea I rh Cvn ei3 ls$<lci ati rr PHO'jf ,r 910-202-139,
Oi*lEn'S ADDRESS: :a C .'"-.:l tb D! t1C2 CITY | fi!]ii iqlon
COI'lTlACtOn: :r'le' Roir.: n
ADDIESg: 3l : t:CI1Y; 'il lrn-t 11 ST; Nc IIF: 2g{05EiIAIL AODRESS:
PRO]ICT COr|TACI PERSOUI tt.lct Po1.i.i Pl{ol',f S: 910-61{ -r?ol
tll
ExIsT (sisTru{rloa{ I flI RCoadon, b tr€re 6 Natural Line ':\6
n
Crr.a
RETOVATT$I
:,]l Sh€?tr Yos
a G ESERAL
Nc ,s
t(EPAtr
ELDG
RS
PR}NIAERED2
n LOCAr.l$,n E No
T
s Is Elect
NE{ CO*5rRl.J(Tlofi: n
ACCESSOf,Y STEUCTUNE:
ffir stilrrrln! [ msr rmcr f] snrr.r. E uern E loo ro arst srnxnnE
If UPFfT - ih€ Shell Perl]l
tF Yer, rh:t €r th.
alo{ Df!16}l p*oFrs$IoraL:
E ITB DC9IGI PiOFISSIOIAL.'
< OWNEnYCOTIMCTOR: pa
TOTAL SQ IT UNDER ft@F;
ACRE$ DI9TURBED:
NEW iMPERVIOUS AFEA
PRoPERW UsE EPFFICE
wArER 176ppy1 p
srucn. fficreu,r fr tr
15 T!a15 I C*N: Or OCUrlrrv wrt IOtcupary T)+. P *_--_ Lrat
Por!. on thLs gutldlng El yes [r: ro
vrs firc,.,..
J5 thr l.d o<c[p..cy Tt?a?
PH ttc REG t:
--
pH: C f,F6 t: _ _--
rll0th0r.ppir,bt ss,ott m ..d.D.cFan .rr
N3 S-l!l! 6tJC CodB rNi
DESCRfPTIBI CF l,loq(: Re-R
L
{ !cA/i
b food o. bqttrs0,.s p,sgr6.od tf h trr. ,,L'dur? nye3 [lNo t rt" mp-ty L@l!d In tu Ft@@h?f]ve" [ruo
S'GNATURE
1orE4
lt,,at: h.r.&en ,xa*rtbr. C -bastrt lDi'*13-r6E t.ltv knl!tSdth Arb.d!. r m! Ydl 6r !q-*.d rc
1ad..i{b.i d ']y L.& (. trrre'' E-E..r.hd/rrb8!.,rlrn .t*i j
TOTAL PROJEC: COST: $3e EUlLDtf{G HEIGHT: lto t OF UNrS:
TOTAL AAEA SQ FT SQ FT PEff FLR:
r or srrucrunEi-*, OF STORIES: !
# oF FLOOaS:
Rcrasa] llTE r4.l/!2
PERMIT FEE:00
E(sr LAND DisruRano neaunr f,ves flxo
SO FT EXETING IMPERMOUS A-REA:
f]uanar'nu-e I eouc t] err flcoroo o*ien,
coM S\$TEM T T'ELL
SEPT1C PRMATE se PT]c
P YUENT rrE'rHOD: trCASH
' ' t..ia-.
(pAyABrrro lttc) fieumcar.r mness flrrcmsr I orscown
'*r..-,gC#?9*,
u3i OH:Y1/e:T
tCofimant
FLOOD:
',fi lnspectron Rerurreo ql0-254-0'
5Tr Nc Z:Pt 28103
LrC€,{SE l: s 812
Pl0J! f:9to-,-:;-l5g!
llZOf\,rNG t rSE d,A.sOtFEAlrO*
rl co*lkany SYsr
tu
NEhI
! comr'rururrv
! cerurnnL sr
ANOVER COUNTY BUILDING
APPLICATIoN ryPE; RESIDENTIAL
LEASE ANS}/ER ALL QUESTIONS APPLICAELE IO YOUR PRO]ECT
"Project Responsibility,,
CITY:LC\
;\otc-ryr?
PERMIT PEAU 115 I
APP LICATION
Number
(office Use)
APPLICANT'5 l,lAIrtE:
DEVELOPER:
PRO]ECT ADDRESS:
SUEDIVISION:
EXISTII'IG II'IPERVIOI S AREA:
NEW IMPERVIOUS AREA:
DATE :
PHONE *:t)
I
llK ZIP I
e BLOCK $:A.'J LOT T:
LICENSE s: --7011 I
CITY i
,C)ov.,t
PHONE S:
st;yE.ue t 246
st:1,!L z:+:Z#
PtoNE fl; qro *ZZ+31'1
PRO]ECT CONTACT PERSON:
EXISTING CONSTRUCTION: E At rnarror !RENovATToN ! eerurnal REpArRs E RELocATToN
NEW CONSTRUCTTON: ! rnrCr N RESTDENCE o" fi.lrrrrro* To EXTSTING RESIDENCE
L THAT APPLY TO YOUR PRO]ECT:**PLEASE CHECK AND ANSWER BELOW
PROPERTY OTJNER'S Nfi E:
OWNER,S ADDRESS:q
CONTRACTOR:
ADDRESS:
EI'IAIL ADDRESS:
PROPERTY USE / OCCUPANCY:
DESCRIPTIOI'I OF WORK:
DET GARAGE
POoL _ SF
e
CITY:L
SF OTHER:
i
DtLD
trtr
DATE:
.ffi
SF I-l poncx qF
f] sronacr sHED _ sF
TOTAL HEATED 5Q nr 5{o TorAL SQ FT UtilDER RooF: 55z) ToTAL AREA sQ rr: 5f,6
TOTAL PROIECT C05T lress rorl :4 # OF 5TORIES: t
I5 ANY ELECTRICAL, PLUIiIBING on IilE AI{ICAL Work Being Done to the Accesso.y Structure? ! V", ! ruo
DECK
If the project is a Relocatio
Is thene Electrical Pow€r on
, is there a Ng*ra I Gas Line on the Current Site? fl Ves
his Building? [fu*= [ to
SF
No
lding Code afld Ettoher appticabte Stab and toca aws
plans End specjficalioos or change in conllacbror
Dtsc IMER: lhercbycertify hat.all inbmalon in h applicarion is corect and a[ workwiI comp{ywih the State aui
t S€rvices C€.Erwittbe notfied otanychanges in he approvedand odinances and rcgulalions The NHC Dev€lopm
conlracbr inb.malion.'"llOTE: Any Work Periormed /O t'e Appropriate PemiEwi[be in Viotalon oftne NC Siar-^
otljN ER/CoNTRACTOR:EncdsFT SIGNATURE
,***)t,t)** * * *,i **,r* * r*,* * ** * **,t*
d-NGLE FAIYILY D
J************
I5 THE PROPERTY LOCATED IN A F OODPLATN ?YES
:** ** )t )h* * * !t *,t * ***,r,*** ****,** !t+ * I X;* * *
""n,H.fr..
[ves !NO
rEM
c
* *,* ** )* *)** )t*l* ***)k** * *)*.->-
TOTAL ACRES DISTURBED:
EXIST LAND DISTURBING PERI4IT:
PRTVATE WELL ! CelrRnl well
AIiIERICAN
FT
F T
sQ
sQ
WATER:
SEWER:
PAYMENT TlETHOD:
#;r c I enrvnrr srnrrc ! comrv]uNrry sysrEm
**, SEPARATE PERT4ITS R QUIRED FOR ELECT, [,lECH, PLBGJ GAS EQUIP, PRETABS & INSER]S **-
fJcm, E Ec( (PAYABLE ro uicl I
,rrr,ffi::Ha-,
ADonoval: Cit' tfr,^-lo' t
(FOR OFFICE USE o{rY)
SETBACKS: r, ttF rn 5 RH
EXP R E s 5
v1 I q
Comment:
tcr Sotrn ,.5
<-.)LOOD:
LO
d \rc*'
I rrr canree _ sF
! suHnoom _ sF
! cRerruuous e
-
sr
PHoNE s:?4:433q3:?1
DUP L EX ! ronnnousr
)'tt:if
NEW
APPLICANT'S TIAfiE:
DEVELOPER: t.I A
PRO]ECT ADDRESS:
SUBDIVISION:
PROPERTY O T{ER'5 NAiIE:
OhINE R,S ADORESS: 2 LL
ANOVER COUNTY BUILDING PERMIT
APPLICAIION TTPE: RESIDENTIAL
LEASE ANSI,IER AtL QUESTIoNS APPtIcAgtE To YOUn PRoIECT
"Project Responsibilitf'
PRO]ECT COOITACT PERSON:
ExIsTIl{G cot{STRUcTIoN: f] AL
NEhr coNsrRucrror: I enecr
**PLEASE CHECK AND Ai{SWER BELOl.l
! nrr cnnace
-
sF
I surunoom
-
sF
! cn eelrxous e
-
sF
TOTAT PROI ECT COST 1r-."" r-ory :
Is Any ELECTRICAL, PLUIiBI G or
If th€ project i.s a Relocati
Is thene Electrical Power on
OWNER/COI{TRACTOR : KEF.\ tr tZe-
EitAIL ADDRESS:rtt
EXISTII'IG I PERVIOT,S AREA 3
NEH +TPERVIOUS AREA:
rnarrol ! RENovATToN I eenenel nrenrns fl RELocArroN
r{ RESIDENCE o" ! AOOtrroH TO EXISTII{G RESIDENCE
L TI{AT APPLY TO YOUN PRO]ECT:
! orr eaRace 850 sr ! eoncH _ sF
I eoor _ sF ! sronaee sHeo sF
APPLICATION
Nu[O€r
(offlce Use )
o^rEr 3'A^lb
PlOilE *: l lo' 6?D -4129
crw:rLvIrU oA ZIP : 2R4o3
BLOCK f: _ LOT #:
CITY: \^l i -fb \-\sr: \-1 zIP: ZeAoa
CITY:WI,LV \ttqqTot\srttlczrPt zfua
vl PHo E 8: <to - l1b - 41?2
PK)NE $:q.rc-1.7.o-47U
SF OTHE R:SF
TOTAT ACRES DISTURBED:
Exlsr LAND DrsrURBr G pERlrrr: fl'l ves I-.'l Ho
0 I scovE R
&€vlsED OATE €4l11/12
€
CONTRACTOR:
ADORESS:
.Fo
A Voz{ve-
I orcr
TOTAL HEATED SQ Fr: t'l/A TOTAL SQ FT UtrtDER ROOF: 85O TOTAL AREA SQ FT: g5O
# OF STORIES: 2
HA fCA[ lronk Being Done to the Accessory Structune? ffi V"a [ ruo
, is there a Natural Gas Line on the Current Site? [ Ves [ ruo
his Building? lfl v"r ll''l to
PROPERW USE / OCCUPAT'ICY:INGLE FAMILY I ouelex I rouruxousr
DESCRIPTION OF WOiK:a
DISCIAIMER: I hsrsby certify lh3l all inlormaton in applic all p Slale BU itd 0 Cod€al her app[c able Staieish
and ordinances and reoulations. The NHC De Se Cenbr v ge ir he plan d anscontacbr intomaton. "TNOTE:Any Work Perfo la he Violation of the NC SraE
SIGNATURE:
Bldg Code s Up T $500 00'
(P.
,r * + * ,t +,t ,i :k,*,* ** rt:| * *,t:* * ** *,1,t
IS THE PROPERTY LOCATED IN A Lq)DPLAili? E VrS
*++ *++* *'t !*t:t*t,i + '* ++* ** + +:l )* * *,t,t**+ )t:t +,t +:t** + *Ero
tlIArER: Sl CFPUA
sEt{ER: NI CFPUA
ZONE : _ 0F FICE R:
Approval:_ City:
SQ FT
SQ FT
vsren I pRrvATE WELL ! crurnal wrlr
rrc E pRrvATE sEprrc ! cor,uluutrv svsrem
fl counururrv
I crrurnal sr
*,T+ SEPARATE PERII,IITS QU I ED E QUI P PRE FAB s &I S ER TS
E R
PAY ET{T |,!ETHoD:fJcasn I cx PA E TO tr cAilEYABLNHCAMERI EX PRE s s tr ilc/vIsA tr,r *** r* *,t * )*,k,* *,* ** + *)t,* * ** *,r *r*** + 't* * **:*,+ +*,t:t *:*:* * ,l:r :r
(FOi OFTICE USE d,itY)
SETBACKS: F:- L H: RH: R.
BFE+2ft= z, ,DATE:_ FLoOD: _
A l\l
d*,,..,
i&,,
Pto E #: qro-bao -4?a,
LIcENsc *: lb544- L
FOR EIECT, MECH, PI-BG, 6A5
t )olaa2Do.
,.( . : .:,
.e,
PROPERTY O'.JT,IER'S iAl{E :
O'IER'S AODRESS:Z 0tL
,Fo
HANOVER COUNTY BUILDING PERMIT
AWLIUrIo rr"E: RESIDENTIAL
PLEAST AI{5trER ALT QUESTIOI{s APPLI(ABLE TO VOUI PRO]ECI
"Project Responsibllitr,
F
cu
ll"-L7l
APPLICATIOI
Nunb€r
(offi(e U..)
o,ifEt 3- A-lb
Plr(x{E #: tto- 62b -4128
cfw: \Al t L!,t ! Uqlo L\zIP: 29.r,:3
gLoc( *: _ LOT #: _
CITY: \^l t t-b,{ r N13lb \-\ SI:}l9ZIp:28403
LrcEilsE i: lrqg{- L
cIrY: WrLV\\Kiqlot\sr,:&zrpt Zka
SIG{ATURE :
TOTAL ACRES DISTURBEO:
NE
APPLICAI{T'S t.!$tE:
DEVELOPER: Fl
PRO]ECT AODRESS:
SUBDIVIS]OI,I:
COHTRACTOR:
ADORESS:4
PiolECT COiITACT PERSol,l:
ExISTltlG CO STRuCTIoN: f]
TOTAL PR0IECT C0ST tt-ess tou
Is Ahy ELECTRICAL, PLtfl{8lr{6 o.
If the project is a Relocat
Is there El.ectricaL Powe. o
1
ETUTIL ADDRESS:
zONE:
.tt
i(.A e-v{r
LTERATToN I nelwarrot E errenrl rreuns fl RELocArroN
NEr RESIDENCE o" I AOOtrrOt TO EXISTIT{G RESIDEXCEEH CoNSTRUCTIo|J: El ERECT
IrPIEASE CH€CX AM) AflSllER 8E ILL THAT IPPLY TO YOUI PRO]ECT;
! orr eauer 850 sF E poRcH
-
sF! lrr enmeE _ sF
! sulnool
-
sF PooL _ sF STORAGE SHED SF
5F
IOTAL HEATED SQ rT: h-l/TOIAI. SQ FT UNDER ROOT: 85O ToTAL AREA 5Q FT3 85cJ
* OF STORIES: 2
l4EcHlNtcAL l.lork B€ing Oone to the Accessory Structure? fr V"r I lo
t_
PROPERTY USE ,/ OCCUP,INCY:
OESCRIPTIOiI OF HORX: BUt
DISCLAIUER: I h6.sbycirti, fi .l.ll hbma|nn rhi s1!Br ild,.t9
sad o.dh5o..s and .'wbiions Th€ NHC Ds 56
cont&nr mbinalon. "'NOTE &y Work ta c Bld9 t 500.00T
on, ls there a Natural, 6as t-ine on th€ Current Site? [ ves I Ho
this Butldlng? l7lvur !-'l to
srirGLE FArlILy I ourlrx [ lonnouse
e.\eJor{ ER/CO'ITRACTOR: KTiJ tr
. )rr i *r + t.,t * i* * * iall l ** * t*
IS THE PROPERTY LOCATED IN
*+'rrr4t.r'|**i*tt*+:*aaatr**rr**a'tt'ta*r:r*ti*ar****r**tt***+t+i*1r,rt
rlooopurxr l-] ves EI ro
EXISTING IIPERVTOT'S AREA:
IiIEI{ II4PERVIOT'S AREA :
r{ArER : N CFPUA
ss*rn: $ crcua
SQ FI
SQ FT
I co+rurr Y5 TE D P
LAM, DISIUR3III9\PIRfiIT: l-'l
E ..r*.*r.
rr.frylDfibg6,
vrs I-'l rc
ff;it*ru,
EXI s T
..T 5 EPARATE PERI1I
*lr+rr+*
Approval:_ City:
tl RIVA T E I,lE L L
PR IVA T E 5 E PTIc
a r r r*r r r **r r * * r ***.* r* r*r a a*+.*,t.**r.1r* * *** * r*. * *
s
CENTRAL E P T I C
PAYN€MT }{ETHOD:
REq,IRED FOR ELECT, I,IE€H, PLBG, GAs EQUIP, PTTFABS & II{SERTS
cHEcx (payABrE ro uc1 [ ocnrcAr ExpREss E,czvrse
frl-$"",',*,
(tot oFFt(c u5t dll
sETBACKS: F:
'-Npe*,51
rr, 5' r, 5' ]'vrsto
Drrt e6lrt/t2
DArE:4-?-lGFLooD:
Nc $ore t-rr,rar 3
eye-arA, %as^r t"*d.lcp.,ld,,yp
?-, inmaig bu tcl,^4.
V BFE+2ft.
p,fG*"I -,"^*ot
PltcalE *: qto- b?o '.{'t2J
PffnE *: lto- lZ6 - 4'1Ze
pHs1s sr qt0- t?, - 412€
tr
! cnrrrnous r
-
sF fl oe cx _ sr orHER:
--
E.rc,
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATIOT,I IYPE; RESIDENTIAL
LEASE ANSI,iER ALL QUESTIONS APPTICAB!E TO YOUR PRO]ECI
"Project Res ponsibil ity"
S Co no)
)1 CITY:
BLOCK S:
CITY:
LICENSE S:
C ITY:d
(Offic Us
DATE :
PHONE *I qIO )a/ 1y,-
ZIP | 2fu/L
LOT *:
PHONE E:st:dzrl:7BItz--PROPERTY OWNER,S TIAME:
OTJNER'S ADDRESS:
CONTRACTOR:
ADDRESS:
EiIAIL ADORESS:
6R E ENHOUS E WL-a/SF florcx
n
and ordin6nces and regutaiions.Ihe NHC De
contactcr inb.malion "'NOTE: AnyWork
ot.lNER/CONTRACTOR :
,i,+. + i,+*,t++ i**+ ++****+ r*+
IS THE PROPERTY LOCATED IN A
APPLICATION
Number
APPLIC'NT,S NA E:
DEVELOPER:
PRO]ECT ADDRESS:
SUBDIVISION:
/t
t,-A
ST ilLrrr,z&4o<ato-Zq't-taS-4PHONE #:
PRO]ECT CONTACT PERSON:
EXISTING CONsTRUCTION: E A RATToN qRENovArroN GENERAL RE PAIRS RE LOCATION
NEW CONSTRUCTTOT: ! tneCr
''PLEASE CHECK AND AI{SUER BEL ALL THAT APPLY TO YOUR PRO]ECT:
RESIDENCE o" ! eOOrrrOH TO EXTSTING RESTDENCE
fl orr cnnace sF f] poRcH _ sF
POOL SF
P|oNE *: 4t"'Zql - GSf
is applicaton is correci and att work wiI compty witl ihe Stale Buitding
nt S€rvices Centgr wil be nolifed otanychanges in he approved ptanwo fre An^r.n.ia€ pemriswi be rn viotalon of ihe Nc staF aH-
5F
all o|ner applicable Stac and tocar taws
or change in conkacbror
TORAG
R:5F OTHE
LH:
S E SHED
5F
TOTAL HEATED SQ Fr: lbD TOrAL SQ FT UNDER AOOr: lb<r,
/
TOTAL AREA 5Q FT:/L^'
TOTAL PROIECT COST rressrou :$ ?3ao-f OF STORIES:
Is Any ELECTRICAL, PLUIIBING oT CHA ICAL work Being Done to the Accesso.y Structure? [ Ves fil Uo
If the pnoject is a Relocati
Is there Electrical Power on
PROPERTY USE / OCCUPANCY:INGLE FAMILY I ouer-rx f] rowHxousr
DESCRIPTION OF WORK:b
DISCLAIMER: lhereby cerrily tlai altinbrmallo,] n
, ls there a Natural Gas Line on the Current Site? [Ves fit No
his Building?ffiv"s I r,ro
00"'M-SIGNATURE:
,t,*******+t***r***t+++*++**+**,***)t**,***,**,**+,***,*************
LOODPLAIN I YES E[ *o
a SQ FT
5Q FT
EXISTING IiIPERVIOUS AREA:
NEW IMPERVIOUS AREA:
WATER: ETCFPUA
sEwER: gJ cFpuA
ZONE: _ OF FICE R:
Approval:_ City
Coflment:
TOTAL ACRES DISTUREED: o
EXrST LAND DTSTURBTNG pERmrT: E ves S no
I comnrururw s Y51E t1 PRIVATE WE LL CENTRAL WELL! cmrrml s TIC
*** SEPARATE PER"ITS QUI
PAYMENT 14ETHOD:tr CASH a
Ll pRrvATE sEprrc L_l col4t"1uNrry sysrEr4
ED FOR ELECT, }IECH, PTBG, GAs EQUIP, PREFAB
(PAYABLE To ruc; I nnenrcm exrness tr
E R
E c(
*,|,* ,* r **,** * * ** + * * * )*,t,* *,t ** **ilc I 5A
***+
s &I NS E R TS ***
I orscoren
REVIS€0 oAtE O4l11/12
)* !* )* * ,t,t r* ,*,f * * *,* * )t
(FoR 0FFICE U5a OtiltY)
SETBACKS: F:
DATE:_ FLOOD;
-
A
RH: R.
BFE+2+t =VN
PERI'IIT FEE: g
Jo(to .tlzl7
Wtb-tar+
I
fl arr ennne r _ sF
I sunnoom _sF
&
N EhI ANOVER COUNTY BUILDING PERI'IIT
APPLtcaT IoN rYPEr CO|4IIERCIAL
5E AN5TER ATL QUElIlOIs A'PLICAOLt TO YOi]R PNO)ECT
"ProJect R€sponsibility''
CITY I
)otb-tMZ:L
PEZ lt, 't13?
APPLICATION
Nunber
PRO] EC 1 ADDRESS:
OCCUPTNI/BUSINESS NAHE :
PRoPFRTY Ot"/tiER'S NA,'IE: --
ot4u E 5 A)DR E ss
CONTRACTOR:
AODRESS I
EMIL ADOREsS:
PRO]ECT CONTACT PERSON:
EXrST CONSTRUCTTON; E ALTE
^pprrcrNT's
!,laltE:
DEVELOPER:
lf Relocdlon is lhere a NaluGlGas
NEI CONSTRUCTToN: ! tnrcr
ACCE5SORY STRUCYURE:
lf UPFIT - The Shell Pe.,Dit
....+ I
lF Yes, vhat was the Pnevious
ARCH OES]G( PROFESSIOMLi
EN6R DESI6I,I PRCF€SIIOTIAL :
Z"
OAT! :' t'J tto
PHONE S
PHOl,iE a:
STr ZIPI
LICEIiSE *i ACCOUNT i:'a
CITY:
CITY:
3 R E NOVAT ION
*,LEzrelfu'f
E*o
iIC REG
'NC RE6 I
?wNE *t '//O - 3(? - / 7tl
PriottE it q/a-?6) - /766
'i'ril*^ *roor*, I-l nerocarroxE*o s gLoc spi'frxrenrrz Ives firuo
T
on !r'rEnt Sile ?n Yeslhec
|J sTRucruRE I rsr rnlcx f sner.l UPF IT I aoo ro Exrsr srRUCruRE
f: _- Is Elect Poxer on this Building E Yes
rHrs A cH$tGE oF occuprxcY 956 ' I vts @m ""'
c<upancy TyPe?hlhat is th{ l{er o(cupancy Type?
PH
DESCRIP'T]ON OF hT'RK :
ls tood or beverages Fepar€d o.tn tHs drud{B? E Yes ftl lto ls ttre Property bceed ln The Floodplatn? E ves
^El
lo
h,s a:!l'.aion is correcl610 allvloat mll comgv Mrh lhe sla
^lH(-
J..!,trotrmt S€Nrc!3 CenLr w{l b€ nolir.d ol a.v cr:
!ra.ra ln,,.^,t pa.torrnodwolh6 AooroD,r:rs Pe,milsaI fe)i Blds Cod..nd
d
D rscL rlilER 8Li a
usE cl.As S ICATI o N:
in0 Co(e al S
s
SuUedlo
56 g f-roret lr.EA so FT .
l/ TorAL so Fr UNDER
WATER: ECFPUA
SEWER: E CFPUA
PAYMEMT METHOO: ECASH
m
d3niolllon or.1v tsdll9 o. Durld rO S€€
TOTAL PROJECT COST
,1
COMMU SYS]EIJ f WELL
(FOn OffrCE UOE
SETBACKS:
hrprr**.pl,rt.l!.nc.'rtaPi/.3b€to.r!hrnp.nvnl .?'
BUILDING HEIGI-IT: ,. f OF UNITS:
--a
SIGNAAJRE:OWNEFVCONTPACTOR:
(ou*q!ti1 wneG;r,5. ,3.ilry or blildii9 w!6 bund bNold: o.mol,lrn noinc!!o[! t asb.llos pcrmlt lppucrtoru .n to b. subdldod u.ltt! tl. oPdlcalan fon (tlHS
6nrsh a$etlos o. nor Y@ ir..coulGd !o cal ihtonat EflHon $sndlrns for H!2a firo(ra Af Po{ubr6 (NESl,P}tl 19I 91717-5360 a1 b?31 10 d3y3 Fb. to lho
[.
ACRES D{STURBED.Exsr unND orsruRBrxc eenurr I ves I uo
r.]E\Y IMPEFVIOUS AREA:SO Fr EXISTING IMPERVIOUS AREA|_--SO trT
PROPERTY USE: NOFFICE T RAtrr IMERCANTIE f eouc f,err lcoroo orxeR:(1 it,a^l,o,
ZONI NG
SEPTIC f PRIVATE SEPNC n COMMUN SYST EMrw
(eAvABLETo NHc) f] aru eccouur EMcMsA f orscovtn
zoNE: CS oFFIoER;
Approval: 0L
ofllY)
Fli/ A LH: l.t lA RH:Vrr B:l/A
BFE+2ft=
N
iEtsEr DAIE rufi/l2
PERMIT FEE: g_
r't,ltrtti. n P::'r,gr 9ll,:t1 I
City:\!\!i\A T FLOOD:
,.t't
-7:.tO,
^a
//). *+
SQ FT PER FLR:
--
f OF STORIES:_
# OF STRUCTURES; _ # OF FL@RS;_
YI
-\.{r
S ubJedlo
,6x f.arornl anee so rr ,, TOTAL SO FT UNDER
PRO]ECT ADDRESS:
ov'lN
CONTRACTOR:
AODRESS:
EIiIAIL ADDRESS:
EXI s T
lf Relocalion
DI SCLA IMER
nd local
WATER:
SEWER:
cr'olb-L(q Z:L
PERMTT ?EZ lto -t139NEId
APPLICANT,S IJAI{E:
DEVE LOPER:
OCCUPANT/BUSINESS I,IAfiE :
PRoPERTY OTJNER'S NAmE:
ER,S ADDRESS:
PRO]ECT COI.ITACT PERSON :
coNs ION tr AL T ETRUcT
ts there atura G as L e on theaN
ER COUNTY BUILDING
APPLI1ATT1N IYPE: COMIIERCIAL
ASE ANSWER ALI QUESTIONS APPLICAETE TO YOUR PRO]ECT
"Project ResPonsibility"
d t"'l
CITY:
V.1
CITY:
A"1 LICENSE *:
C ITY:
APPLICATION
Number
(office use)
DAT e:,4-/4- Ad/6
PH}NE *:1/0 -U) -/1 (6
2lefrfu!
PHONE *:
ST: _ ZIP:_
ACCOUNT *:*.pg@9
SO FT ^
NEr,'l coNsTRUCTrOru: ! enrcr !r srRUcruRE f] rnsr rnacr ! sxtr-u ! urrrr !
ACCESSORY STRUCTURE:
rHrs A CHANGE oF occupANcy usrr flvts [rc -.-.-
cupan€y Type?What is the Ner occupancy Type?
PH:NC REG #:
If UPFIT - The Shetl Permit
****r I
IF Yes, what was the Previous
ARCH DESIGN PROFESSIONAL:
ENGR OESIGN PROFESSIOML:
in contractor
Fines Up To
TOTAL PROJECT COST: /00 BUILDING HEIGHT:
SQ FT PER FLR:
(check a1l That APPIY)
RENOVATION GENERAL REPAIRS RELOCATION
Current Site?n Yes No IS BLDG SPRINKLERED?[v"s [No
ADD TO EXIST STRUCTURE
Ilty or building was found lo
(91 9)707-5950 at l6ssl 10 days prior to lhe
PH:NC REG f
DESCRIPTIoN 0F I^IORK:4 lfua
ls food or bevemges prePared or in ttris srrucrure? ! ves ffi llo ls The Propeny Located ln The Flooddain? [ v".
^ffi1
ruo
th at a inform on in Code and all other applicable Slatehereby cerify
nd ordinances The pp and adecificetrons
Bldg code and
$500 00-'
OWNEFJCONTRACTOR:
(Oudifsr)
SIG
Nol6: Demoliton notlffc€llons & asb€slos permlt eppllcsions ar€ to b€ submltted uslng lhe appllcauon iorm
conlslo Asbestos or not You sro requlr€d to call Nalional Emlsslon St6ndards br Hazardous AlrPollutanls (N
domolltlon of any feclllty or bulldlng. 56o Web Sh6: hfiprn^,ww.epl.stat6.oc.usrep?asbestos/ahmp.htnl
# OF UNITS:
ROOF # OF STRUCTURES:
ACRES DISTURBED:Exsr LAND DrsruRerNc penirrrz l-']ves I No
NEW IMPERVIOUS AREA:SQ FT EXISTING IMPERVIOUS AREA:
PROPERTY USE: lOrrrce !neNr lurRcmrru EOUC ! ner [couoo ornen:a
EF tlE SEPTIC
SYSTE tr flzoN ING USE CLASSI FICATIONCFPUAcoMMUMWELL
CFPUA CE PRIVATE SEPTIC coM MUN try SYSTE M
". SEPARA-I E PL:Rt,4I']RECUIRED FO'T ELEC], MECs, Pi,AG, GAS EOUIP, PREFABS 3 INSER1S "'
REVISED DATE 1,/1 1/T2
ZONE:_OFFICER:SETBACKS: F:-LH:- RH:- B:
Approval:_ Citli:-
Comm6nt
FLOOD:_ BFE+2ft=
AVN
r6 hr<r
PAYUENT METHOD: [CeSn crEcK (pAyABr"E To Hxc; [atr-r- accouur fiucnrrse I orscoveR
(FOR OFFICE USE ONLY)
3r az
PERMIT FEE: $/ .d.
,&-
D tr
Is Elect Por.,er on this Buildlng E Yes E uo
PHoNE s: 410 -3et-17t6
PHoNE s: qto'36)- /766
#OF STORIES:_
# OF FLOORS:_
(.Ll
,oN ,\./
ffi
RECEIVEDAPRt420t6
NEtd HANOVER COUNTY BUILDING PERMIT
,PPLICAIIOI TTPEs RESIDE TIAL
E^st tllssR ArL QUESTI(I|E tPPtTCAaLE rO Y(lrR PRoIECT
'ProJ rct Rlspolls i"bUltlf
?tt-rb- \t{t
2DlC-tt+2L{
IPPLIfITI(X
llder
(offlc. u3! )
APPLICAI{T' S l{AllE: xcvin L.iller
OEVELOPEiT N.,A
PROJ tCT AIXnCSS: 132 clair:eDr
SlrBDMSIOli secr
Pi{PERTY oL{ER'S ttAIE i xevr L, Mil.ter
(,,|{ER'5 AIDRESS: 132 clairt DI
COI{TRACTOR: tr-/A K6v1P rt tf(-
ADORE 55:? Cli\(
E AIL ADDiES5: kiml11er3?e l1south. net
molEcT corT ACT PER50 : rev h L, M1l1er
oafEi 4/\3/2016
PlIr{E {: 910-23r-6392
CIW: lilrni!]qton
BLOCI t: j_ LOT t: 4_
P E l: 910-231-5392
CITY: !!tlllingtoq ST: NC ZIPi 28412
LICETSE T:
CITY I ST: _ ZfP: _
PIInE S: 9to-231-6392
e cellin f Loo! fo! €.Ievator/lifr.
PllOlE #: e'r 0-231-6392
cAf Lo.k B€tnt oon€ to the Ac(essory stru<turcl I Ves [l ffo
, ls there a Natural Gas Llne on the current Site? lves @ tto
thls Buildlns? [] ves fl rc
srr{GLE FAr{rLY [rurlex ! roruouse
rnrrron I REilouATror,r I errrnal neeerns ! RELocATToN
llEr COflSTRrJCTtori, f) rrecr
..PLtASt CHECX AID AttSt{Ei ATL III,AT APPLY TO lo.n PNO]ECT:
! orr eemer sr ! roner
-sF
I cml _ sr I srmrer sHEo _ sF
ATT GARAGE 9J5 SF
fl orcr SF OTHER:SF
TOTAL HEATED SQ FT: 3801 TOTAT SQ FT II{DER ROOf: {"?5 TOTAL AREA SQ FT: 4175
TOTAL PROIECT COST co t-ar :t -@.99__* OF STORIES: 2
flsurnool
-sF
! enrrnxorsr
-
sr
It Any EIECTiICAL, PUllaI G o.
If the project is a ielocat
fs there Electrlcal Poxer o
PRPERTY I.|SE / OCCUPA CY:
DESCRIPTI(I{ OF lloRl( i (:onsrru t hole in
EU I}IPERWOUS ANEA: 4i 6
,ld d ohd 4pac.ba Stab and tlcd bi6
svsru I enmre ueu I cEilrRAr IELL
prrc El pRrvarE sEprrc f] comnrw srsrrn
iEQUTRED Fm EtECr, ltEC[, 9LBG, GAS EQUIP, pRrFlAS & ITaSERTS ...
DEC_LAIICR ! f6sby c..tly h.l .l ht malon b 4pk.lo.r a co.?lc! 'd a rort wtl cdnply r.lh tE SLb
.nd odil'lc.. ld ..gul.to.!5. Th! l{Hc S.Mc.r Ccnt il b. nollbd 01 rly dr&g.. h h. +pro\,6a d tpcinc.|ions or 6'l!. n coit-br o.
coot.cbr htm!!on. '- OTE:AnyWo.i lvlo tE Appmp.l.t PdmlE tlll b. h Moldon o{ dl. NC ShE
OhiIER/CO{TRACTOR: nevrn L lri I Ler SIGI{ATURE:
,ar ra*a * il rt ***arrri *ra a*ar rt a 4l ti a *,laa*r* tr** *** **,r *:|.. r irr,| r*
IS THE PROPERTY LOCATED T rlmrlum I vrs [l ro
EXISTIT{G IIIPEiVICIJS AREA: 1i SQ FT
5Q FT
TOTAT ACRES DISN.NBED: O
EXIST LA'{D DISTURBT 6 PER}'IT:I ves I-'i ro
}IATER :crrul ! comrr
creul f| cerrnalSETER:
PAY}IEIT irETH(D: Q crsx cxEcx (pAyABrE ro rry flenenrc^x ExpiEss I irc/usA ! orscorcnr*ra*a+*rr arr * a,* ttit* ***r rrrt t+a :r***,r*rt+l}r **r at*r aarlr.+rr,raa*taa *a.rat
(FOR O;F!(C Usr (raty) tavtrto o rE oalr1/t,
SETBAC(S: F: LH: RH: B:
". SEPIIATC P€N TT
Z0 E: _ OFFICER:
Approval:_ Clty:
C cnt:
DATE: FLMD:
l _ BFE+2ft=
PEiTTT
'EE: '
7 .c\2
L
ztP I zs!)j_
EXISTIIIG C(XSmUCrrOl: @
iEsIDEticE o" ! rmrrru To ExrsTrx6 rEsrDElrcE
\w NEt^l HANOVER COUNTY BUILDING PERMIT
APPLICATIOT'I IYPE; RESIDENTIAL
|-EASE ANSWER At-L QUESTIO S ApptICASLE TO YOUR PROIECT
"Project Responsibility"
tu-lagt,
2-at-qqzv
APPLICATION
Number
(offi(e use)
qlte/rcAPPLICANT'S tlAI''lE:
DEVELOPER:
S\c Ctr\
SF
DATE:
PRO]ECT ADDRESS;
SUBDIVISION:
PROPERTY Ol,I'lER'5 t.lAIllE :
OI,'iNER'S ADDRESS:
BLOCK #:
PHONE *:
ZIP: Lc.A Q J-
LOT #:
PHONE S:s.l-ogrcU5-L1
ST: ZlPi 2.c.1 6\
L
CITY:
T
CONTRACTOR:
ADDR E SS :
LEASE CHECX
ATT GARAGE
suNR00tl
PROPERTY USE / OCCUP
DESCRIPTION OF TJORK:
(LICENSE #:
CITY:
El,llAIL ADDRESS:
PRoIECT CONTACT PERSONT a a!,
T
LANDSl,,JER BE ALL THAT APPLY
SF DET GARAGE
TO EXISTING RESIDENCE
PORCH cAA sF
STORAGE SHED
PtoNE *: (i t0 Z}CI tSG I
PIONE *: rli [. 41 qrtal
ST: ZlP I
5F
EXISTING CONSTRUCT
*r, aorrr*r'litio*,EC !,] RESIDENCE or
ERATION R ENOVATION
I
IUDDi
RO]ECT:
5F
SF
6R E ENHOUS E 5F
TOTAL HEATED SQ FT:
TOTAL PROJECT C05T lressLol) :
Is Any ELECTRICAL, PLUIIBING or
If the project is a Relocati
Is there Electnical Power on
POOL
DECK SF OTHE R:5F
TOTAL 5Q FT UNDER ROoF: \-" i, ToTAL AREA SQ FT:
HANICAL !,jork Being Done to the Accessory Structune? [
$
n, is there a Natural Gas Line on the Current Site?
this Building? ! vet ffHo
ANCY:rNGLE FAMTLv I ounlrx TOWNHOUsE
ves ffio
[v"t @{o
DISCLAIMER: lhereby cenily hat attinbrmalon in
and ordinances and regulalions. The NHC Develop
is applicalon is correct and alt workwittcompty witrl he Stale Buitdng
contactor mbmato-. "'NOTE:A1ywo k Per,o,
nl seturces center wilrbe norrlied ofany changes in ihe approved
WO $e AppropriaE Permilswiltbe in Viotarion olthe NC Sble B
)i,t * )t * ** **,** * * ** **+,i )*,t,t *,t
h
l (-:
COI'1MUN I SYSTE M
(SI6NATURE:
t**t********+**+**i*,t* *r***********, *
elnd allo$er applicabte Siale and local taws
orchange in contracbr o,
d Subl€ci 1o Fines Up To $500.00'.'
,t* *,* * ** ** * )i* * r*,t * * *+
BF E+2ft=
I5 THE PROPERTY LOCATED IN A FLOODPLAIN? E YES SruO
OWNER/CONTRACTOR :
ZONE: _ oFFICER:
Appnoval :_ City
Coflment:
EXISTING IMPERVIOUS AREA:
NEW II.IPERVIOUS AREA:
WATER: M CFPUA
sEtrER: m, cFpuA
SQ FT
SQ FT
TOTAL ACRES DISTURBED:
ExISr LAND DTSTURBTNG pERrlrT: I yEs tf M)
PRTvATE wELL ! crurRal wrlr
CENTRAL 5 PTIC ! enrvrrr srerrc fl comi\4uNrry sysrEr4
*** SEPARATE PERT1ITS REQUIRED FOR ELECT, I4ECH, PTBG, GAS EQUIP, PREFABS 8 INSERTS **II
PAYIiIENT METHOD: E COS'HECK (PAYABLE rO ruXC; I aurnrcAN ExpREss E rrclrrsa El orscove n)t * *,* * ** * i*+,i,t * *,* *** * )r*,i,t * *** ** *,r * ***+,i* * * *,f ,t * *,t * * * * *,* * * * *+ * * **,*,t * * + * )** * * )t* * r*** * **+ x *,r* **
(fOR OFFICE USE ONTY)RtvIsE0 DATE O4l 11/12
DATE: FLOoD:
PER'VIIT FEE: $60
I
CITY: \ ]"
GENERAL REPATRs ! nr rocarroru
I I
# OF STORIES: I
SETBACKS: F:_ LH: RH:_ B:_
$
',.,\
uI(,,,,,,,,,,,,,,,_LDtbrN5+
RECEIVED MAY 12 zOItr
nI'J1
!\
\l)4
NEt^J HANOVER COUNTY BUILDING PERMIT
APPLICATIfi,I rYpE: RESIDENTIAL
LEASE ANSWER ALL QUESTIONS APPL]CABLE TO YOUR PRO]ECT
"Project Responsibility"
APPLICATION
Number
(Office Use)
DArEt ,{-/z -,//
PHONE *: 732 s.ft. -r?s'e
BLOCK #: _ LOT f::e?
PtroNE *: /-12 -Znt - {f{sT:/YLztPt?9q,^7
sr;7Y/ztet-%('-
PI0NE f : 4/ -?3A _7??e
PHoNE #: ?,? -47/-8??
RELOCATION
I eoncx _ sF
! sronacr sHED _ sF
OTHE R:SF
APPLTCANTJ S i,IA}1E :
DEVELOPER:
PRO]ECT ADORESS:
SUBDIVISION:
IdATER I
SEWER:
N
q_
TY
PROPERTY OWNER'S NAME:
OWNER'S ADDRESS:Y: h)z
CONTRACTOR:LICENSE #:
ADDRESS:C ITY:Vtz
EiIIAIL ADDRESS:
PRO]ECT CONTACT PERSON:
EXISTIN6 CONSTRUCTION:tr A TERATION p nrHovnrroru f] crnrnal REpArRs E
NEl^l CONSTRUCTTOT: ! eneCr
'*'TPLEASE CHEC( AND ANSI,IER BEL
EW RESTDENCE o" ! AOOrrtolt To EXTSTING RESTDENCE
ALL TI{AT APPLY TO YOUR PRO]ECT:
TOTAL HEATED SQ FT:
TOTAL PR0IECT COST rressroo :
Is Any ELECTRICAL, PLUIiIBING or
If the project is a Relocati
fs there Electrical Power on
EXISTING II1PERVIOUS AREA:
NEW IMPERVIOUS AREA:
DET GARAGE
-
SF
POOL _ SF
DECK SF
TOTAL SQ FT UNDER ROOF:
-
ToTAL AREA sQ FT:
$ ao4"!# OF STORIES: /
HAI'IICAL l,Jork Being Done to the Accessory Structure? [ V"s [ ruo
, is there a Natural. Gas Line on the Cunrent Site? [ves I no
his Building? [v"s !Ho
n
DISCLAIMER: lhercby cerriry hal a[ intormaiion in appl wi wlh sta B
and ordinances and regu atons The NnC Deveto Se Cenle lilie chang
PROPERTY USE / OCCUPANCY:
DEsCRIPTION OF WORK:
conracbr inbrmaton. "'NOTE: any Work
OWNER/CONTRACTOR :
* )t )t* * ** * ** * * ,*,* * * *,t,*,t* * )**
I5 THE PROPERTY LOCATED IN A F LOODPLAIN?
sTNGLE FAMTLv I ouer-ex ! rowruxousr
lding (bd and all oher appticabte slale and locat laws
change in contaclo r or10iolalion ol lhe NC sta€
SIGNATURE:
)*,* *!t )*)*r** **** )t**,*+* )*:**+ )t ** *)**:** *+** *** )*+,*)t rt,t,t )* +,t** +*l-l ves E rrc
Brd Code ines up To $500 ocr*
TOTAL ACRES DISTURBED:
EXIST LAND DI5TURBING PER[{IT: T-'1 YES Ef NO
SQ FT
SQ FT
creua I comr,runr
creua I crrurml
svsrrm ! pRrvATE t^lELL fl cerurul wrrlprrc E pRrvATE sEprrc I cor,l,rur,rtw svsrrm
*** SEPARATE PERI{ITS QU R EO F 0 R t L E c T ECH p L I G GAS E QUI P P R E F A B5 &I NS E R TS
R E I
PAYI.I E I.IT ETHOD:CK A8 L E TO NHC a,rl R ICAN EXP RECHEE ilc VI SA 0 ISC 0vE R,i )* * *,t ** rt*)t* * )*,* * * *,t * )*+ )t * **
(foR orFrcE u5r oirY)REVISED OATE O4l11/12
tr tr
SETBACKS: F:_ LH: RH:_ B:DATE:- FLooD: _ BFE+2ft=AVN
ZONE: _ 0F FICE R:
Approval :_ City:
Coment:
V
N?^
Y\
At>
p
I arr cnmcr _ sF
! sur'rnoom
-
sF
! cnrruousr _ sF
I cos,
I
\.
PERMIT FEE: $_25_
,M
/l 'rfiln
"i:i
bt <__-
ECEIVED MAY 12 Ml$
)t )i )i**)* )*+** *** *,t
(FOR OFFICE U5E ONLY)
:.ou_Iw?
APPLICATION
Number
(Office Use)
{PPLICANT'S NA E:
DEVELOPER:
PROJECT ADDRESS:
SUBDIVISION:
PROPERTY OWNERJS t.IAfilE :
OWNER'S ADDRESS:
CONTRACTOR:
ADDRESS :
ETIAIL ADDRESS:
PROJECT CONTACT PERSON:
*'PLEASE CHEC( AND ANSWER BEL
HANOVER COUNTY BUILDING PERMIT (
APPLICATId'| IYPE,; RESIDENTIAL
LEASE ANSWIR ALL QUESTIONS APPLICABLE TO YOUR PROJECT
"Project Res pons ibility"
DAIE: S--/Z-/1
CITY:7
PHoNE #: 9,/p - qtr2 -A//27
sr,:uLzrpt >4lt4
LICENSE #;
CITY:st9,!/,2w, ZeZoS'
PTONE *: 4i/9'72r 1a
pHoNE #: e/D - //7/ "aAij
A TERATION I nrrcvarror f] crnrul nrcarns ! RELocArroN
Et/ll RESIDENCE o" ! aOorrroN To EXISTING RESIOENCE
ALL THAT APPLY TO YOtlR PRO]ECT:
I oer crmcr sr ! noncx _ sF
I eoor- _ sr I sroRacr srro SF
SFDECKSFOTHE R:
TOTAL SQ FT UNDER RooF: _ TOTAL AREA SQ FT:
$# 0F STORIES: I
ECHAiIICAL Work Being Done to the Accessory Structure? [ Ves ffHo
TOTAL HEATED SQ FT:
TOTAL PROIECT COST lress ro9
Is Any ELECTRICAL, PLU BIiIG o.
If the project is a Relocati
Is there Electrical Powen o
PROPERTY USE / OCCUPANCY:
DESCRIPTION OF WORK:
ZONE: _ oFFICER:
Appnoval:_ City:
Coment:
n, is there a Natural Gas Line on the Cunnent site? [ ves ffiothis Building? [v"r [ruo
STNGLE FAr4rLy ! ouerex ! rowruxouse
DISCLAIMER: r hpreby cenrly flat att rrbrmaron ,his applicaton is correcland altwo will comply witr the State Buitding Code and al oher applicable StaE and tocat tawsand ordinances and reoulalions. The NHC De S€rvlces C€nEr w lt be nolried ofany changes in he approwd ptans and spcilicalions or chaoge in conl.acbrorcontracbr inbrmaiion. "'NoTE: Anywort Perfo to th ppropriaie Permlswil be inviotarion ot rhe NC stae 8kl9 code ines Up To $500.0O.'
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IS THE PROPERTY LOCATED IN rlooonrarlr fl ves E rc
EXISTING IMPERVIOUS AREA:
NEW IIiIPERVIOUS AREA:
SQ FT
SQ FT
SEWER:
TOTAL ACRES DISTUREED:
EXIST LAND DTSTURBTNG pERrlrT: ff yrS l-'l m
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CFPUA ! cerurnal EPTIC I nnrvare srrrrc ! coMMUNrry sysrEM
COMIYUNI SYSTE M ! enrvlrr wrr-r- ! cENTRAL wErL
*** SEPARATE PERI'II REQUIRED FOR ELECT, I.4ECH, PLBG, GAS EQIJIP, PREFABS & INSERTS ***
PAYr.lEr,rT fiETHOD: E CaSr H E c x PA A 8L E TO NHC AI4E c AN EX PR E S s tr /v1 tr*
REVISED DATE 04l 11l 12
F: LH: RH: R.5 ETBACKS
DATE: FLMD:
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PERMIT FEE: $15"'
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BLOC( #: _ LOT #:
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CITY:
PHONE #:?SL,$Z-q(p
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EXISTING CONSIRUCTION: E
NEW CONSTRUCTTOH: ! eneCr