SEPTEMBER 26 2016 BUILDING PERMITS'[,9"l:$' 9^u,{ E{ NEI^J HANovER couNTy BUTLDTNG PERmrr
f'., {h
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ApplrcArr,,t rvpE: RESTDENTTAL
,f [ " pLEAsE A*swER ALL qJrsrto*s ApptrcAELE To you' ,Ro]ECT
) "Project ResponsibilitY"
'blb-7Yo i
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APPLICATION
Number
(Office Use)
D,iiE. 7 -27- le
@rPRO]ECT ADDRESS:
SUBDIVISION:LOT *:
PTONE *:
ST:
7lo -,for-lq.?r
_zlP:_
EIITAIL ADDRESS:
PRO]ECT CONTACT
EXIsTII.IG CONSTR
I-l suxnoom sF
fJenrrNnousE
-
sF
sr t[ rrr, Z&f3 5
$: rfi -2J2^3607
PH6NE *. ?fi - 23 { -Zt+otr
PHONE
FT UNDER ROOF:
(roB 0rrtcr u$ oltY)
iACKS: F :
F LOOD:
l-l sronaer sneo sF
OTHER:
-
5F
TOTAL AREA SQ FT:
BF E+ 2ft=
5F
pRopERTY USE I OCCUPAilCY: fJ Srner-e FAMTLY DUPLEX [-l rorxnouse / t
@*., , Flo.t d- < h
IQTAL HEATED 5Q FT:
sornl PRolEcT cosT(r-essr-or)
Is Any ELECTRICAL, PLUI4BING or ilEC}IANICAL Work Being Done
If the project is a Relocation, is there a Natural
Is there Electrical Power on this Buildingll-ly"s
OF STORIES:
to the Accessory Structurei I ves f] *o
Gas Line on the current site? [ ves E] *o
El*o
frr.
RtvtStD oar€ 04l1rl12
^-'lrutgrl rZ" ts
rs rHE pRopERTy Lo(ArED rN A FLooDPLATN? E vrs fl no
EXISTING Ii{PERVIOIS AREA: _5Q rT TOTAL ACRES DISTURBED:
ilEl.l !,IPERVIOUS AREA: sQ rT EXIST LAND DISTURBING PERMTT: I-l Yes l-1 Ho
NATER: I creUa f] cowuurTY sYsTEM flenrvare well I cerurnal urell
sEhrER: I crrul I crtlrnal sEPTIc n pRrvlre sEPrrc fJ conmuurTY sYSTEM
rt' SEPAIIATE PERI,iITS REQUIRED FOR ELECT, trtECH, PLBG, GAS EQUIP, pREFABS & INSERTS *rr
pAyr{ENT nrrroor
-
[ cosor ftcxecx (eAvABLE ,o n*) [ anearcal ExpREss fl ncrvrso fi orscovr*
B:
&a,a n, Ao,rtbal SA.
p*opErry or{NER's nan,,, hPiDNo S$t4pu bPEz-
ADDRESS:
Ot{},lER'5 ADDRESS: Z7a6 -S4P&e ClAcua- CrTy: t<ltt,tt&cin,a
COMTRACTOR:61r-t 1a211,,q7a47bt LLC LrcENsE
CITY:
iifruon fl nerovarron p crnenar- REPATRs f, ner-ocarron
NEl,t CoNSTRUCTIOil: fJ enrCr NEhr RESIDENCE or flnOOruoN TO EXTSTTNG RESTDENCE
TIPLEASE CHECI( AND AI.ISWER BELOI.' ALL TI{AT APPLY TO YOUR PRO]ECT:
flrrr GAM6E
-
sF I oer GARAGE sF DPoRcH
-sF
f] eoor
-
sF
I oecr
TOTAL
ZONE: ,/ Orrr*
DATE:
LH:
J.*t rrr,, 8f--
fX,-\:/
l' ,r' .o'\
s',: d\r
ir'$'i^ |\',,U \Y\:
$(
DISCLAIMEF:cortity l'let afl rn hrs applEalion
and ord,nences and teoulatbn3. The NHC
contacbr inbrmslon. ".}|OTE :
OWNER/CONTRACTOR:SIGNATURE:
**r**************lt**
* * * + :| * * * * *'i * * * + * + + * :i + * *'i *'l. * ** * * *'| * +* * * ** * * * * * * r * I it **'l *'i
DEVELOPER:
aI wotk wiil comply tyi{n
'le
S<e Bulldang Code and al olhet applicable
(...)},,' ;.ffii
NEW HANOVER COUNTY BUILDING PERI,TIT
APPLIiATIf#{ TYPE : RESIDEITTIAL
Pr[Ast ax$!iF* Att QUtSil0tit ,.efl]CAELt IO YOUI Pt )iir
"Irojact Responslbili ty"
€IT}':
BLOCI( f : _:-- LOT ,:
t *u,plr*ilE s:
CITY: 1l
LICEI,ISE S:
APPTICA&T'5
OEV6LOFT*:
?80lEcT iDoflt55:
SUEOIVT9ION:
PnOfEnTY Ol.ftltt'S ilAtrtE 3
Ot,t*lfR'S loDRfSS: 1,r ^:.
IOI{TRACTOR:
&llo8ESs r
EltAfL AB$PIsSl. "r)iii
Pft0lICT C0|{TACT FtA50N I
ST: ZfP I
PtntrE $: L{e:JA-A,--t
Plmlrr s: /"t-"H t 7*-
Exlsrru6 cs.tsrfiuqtrgil, {-lletrraarrctt I nemua'rror I ee Nt*aL RtPAiRs f Rrlocarlox
J
Hgtnt c$tsT*ucTIglt! l:J ERrcT llrt* REsIsEt{cE o" f *orrrrop r0 ExISTI};G RGsrDftcE
.*PL[ASEcHEcxA}lDl'{gx€RBELohIALLIHATAF'LYToY0URI'n0]€.1:7(
^cE /^kD - sr f] rcncx ."*- '$rf] nrt GAFJlci ....- sF L(J ttET GAR.
fr ruu**,
-;;
il pooL
-
sr' fl sro*aer sHrD
-
sr
I ootu,*ourt
-
tr I orcx
-
5F or*[fi: ' ' 5r
TOTAL PK{JJttl Lu>l ttQstlor} ; a 'Y-:l-::- _,/
ls Aoy gLE(rftIcAL, pLur{gIHG or ttECHAfir(AL work Seing ec,ni'to the A(cesscry Stru'ttrr.e} W'f2.frn'*/--
If the project is a Relocatior, is th€r€ a Natu7l 6as Line ofl the Curr€nt Site? f, ves ffino
rorAr HEATI' sQ Fr: -/AZ'? rcral sQ rr uilDER **r, frl{7 rorAl AREA 5Q FT: ffi!
rorAL p*.,rc, ."rru* i imU, s oF sroRrEs: .i.*
,*7v
YJ
rf the project is a Relocatiot, is th€r€ a t:1!r1 $ l-'ne en
Is there Eloctrical Power on }[ris Building? ltztrYes I l No
pRopERry usE / occuP^ncv: (slyctE rryfiLY I oueLu I ro'$rtnyse
fi".,. l, .."1 "''t,"^,./, ,...r,-- /,- F. n.
DtgCRrPTr0ll ff t"$Rx:
;l;rdlr[wolldricrft't'wt}ntrsG!'e!,r,in?c0i{}.icr!'EiPi}''rf,5}-hstiln.mdh(a]lm5
sd crdnsffii $,d retrla*itii the NHC OB*tr'lnlat Soryf,es C+it' dr! b' noli*d ol ay rb8ltr * "t TT:-T1lf:Y::::*'::'-"Xfr:il;#j:
cofttr-h, hberri?n ...t,io?[ Any Wors &rtDftg, !1,i, tt( ]tr}.qg,r** 3,** **, b" . yo1ri," ur *'t t;C s1"] ?ldq.93rt" fd glb]c! b File' :"b ro t!00 (){r"
oefiEx/co6r1A6 ,os, /ii',r'irr;i I t {/nl Lr srGt{ATuRt , ,4- { {r**-:.
(9rrnt xa*)
,, ;:' ;;;;; ;;; ;; ; ,l*;'.';; ir ;;; "''a';" " ? a'' * 4 i'''' a'
;;""'.
"'l {' a
EXTSTI!{G I'4PTRVIOIJS ANEA: . .{'/*SQ ?1 TOTAT ACRTS DISTURBED: . ?, {
rE.o r|lp'Rv:out o*uo, Zfr-.ti n Exxsr LA^D DrsruEBrHG pcnnir, [J vrs Mno
,--J'
MrER: Crrruo fJ cc*uNrry sysrrl.l Irn:vr,rr wELL f] rEilrRAt *ti'- _hf dre{1. itrlfltlt*
SEIER: ffirolo f] r:rur*,al srpt:C I rnrvrtr sFrrrc I coq6ur'l:-'.Y sYS]rH
."' ![pA!t&][ P€i.q:I5 RFQ{J:R[9 rsF fttc], li[ci!, Pt8G, CAs tq,i:!':, DBIta8s t r]$rRTs'+'
pAynElrr,,rr*rl"""ij'.^r,, n.;;;; (;o"o*.r ro *nc) C*r*r.^* rio**r, 6olrroo [-']o:s.ouu*
,--,,. ;- ;;i,:*"ld't,i;;;: ;:"ic',',*-' -.,B-
"**:" ;I*l u'" "
rpp"ouai: Qk- citylillLllJ **t,?*L1lb- rtooD: *--**- 'efiix oFE+?*t=
IJ
PTRIIT fEE: $
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Number
(Offi(r t,$)
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NEI^J HANOVER COUNTY BUILDING PERHTT
A4PLICATTON rrpE: CO|,|I{ERCIAL
PLEASE ANSHER ALt QUESTIONS APPLICABLE IO YOUR PRO]ECI
"Project Responsibility,,
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APPLICATION
Number
(office use)
g4LgfS Farrow Archj.tecrur
PROIECT ADORESS: 3739 Careti_na Beach Road
OCCUPANT/BUSII{ESS NAlrlE: c;_rcte i{ j:rtor:rr, rnc
pRopERTy OhNERrs t{Iil{E: l,ee xarrikinson _ clrcle K srores, rnc
O!{I{ER'5 ADDRESS: 311} Gr*qsor D:ive CITY: 5.ii1'
CQTITRACTOR: iei LICET{SE *:
CITY:AODBESS:
E$AIL ADORESS:
PRO]ECT CONTACT PERSOtl:
PHOiIE
DAIE: :,'t?. L'-,
PHONE *: (40.1 ) 6or*4ccc
ZIPi 2t,4r]
S: _(9r9) 5ac*r75i
ST: NC ZIP; z"tr;tt
ST:_ ZI'PN _
PHONE
PHONE
f:
s:
Exrsr cs{srRucrroN: ff alrenrrron ; *rnJffi# 'nT?'il-^L REIATRS I nerocarrou
lf Relocatio*, is there a Natural Gas Line on the cunent siter f]yilf] r.ro ts BLoc spntNxr-eRED? fJ yes ffi ruo
NEt{ coNsrRUCTr${; EI enecr NE]l srnucrune f]FAsr rRAcK I snrr-r- f] unrrr f] mo ro Exrsr srRucru1[
ACCESSORY STRUCTUREi F..:eI cancpv wirl-. 1C fuel pumps.
If UPFIT * The Shell permit *:
ARCH DESI6ll pR0FESSfONAL: ],1ir-cn Deursc.
ENGR DESIGN PROFESSI0IIAL: f,rrc !,Jclf
Ptli {404) 501-d0C0 *: 1 3223
*: 4101 6
'Typel
NC REG
NC REGPH: (404) 501-460C
DESCRIPTION OF I^IOR(: conven:ence store with associared fuel dispensinq oumps
ls food or beverages prepaed or ssved in this strudurer flves fJ ruo ts The property Locared tn The Ftoodptainz f] yes EI no
DISC.LAIMER: I hereby certity lhat all rnformatlolr. ln lhis applical.ion is correct and all work will corncy wilh the stare Building code and alt other appticable stateand local laws and ordinances and regulations. The NHC ilvelopment Sewices Center wfl be notin6d of anv ctrjnoes rn tiroi irrange ',i'ion6;i; "; 6-"1i?';"tdXi#;:iil^: ':Y'tiijYelT}ry wo.r per{ormed wo rhe App'opriate permits wilr s" ,n v,oflfff'otirid" fl"i*i"d fPo"f f!ft"J"ia.,Li^^rA-
roved olans anct soeciticauons
of the NC State Bldg Code andor chanqe in contracto( or contractof
Subjectlo Fines Up To $500.00"'sublect lo t-rnes up I o $5u0.00"'\, Owner's hepresenlative:ffiosca!: l.,l.rerlrl SIGNATURE:
(Q{amd)(PrhtNffi)
Note: Demoli$on nodficatiofls & asbstos r€moval pemit appllcatlons ar€ to be sutrnittod using the epdicaton fd#itr whethef tne bcility o.was fcxrnd to
contaid Asb€stos o. no{. YGl atE re(Frit€d to ca$ tho Natiotl Embsioa S:tandards foc Hazardous l\ir polkrtants (NESHAP) at (9f Si:OISSSO a teost iO Oay"to th6derndifon of any faci[ty or buildirE. Sre Asb€stos Web Sire: htp:/nrvrwv,epi.stale.nc,us,/epi/asbest6/ahmp.html
TOTAL PROJECT COST: :\ , ,:ttlt , r\{i{ BUILDING HEIGHT: ::r , -8,,
rorAl AREA sQ FT : i,ev5sr se Fr pER FLR: i;elssr # oF STORIES: :ToTALSoFTUNDERRooF:|..,9}st#oF$TRucTURES;i-soFFLooRS:l-
ACRES DISTURBED:EXST I-AND DISTURB|NG pERMtr? r:yES fJ No
NEW IMPERVIOUS AREA: :i.'i , , i,.SQ FT EXISTING IMPERVIOUS AREA; _]-u t t, r SO FT
PRoPERTYUSE: floFFtcE I]RESTAUMNT ElnencnlrllE nEDUc fJner f]coxoo orHER:
wATER: [.ncFPUA fJCOMMUNITSYSTEM DwELL flzoNtNcUSEcLASStFlcATtoN:SEWER: [l CFPUA f]crNrnaI SEPTIC f, eEivare sEPTIC ;6ulaur.rlw SYSTEM
"' ::iiirAf,ijil'i i i ,,t"]ri::i I'1, ,liii,ril) r:'l)ri il.i/.,r iii,..ti, , i i;ir, r:,:,,i, i(itiji' t,trl-f:.:i:: L iltr:iiirfr. . .
PA'MENT *"T.?l;..H::::.9,:::::i:::::.'":::::1.._?y::i:::.::::::.:...!*::.::: florscovrn
(FoR OFFTCE USE ONrY)
SETBACKS:F:-LH: RH:
REViSEb DATE 4t1 1/12
ZONE:OFFICER B:- 1_#=.r',=_+2,t0L
PERMIT FEE: $
Approval:_ City:_ DATE:_ FLOOD:
Comment
Is Elect Power on this Building ffi ves f,f *o
***** rs rHrs A CHANGE oF occupAr,rcy usE? fives flio *..**
IFYes,t&atHasthePreviousoccupancyType}-ffiratisthetrerroccupancy
# OF UNITS: :;i.i
A0l (o-qL{T(
APPLICATION
Hun&er
(Office Use)
DATE: 4 ..9 - l"a tt
ZIPr 284a3
P}PNE
PH}NE *:
NEhI HANOVER COUNTY BUILDTNG PERHTT
APPLIaTIU| TYPE; RESIDET{TIAL
PLEASE AIISI{ER ALL q.,ESTIOITS APPL'CABLE TO YOUR PRO]ECT
?roJect Responsibilitf
I{AIIE: North sqate p4rtners Construction. tLCAPPLICN{T,S
DEVELOPER:
PRO]ECT ATDRESS:
ST'EDIVISIOI{:
590L Airlie Oaks Lane CITY: Hilminsron
6901 Airlie Oaks Lane CITY: tlihrinqton
LOT *:
#:
ST: NC ZIP: 28403
5T:gqzIP:28480
*:j-@-
*i 9!o-+42-7s74
BLOC( #:
PRWERTY OhIIIER'S
Ol.tttlER'S AODRESS:
NAI4E: Tim and Maria Gibbons
CONTRACT0R; North statse Partners construction, LIJC LICEII|SE S: 70045
ADDRESS: P.o. Box 3s9 CITY: wrlqhtsvj-lle Beaqh
Efit ttL ADDRESS: of f ice@norchsEat.ecusEordcuilders. com
PROIECT COItITACT PERSOI{: Jim wiseman
Pl()lilE
PlI)t{E
EXrSTrl,rG COHSTRUCTTOT.I: fIALTERATTON I neNWArrOn f]erruenru REPATRS I nrlOCarroll
ilEhl coilsTRucTroil: [l enecr ilEH REsrDEilce or f]ADDITTOT{ TO EXrsTiltIG RESIDENCE
**PLEASE CHECK AI{D AtlSl{ER BELfi ALL THAT APPLY T0 Yo{rR PROIECT:
fl nrr GAM6E r.006 sF fl orr GARAGE E] poncx t:g- sF
fl sur'rnocx'r _sF
I enrrruHousE
-
sF
flnoor.fl sronaer sHeu ,5F
SFfl orcr rzo sF orHER:
TOTAL HEATED SQ FT: 3007 TOTAL 5Q FT UI'IDER ROOF: 47si- TOTAL AREA Sq FT: 4871
TOTAL PROIECT COSTGessr-oo : $ ees,ooo # OF STORIES: j_
Is Any ELECTRICAL, pLtC{BIilG or IIECHAilICAL [{ork Being Dorc to the Accessory Structure? ffi Ves EI Ho
If the project is a Relocation, is there a Natural Gas Line on the Current Sitel fl yes fl no
Is there Electrical Power on this Building? f:l ves [lm
pRoPERTy USE / OCCUPNCV: p STNGLE FAMTLY I nnreUeX flroUUnousr
DESCRIPTId{ OF l{}RK: Constructs sj.nsle Family-Beeidence
DISCLAIMER: I hereby ceniry flal afi inbrmalbn in this appllcadoo is con€ct and dl work will comply with tr state Buiuing code afd all olher applicable slate and local laws
and ordinanc€s and regulalions. The NHC Devebprnent Services Cenbr wiil be nolified ot any cianges in rl€ appro\i€d pbns and
contacto. inbrmaton. *-NOTE: Any Work Performed W/O the Appropriae Petmits wU be in Vblallon of lhe NC Stab Bldg Code
OhINER/CO|IITRACTOR: ;im wiseman SIGI'IATURE:
(Print ilatre)**** ****,*** **** ****,i:** r.*** *.* tll*,t'*-*** ******** *** )t*rt!t *:t***** 'a*d.,8:i*.i !t *t {.)t,1.'t'1. *,t,t * **,** ***'t 't*
rs rHE PRoPERTY LOCATED rN A FLOODPLATI{? n YES ffi rc
EXISTIIT IMPERVIOTS AREA: o SQ FT
NEhI IIIiPERVIOUS AREA: >1 5Q FT
ZONE: _ OFFICER:
_sF
SF
or change ingafitracor or
b Fines-lroJd$soo.0o.'
TOTAL ACRES DISTURBED: >1
EXIST LAiD DTSTURBTNG PERMTT: Fa VrS ffi rw
IATER: [] creua f] cor+ruurry sysrEu f] enrvarr weu f] crxrml nrll
sEHER: ffi creun fl crurnm sEprrc fl enrvrrr sEPrrc fl co+Enrw sYsrEM
*** SEFA&{TE pERftITS REQUIf;ED FOfi ELECT, }tEC}|, pLEG, (!AS EQUIP, FREF*86 & trlISER?S *t{'
pAvr.tEr{r ilEr}oD: EJ *r* Eftrecx (pAvABLE ro Nr{c) fiamnrcan ExPREss ff, nclvrsr fi orscovrn
*********,r**:t,t't**:*,t;i:t***)***r.***:t******:**!i**)N:ttl*:t***tl.'t**r*:i*!t,t,t {r**rirt:*:{.****,*:L)*r(*ri***!t******
(FOR OFFTCE USE O|LY) REVTSED DAT€ UILUL2
SETBACKS: F:- LH:- RH:- B:-
Approval:- City:- DATE :- FLOOD:BFE+2ft=
Coflment:Jr*r' ree, tLi}b-OO
Ct, cf"uA
APPLICANT'S NAIIIE: Steve saieed
DEVELOPER: Masonboro Construcgion and Development, Inc.
NEhJ HAIIOVER COUNTY BUILDING PERfiTT
APPLIf/.TIilI TYPE : COIIIT{ERCIAT
PLEASE Ar{Sl.rER ALL QUESTIOiIS APpLICABLE T0 YCtiR pR0lECT
"Project Responsibility"
ZIP'. za+ot
ST: nc ZIP:3949
ST: Nc ZIP: 28401
Sz gta-q+l-izgz
s:gg:i.43..3,3.g.3-
t *'Jffiil;ii 'i'i?';il*o. *roor*, [t nelocrrroN
lf Relocdon, is there a NaturatGas Line on the Cilrent Site? flvFEI*o tS BLDG spiiilxleneD? EIves fllruo
ttrErir cotrrsrRUCTroil: f] rnecr NEhr srRrrcrune flFAsr rRAcxfl sxru IuerrrI mo ro Exrsr srRtcTURE
Redo the Lobbv
2,olu .. lrlgl
APPLICATION
Number
(Office Ure)
DATE! 9-6-16
PHONE *i eto-443-32a2
PROIECT ADDRESS: 11s Nortrh 3rd srreer CITY: wilminqron
OCCUPANT/BUSINESS l,lAltlE: :gLe Harrelson euitdins
PROPERry OHilER'S I'lAItlE: tne Harrelson Buildinq, LLc PHONE S:
OhlilER'S ADORESS: 11s Norr.h 3rd sEreer CfTY: lvitminqEoo
CONTRACT0R: Masonboro Construction and Development LICET{SE S: .19Q1_
ADDRESS: 115 North 3rd srreeE CITY: wilminqron
EMAIL ADORESS: sdsai.eed@masonboroconst.ruction.com PHONE
PROIECT CONTACT PERSON: Steve saieed PHONE
ACCESSORY STRUCTURE:
rf UPFIT - The ShEII
IF Yes, rhat vas the Prevlous Occupancy Typel
ARCH DESIGIII PRoFESSIOIIIAL: Lisle Archirecrure
rs Elect Power on this Building [l ves EI ro
tdrat ls the ileu 0ccupancy Typel
Permit *:
*rr** rs rHrs A cHAr{6E oF occupAncy usE? flves flilO **.**
PH:
PH:
NC REG #: 7eo3
NC REG *: lf:g_ENGR DESIGil PROFESSIONAL: Sims Ensineerlas
DESCRIPTION 0F NORK: Redo Lobby
ls bod or bevrrageo prepared or csrved hr ttris *uclrref f]ves fl No b Th€ Propsrty Located ln The Floodplain? flves E *o
erfilNinc)
Notc Domoll[on ndlflcsdonr t !$bo$o! rsnoval p.mlt appllceuons ara to ba ruknlttsd urlng ha applkaflor ftrm (DHHS-3768) whclher lha hdllty 6 bulldlng was bund b
conch Albodos or nd. You are roqulr.d lo call rhc Nadonal Emlsdm srrndsr& lor Hazadou3 Ah Polubnts (NESfrIAP) d (919)70rc950 .t l.art 10 dsy3 fior b tE
ddndHot d lny bdllty or MUhg. S.. Asb..b. Wbb Slta:
TOTAL PROJECT COST: 13 o, ooo BUILDINGHEIGHT:50 #OFUNITS:
TOTAL AREA SQ TT T*&€SEI,'AO- SQ FT PER FLR:1 000()
TOTALSQFTUNDERROOF: soooo #OFSTRUCTURES: I
ACRES DISTURBED:
NEW IMPERVIOUS AREA: o SQ TT D(ISTING IMPERVIOUS AREA
pnopERryusE: moFFrce flnesmumm flyERo$rnLE f]Eurc nlnr flcoNoo OTHER
B(sr LAND DrsruRBtNG pERMtr? ElyeS EINO
WATER: IACFPUA flCoMMUNITYsreTEll EWELL EJZOIISTI0USECLASSIFICATIOI*
sEwER mcFPt A flCeUrnAL SEmC flpRrVArE SEPTrc nCO[rMUNrTySysTEM.. SEPARATE PERMIIS REQUIRTD TOR 5LECT, MECFi, iTI-BC, GAS EOUIP, MEFABS & INSERTS ''
pAylrENrMETroD: EJcnsn QcnecrprvnelE ro NHc) f]mrenrcan E(PREss f]ucrvrsn Elorscoven
(FOR OFFTCE USE Oi{LY)RFVISED OATE 'I'tT'12ZONE:,,, OFFICER:SETBACKS: F:- LH:_ RH:- B:_
#OFSTORIES: s .
# OF FLOORS:I-
SO FI
Apprwa[_Ctttt:-DATE: FLOOD BFE+zfi=E**,r*&-
7o/b- 13/1
l{b-}}, O
a#Iiffi
Nufiber
(o{f irG U3r }
NEW HANOVER COUHTY BUILDING PIRMTT
APPLICATION,Y"E; RESIDENTIAL
PLtASt Ansi*rs aLL Qu€siXlI! '1ttrI(ABL6
TO YOUI PBf,)i'r
"Frojeet 3arPonsibiljtY"
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PBAIECT aDottSs:
SUBOTVTSIOH:
PROPtRYY Ol.aNIR'5
ourHfB's A$0f,[$sr
CONTRACToA: i
.'-:,:: i s5 :
Er.tAIt ADDF[SS| .r)?t
PRO]ECT COI{TACT PIRSON'
f] nrr GAR^6r ..- sF
f] sur'rr.ool,l
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I erttauous[ --..- 3F
PHOI,JE f:
cT'rY. ir'f,l
LICEfiS€ t:.Jr,ft!
EXISTII$G c$tsr8u(r1oN, [l rtrrnnrr*x I neno,larrOl f]eenrnat RIPAIFS f, Rrtorr'lioN
"*1/
NEr.t COnjSTf,UCTI1lt: l!.1 ERE{T ilghl RESTOEHCS o. f loarrrgp rO EXISTIHG R€SI}ft{(E
.IPLIASEcHtcxA}loA}lgHtxSELc[dALLr}GTApFLYTgYounPn0]E.1:
fr or,, GARA.E /orhP - sr [ rcacH =- sr
f] raor. _-. sF
f] oecx .*- sF
CITY:
fl s:anacr sHeD .- st
5I'
TOTAL ACRES DISIURBIIi: ': / -
EXIST LAI\D DISTuRs:l{G pt*rnl,t f,f "S ffino
rorAr HsArrp sQ rr: /tyZ'\ rorAL sQ rr uirorR ^*r, 4 !17 rorat AREA sQ FT:///q0
TOTAL PR0lftf (OSTn"r*rotl; $ J-W.k'!k), aN * oF SToRIts: l-TOTAL PROJTLI L{r}l ttei*lor} ; a 15;.{:=- ' *'*@
-,/Is Any tLE(IftICAt, pLUtrSIfilG or BlcHANtcaL Fork Eeing coft!' to th' Accesscry Strt''ttrre? 9-";q F
-l
Is Any tlE(rftrcAt, pLutrgrfitc or BlcHANtcaL Fork Eeing coft!' to th. Accelscry strt''?uret L3 rtr:' L-i rlv ./
If the pr.ojert is a Relocatiori, is there a tyl Gas Line on the gurrsnt Site? f ves ff*oIf the p.ojert is a Relocatiori, is there a ty' 9 t'
ls there Elortrical Power on tiris Building?ll/1Yes I Ilto
:)crE FrflrLY I ouerg f loNrivrtrst
/ ' ,.' , ''' ,-,', i;ro, ,i ,, -'-,.'l
t,. ?+r..rr. r.+t, r. +. r,,,.,.(31'31 l;T1 ....,. r r.. +...t.y,..a.r .. r r .
rs rHE paoprRrY LocArED ${ A FL0o0PLATN? rl YEs ffi m ;/
DESCRIPTIOa{ Qf t+0EK:
;ffi*;*,!::*,#;:j,i;i;:i;;:f::*.,...-<,,iv,.^,r,i.::-!r,\u,}F.sralnElikl,iq^(:i(:i:iar"r'',ii']'i'it*-:!'&1d|-i'+rrrats
ild crdttrml YtU a?rl:lxi5 Ihe NHC (>'*eiireal Se :vtrss l-f i5' dllr le noltrJ ol sl r!:3:;ir r t" :;t;:-::'i;. :Ji;;:,:;:",';l'"iill";: l##:'"*f:ffXXH'.:XHl ffJ**h F?r-rrnrgd r*,{, r* tur,.'u,,n* i,.,o,i, *rr tc''it':r''i"' r:t rt*' ric q:"r F:'i b F'et $ ro 3500 uir"
oeHER/coNrRACYoR: /]f',';'t,ri I t/iti 1l sTGNATuRE t ,4' ,r $*::::: '.- "
EXISTI|G IIIPERVI0US AREA: --a'' 5Q rT.-..7.-'7-
ilEW rrrPERVrOUS ARCA: li'oi;s 5q ,,
MrER: C;rruo flcoruqurrry sys;r.r,r f]rnrvr,rr uerr- fJ rE*r*ot-rr..:
-J^6t dre& iblfqt*
sEr-lER: ffcrrlo f] crltrnal :rr)r:c f-l puva'r t6p?rr f, ca"rux:lY sYsrt''1
.'' s''rA,1A.II pEi}n:Is RrqU:RrD roR rtEcT, P,tc'1, Pl.8G, GAs ts'JIt', pSgltES t IiIS'RTs .+.
pAynEM *rr*1"' 'D'.^r,, n.;;;; a;^"or., .o isrc) n*,u*r.on ,io**rt Wuntuo I--'lrtsto'u*
iirt l.r. airrirt tr{f,lt
rn: lL'
approvar: Ots- cityl*IIJD *:t,fl||)b tlooD: *-*-*- 'affr"X BFE+?*I'
kot'. crs\nchui c:du A6\L t\l61qV- rs Ii
F[RllIT FEE: $.
ffi*--ui,'ii
Blocl( {: I Lor it ;llA-
m'r','7,tijl',ae7
PHOHT T:
rurLDrNG PERMTT @ffi : 1y19.
Application
(office use)
APPLICATION TYPE.. RESIDENTIAL
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROJECT
"Proiect Responsibility"
AppltCANT,S NAME. Wallace Ann Coverdale Date. 09/02116
pRoJECT ADDRESS: 206 N. 22nd St.ctTy. Wilmington, NC ztP.28405
5g gp;y151g1. Greenbrook Lot e: 14
pRopERTy owNER,s NAME. S€me [L,
OWNER'S ADDRESS:ffi
CONTRACTOR:ffi
ADonESS:ffi
EMATL ADDRESS: wacoverdale@gmail.com
PHONE #. 910-343-9838
BLDG LICENSE E:
PHONE. 910-
pRoJEcT coNTACT pgg591. same - Ann Coverdale PHONE. 910-343-9838
NEw CONSTRUCTION: n Erect New Residence llZAddition to Existing Residence ! Relocation
** IPLEASE CHECK AND ANSWER BELOW ALL THAT APPLY TO YOUR PROJECT'"*
D Att Garage (SF)_
E Sunroom (SF)_
E Greenhouse (SF)
! Det Garage (SF)_tr Porch (5F)
! storage shed (sF)
./
EXISTING CONSTRUCTION: ElzAlteration ! Renovation n General Repairs
! Pool (5F)
! Deck (SF)
ls the proposed work changing the existing footprint? n yes D No
ToTAL SQ FT UNDER ROOF lJor proposed workl Heated:2]!Unheated: 209
TOTAL PROJECT COST (Less Lot): g40,000
lstheproposedworkchan8ingthenumberof bedrooms? E yes E trto
ls any Electrical, Plumbing or Mechanicalwork being done to the Accessory Structure #es D tJo
lf the projectisa Relocation, isthere a Natural Gas Line on the current site? E yes E No
ls there Electrical Power on this Building? El/Yes E t,to
Property Use/ occu p.n"y, d Single Family
Description of Work: home addition
E Duplex ! Townhouse
laws and ordinances and regulations. The NHC Development Services center willbe notified ofany changes in the approved plans and specifications or change in contra€tor
information. '**NOTI: any work performed without the appropriat€ permits will be in violation of the Nc state Btdg Code and subject to fines up to S5OO.OO."
"Licensed Quolifiel'
rs the property tocated in a froodptain? ilv", G NoAE lO.l ?fcltlYi,nL4
Existing lmpervious Area: 2780 sq Ft TotalAcres Disturbe6. 0.01 ac
New lmpervious Area: re Sq Ft Existing Land Disturbing Permit: E Yes E t,to
owner/contractor; I9llace Ann Coverdale sienaturet LN , b{+141n 0 L
WATER: dCFPUA E Community System ! private Well E Central We E Aqua
SEWER: /CFPUA E Community System E private Septic E Central Septic E Aqua
zone.RlOres ofricer: 6d0A setbacks(F)30'i$1 .*_Rtt /ot lelj.s'
city: lp lqn ort",lhlL Ftood: (A) l0, I (v)
-
(N)BFE+2ft= Ll.l {r$D-
City lnspection Requneo, 9l &254.0i{
Permit Fee: S
U/6ther (sF) 220 inside; 429 hr
Approval:
Comment:
tt frk
l*'ttrn{ hotl:[, x\o €.c.'rcbu rvcat -t \o p6r+r'sn "( atructore- in 5FttA..
ST:
1':\
&prucAt{T! ItAtrrlr: f' '1 " !- r--\ !;
NgIi, HAT{OVER COUNTY BUII$IT{G PTRMTT
APPUCAilAX TYPE: Rt$DtilTnt
PITAST A$sWER ATI. QUT$?}ONS APPLICABLE TO YOUR FROJTTT
-Proj*rt f;e*Wnsibllity'
Appli*tir,n
Itlumh*r
{ol{it* *re}
gry; lJ-r\v.rr', v-..h rr zri:'.,*+tUJi . -'LOTf: ": *-
EtoG rrcEflsl a, ia I *) 'i
AOO[[S$I a,ir {l-".r* -.:'-1*r--iEMAIL ADDRESS: i vr{
p*(}rECTCOilfACf PEisON: P+*-, t-.f- d. , ,,,,,, . pxOxe,M
B(l$flffe tOt{SfRUCnOil: i] Aheration lJ Rerr*vatioa n Geecrat Repairs
HEW COI*SfRUCTI0I{: *{rect f{ew Residence ill edC*ion to fixisting Residenre fJ Relocario*
r{
il cetGoragrtsfl-
Sunrccm tSFl
-
Greenhouse {Sf}
-
ls the pr$os*d work changing ihe existing footprint? fJ Yes ll No
tsrl
n
u
Pool(sf)
Deck {Sr}
Ij Storageshed{SF}
{3 othar {sr}
{o $*TQTAL 5Q ff Ur.ptR Roof (for proposed;gort) tketcd: Jf * a unhcated:
TOTAT PfiOrECTeOfT {Less rot}: $
ls the praposed trork char{iing the number of bedrooms? E Ycc tl tlo
lp any E**riric*|, Flumtfns or lrlleshsdc*l umrk beiry don* to th* Acees:ory Structure [J V:r tr lilo
lf the prsiect is a selocatbn, is there a N.tural gas Line on the curr€nt stte? EJ Yar E ilq
ls ttrere El*ctriml Pow*r *n this *uilding? [f Vc: f3 no
..,
propc*l lri€/ oGqp.ncY: g1.tsirtsle Fertity tr Ouptcr El Totrnhouse . t i ,
s--.ririlhrrsfltrark -...,-t'-lrt, :r' frifi"- l{ j ; i.'** ir f *"'^ t* \ Lt.''-'< .
ztq.
t*FI {ag llsa BE siw I slY
informatl*, '.rltGIE: Any wfr-piormeo *inogt t-trc rrp1r1pri.t. F..!nic xl8 b€ in vn*atioo of thc mC $ae p,Code *rd rut{tct to fines qp to 5500.00'"''\ ,i
owncr/contractar i--)i^.,'"., ki'"Ljr..b'i r- signeture:
'trcensed Qrutfrar- Fnntrtlome J.
Itr the property losted in a floodplain? D Yec &
{Bdstlng tmp:rvknrs Aree:
-
tq Ft Total AcrE Disturted: - I '
':'lz?;*HewtmpMousApr:S,{ I'l "> ser, E**hgtr*dDbturbkrgPamlt;f} vcs E} tto
WATER: q/rr:l C3 CommunltySyrtem E PrtvateWell E CentralWell El Aqua
s€wGR: qrdeva Ct {omrnun\sptem f} rriwttitgtie [l C€g1trfrliep1iC E AqUa
Irncr
-
Officcr: Saiba*e (Fl
-
{L}l}
-
(RH}
-
{B}
-lpprqrel: Cttr:
-
Oeter
-
Flood: {rtl
-
{V}
-
{il}
-
BrE*2ft=
Comnnert:F*rmit *.,J,It1 l
&crb- lvq\ffi
--##qh*q
fiIEW HAII*OVER COUNTY BUILDIHE PHNMIT
AP P Lt CAT P F,l TV Pf : RESI DENTIAL
PLTASE Af{SWTR AtT QUESTIOT*s APPI.ICABLE TO YOU* P&OJ[C?
"Proiect Responsibility'
f3,
\1rl & Fr l"re {ar&s ,$llu*
Adicaria*r
*umbqr
{oiffice ure}
APPLI{ANT'! IIIAME:
PRO}f;CT ASSRES$:
SUBDrVrSrOt\r:
PROPENTY OWNER'S
OWTTGR'S AI}DBESS:
},DDftf$S:
EMATL AOD*[SS: i
BLDG LICEN5E S:
t\ t 'J "*'/' PHot{E:TROIECTCOI'TACTPIfiSOH: .tlz.* \ l' :t L t c-
EXl$nftG ffiISfRUCflOH: tll $teration fl Renovation il General Repairs
I{Ew COtr,STRtlCTlOtl: {fr*Hew Residence fl Addition to Exirting Residence il Relocation
*tl
fl PoollStl
fl Deck(srt
I) StorsgeShed {Sr}
PHONE f:
,/ .*ILEA*. cHFq( #rc #I$!i,r,&!lclosr 4Lr rltAT Apply ro vflrn pRotE$r'/
.4"Garase tstf {{ "i{ ?. Il kt Garase {sr}
-
drch $rl
ilJ Sunroom{Sf}-
If Greenhosse (SFI t] Ottrer {Sr}
ls the proposed work changinS th€ existinS footprint? U Yes Li No
ror&LsqFruf{DE*RooF(/orproposedwo*} xot a,#5-J3-- unheeted: 13 ] |
rorAL PRorEcrcosr (Less Lot): S I ift {}"n
lr the proposed work changing the number of bedrooms? O Yes El Xs
ls any flec$i*g|, Plumbirry sr M*(honicnl ryorl heing done to the Acces$ory Strtcture O Vts tr flo
lftheprojectisaRe{ocetian,istheraallaturalGasLineonthecunentsite? [J Yes Cl tlo
l$ th*rs Els*trieal F$,wtr sn this &ujlding? O Yas f! ilo
,/
Propertyuse/ocqryancy: Ef sinepFamily tr Du*rE Twnhouse ; .l
Decrigonof wark f *n ltn-r "t t*". ' t-, ^ t I f e"r^ 'i*\ JiI"r&q'.{t-
lnlonnation. 'ftHOTf" ru1y wq* B€rt$nfied yrithorrr thr srproprtate perm.t'wtH b* hviolati,oaot th. t*C Stite Bldg Codc erd 3uBlct to *n+* *9to$500.00**">, ,l I
orncr/f,.ontrartorr - L.)f,.q-] "k"M$[natue:
"Lkenstd Qualifier"Print Nd.fie
ls the property lsdated in a flotdplain? C Yes dn"
fxisfing lmparulcur,Araai
-5q
Ft Total Acres Dlsturbed:l'l
ttew tmperv'rous Arta: lJf S' q r,
-lWATER: B.drng* t]
$suYEff; 6uo g
?one:- Offfcer:
Exitting tand Di:turbing Permit E xes fl tto
Community System fl Prfuate Well E €entral Well 0 Aqua
{emfl}$nity $y;tern ! Prwete $eptic B (entrel Septie EI Aque
*tbaclts tFl
-
(LHl
-
{nH}
-*
{8}
-Appraval: City:
-
Dat*:
-
Fhod: tAl
-
tVl
-
til)
-
BFE+2ft=
Commsnt:Fermit
I u-av -^Fe€:s\/ I l0
PHOIIIE:: ?"(li/r3ll*-"",,.
ZIP: * r..
./-iiil:\
,/,.21-,t\
W
APPLICINT'S
DEVELOPER:
NEhI HANOVER COUNTY BUILDING PERMIT
APPLTCATION TYPE., RESIDENTIAL
PLEAsE ANSOER ALL QUE5TIONS APPLICABLE TO YOUR PRO]ECT
..project Responsibiliqf
&at' - qum,W+
APPLICATION
Nrmben
(Office Use)
oarc.1 l'-l-lu
?le t E4ol
PRO]ECT ADDRESS:
SUBDTVISION:
PROPERW O{.]NER,S
Oi,.INER'S ADDRE5S:
CONTRACTOR:
ADDRESS : l<-
EMAIL ADDRESS:
PRO]ECT CONTACT PERSON:
*: Arc- tt4 4G1L
st:W AP: Z99O\
l'( [ t
PHONE #:
I eneewotse
--
sr
PROPERTY USE /
DESCRIPTION OF
f] eool _ sr
l--'l nrrr
Sponcn 2- zn sF
I sronnoe SHED _ sF
OTHER:
-
SF
EXrSTrr{G coNsrRUcEON: E nr-rennrroru [ ner,rovarror,i f] eerueeal aeearns f] RELocArroN
--.-NEhI COT{5TRUCTIOI{: IgI-TNrCr NE}I RESIDENCE O" I AOOTruq.I TO DGSTING RESIDENCE
{.+PLEASE CHECK ANE AiISIIER BELO}I ALL THAT APPLY TO YOUR
I arr onnaoe _ sF f| orr oraroeI sur'rnoo,r SF
TOTAL HEATED 5Q FT: I5qO TOTAL SQ FT UNDER NOOr: IgI{ TOTAL AREA SAF[. 19Iq
ToTAL PRolEcT CoST 1ra:s r_o0 t $ Jl_OfOt O - # oF STORTES: t ?/rs Any ELEcrRrcAL, PLullBrNG on l,rEcHAIrcAL l,,Jork Being Done to the Accessory s!.Lcture) ffvua I r.ro ,.If the pnoject is a Relocation, is there a NaturaL Gas pne on the Curnent Site? [ vu= ffltoIs there Electrical Pourer on this Building? f] V"r ffino
OCCUPAI,ICY:FAl4rLY n DUPLEX f] roHMtousE
NORK:
and ordinancas and rcguladons. Ths NHC o€\rBlopmont S€Nic€s C6nGr v,illb€ noritud ofany changG h fiB apptov€d pLn6 and Ep€dfic€tions or change h conEebror
ol{NER/CONTRACTOR:SIGT{ATURE :
IS THE PROPERTY LOCATED IN A FLOODPLAIN? N YES ffIN
EXISTING IIIPERVIOUS AREA: _sQ FT T0TAL ACRES DfSTURBED:
NEW !'1PER\fiOUS AREA:SQ FT DGST LAI'ID DISTURBII,IG PERITIIT: I-I yes I_I Ip
r,arER: trJFpuA I cowururw sysTEM E pRrvArE VJELL I carau wer_r-
SENER: [l cFpuA E CENTRAL sEpTrc I eRrvare sEprrc n cc,fr4uNrw sysrEM
*,.,! sEp{tATE pERarTs REqUIRED FOB ELECT, t{ECHr pL86, CAs EgUIp, p&E FABS & ITBERTS *$
pAyr,rEMT r,,lErHoD! [ casx f] cnrcK (payABLE ,o u*; I rrri *.*n] -
E rczwsa f] orscoren*** * *** *,1****)t* **:t***i.:1.**+** ** *+*,t rhtt*******rt * * rt *:t +* *i**:tit;ts:ts:t:! * **** **** *** ****,r;i;r*;*** *:B
^\, r,?- 6 orrr..*, (Kl-t'{)) . "IJ;:'-:':i':b_uJ,l_ ns,5' ,,rSi"*'ooo"*""'
approval: r.z/ cityr Oaterl- i+-lb FLooD: _ \. BFE+2ft=., I r /l . A v --ii-7\.*,.n, mrrr, r fiT]-
eJbcL-
PROJ ECT:
SF
I,IAT,I E :
PA+t\.\d "? tD {i^tCz
City lnWection Requueo, 9] 0'254{t'$
+: J LoT *:
PR0IECT ADDRESS: 8524 Fazio Drive
NEId HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE: RESIDENTIAL
p LEA'E ANSWER#
:::TT,:H[1T#,Y0,R
PR.r Ecr
Charter Building Group
CITY: wilminqrton
aotb -Woo
APPLICATION
Number
(office Use)
APPLICANT'S ]\lAfiE:
DEVELOPER:
DATE: 9/9/16
PHONE *: 9L01692419
ZIPi 28417
85SUBDIVISION: Porters Neck Plantation
PROPERW Oh.INER'S
O{NER,S ADDRESS:
MME: Tom and Margo Russel-1
CITY:
CONTRACT0R : charter-qlll l-!LLng-Sregg LICENSE #: 61 6'7 e
ADDRESS: 108 Giles Avenue suite 104 CITY: Ivilmington
EMAIL ADDRESS: tonyaGcharterbuildi-nggroup. com
PRO]ECT CONTACT PERSON:Sean Lewis
Is Any ELECTRICAL, PLUmBING or I{ECHANICAL Wonk Being Done to the Accessory
If the project is a Relocation, is there a Natunal Gas Line on the
rs thene Electrical Powen on this Building? l]lYes EJuo
BLOCK f: LOT #:
PHONE #:
PHONE
PHONE
ST: ZT?:
ST: NC ZIP:28403
*i 910'r 692440
*z 9t02625899
Sinqle Earnily dwelling with an attacheSl-g4r4ge
EXISTTNG CONSTRUCTTON: ! ALTERATTON I neruOVarroru [ ceurnnl REPATRS I nelocnrroru
NEhl CoNSTRUCTTON: @ enecr NEhJ RESIDENCE or I nOOrrroN To ExrSTrNG RESIDENCE
{'*PLEASE CHECK AND ANSWER BELO}'I ALL THAT APPLY TO Y0UR PROIECT:
[nrr GARAGE se1 sF I oer GARAGE sF gPoRcH LsF
f] surunoom
-sF
n pooL
-
sF I sronner sHED
-
sF
I oneeruHouse SF I orcr SF OTHER:SF
TOTAL HEATED SQ FT: 2't'73 TOTAL SQ FT UNDER R@F: 3s8e TOTAL AREA SQ FT:3sB9
TOTAL PROJECT CoST(t-esst-o0 l $ zgzazq # OF STORIES: z
PROPERTY USE /
DESCRIPTION OF
OCCUPANCY:
WORK: ttew
[] srruer-e FAIvrrLy ! uuelex ! rowruHouse
stnucture?[v"t Eruo
Current Site? [ Yes E No
DISCIAIMER I hereby certifo hat all information in his applicaton is conect and all work will comply wilh he State Building code and all olher applicable Stab and local laws
and ordtnances and regulations. The NHC Development Services Center will bs notified of any changes in he approved plans and "p:lf::ti:n" ?:"h":9"1! ::ig*j."'
contracror inbrmarion. .-NOTE: Any Work Performed WIO he AppropriaE Permits will be in Violation ot the NC State Bldg/ege and Subiect$ {ines Up
OWNER/CONTRACTOR: charter Bui-1dins Group SIGNATURE:
fPrint Nane) I
**,t *******,r*******'t,***{.***S*************************,tr.****************t ******x***
rs rHE PROPERTY LOCATED rN A FLOODPLATN? n YES E *O
TOTAL ACRES DISTURBED:
EXIST LAND DISTURBING PERMIT: fi VES I]I T'TO
6ATER: El crpua D cor"lqururw sYsrEM f] enrvarr wrll ! cerurnal well
sEWER: [t creua I ceurnal sEPTIc ! enrvnrr sEPTIc ! commururw sYsTEM
*** SEPARATE PERITIITS REQUIRED FOR ELECT, MECH, PLBG, GAS EQUIP, PREFABS & INSERTS **'I'
pAymENr r,lETHoD: ! casn E crr.* (nAvABLE ro NHc) [ amenrcm ExpREss E mclvrsr l]l orscovsn
*{.*)***********:**{.)k,f***r(*******XX***************:t*r(*********)t*:F****{c*****d(************:t**
REVISED DATE A4/L1/72
LH: RH: B:
EXISTING IMPERVIOUS AREA:
-
SQ FT
NEhI IMPERVIOUS AREA: SQ FT
ZONE: _ oFFICER:
Appnoval:- CitY:
(FoR oFFTCE USE 0l'lLY)
SETBACKS: F:
N
PERMITConxnent:
DATE:F LOOD:'r'r'r*rnlffi'1-
v9 C\-.1
NumbeJ
{ottce urP)
29./6
PROTESTADDRE55T .-Aiij**U**"t:i- i,t,*x. cnvtJt),t-or'*tr"' ztp:*Zfit/*Z-
' ''''
"""
#h
$ff'
SUBDIVISION:
I att Garage (SF) --, . --
--,I Surtroom (5F) - ,-."---^-.
-l Gre,erhouse (SF)
--
PLEASI ANSWER ALL QUEsIIONS APPLICABTE;O YOUR PROJSCI
"Pro,ect ResPonslbilitY"
C Det Garage (Sr) __--
[] Pool (sr]
I oeck (Sf).---
fotal Acres Disturbed:
Existing Land Disturbing Permit: il
0 PrlYatr well E Central well E aqua
fl Prrvate Septrc fl Central seplic [:] Aqua
PHoNE: dte:833-J z*Q3- -
l-l Porch (5t)
-
. : Storage Shed (SF) .-.
E otrrer l\il -l,a*fu{*dtwi
Yes *l
toT s
pRopERry owNtn's r,rarvrt: ..fi15-)*--. .}.cc.hlsJ* --"- PH9N.E tfuZ;i3 9..: 2{9*6^
-.
'
owNER's ADDR(ss: j'fJ?.+i,'-5rr * D*-.= aw'Q1-9sr,***-_.-*-.*zrp: Z''{Y"/
coNTRAcroR,-. kr,r..ri /A*r./urulr,. *-.BLDGtlcENsEet]335j{-._*''
ADDRr5s:**a2Ai-.--C}TY:fu,[-g*y21,n.1u"v.".-st-4/{-,zw:7K*r.-.
,ro,,or*rss, -Utte /*/^/*{*o-"1*1-.L,-ro.tt-r4-- PH9NE; 2->'2''2\o 7*1"t41-
PROTECTCONTACTPERSoN: - y'-* a-d-
EXIST|NG CONSTRUCTION: I Alteration I Renovation 'f General Repairs
NEW CONSTRUCrtoit: "'l Ererl New Residence Lj Addilicn to Exisling Residence ; ffeiocation
'*'PLEASE CHEC-I!.AND ANSWER BE|OW A -yo.u&r3"9JEg1'"'
ls the proposed rvork changing the existing footprint? l-: ves X No
TOTALSqFTUNDTR RooFVot ptoposedworkl Heated: -2OOV Unheated:
roTAr PROJECT CO5T (Less totl: s -ir.lfu.a.
!-
15 the proposed work changing the number of bedreomc? D ves S No
ls any Electrical, PlumbinB or Mechanical work being done to the Accessory Structure 3 Ves ! ruo
tf the ttroject is a Relocation, i5 there a Natura! Gas Line on the current site? [l] Yer E No
rs there Electrical power on this BuildinS? E ves E No
Property Use/ occupancy: $ single Family E Duplex D Iownhouse
Description of Work: -.....^ . .... { , , 4/, (q..A..7-,g^**ZAX";r}A....^Z*.t-21. -J0uJ-zo**i(g'.. ' -
-J)-oJ **.:l ,De **-
iilforln,ltron . . . 1.i9-t1 any work po4{rmed wrihout thr nppropr}atr of 'rrr wrll be in vrolation ot thc NC 5!a1" Bldg C.*e rnd tubfft to tinar up lo 5500 00" '
./
owner/Contraclor: j1*g-s+-t-A;r7',/ atJ*--**-signatur:F, -*tr?*-;rr2ngsi Qnctlilier" Print N1/r:e '/
ts the property located in a floodplain? C ves E t'to
Exlsting tmpervious Area: *-. -* tq ft
New lmpervioug Area: -------
Sq Ft
WATER: 6 CrPua n :omm'Jnity Svstem
SEWER: S croro n ccn,m'.rnily SYsten:
No
zon",-S; 15 off,.",, !}-(lL serbacks{f)NiA{rx1';[(RH) iliA 1s10-iA
orr,.,n, 0,y - citv: LS.Lifl- Datei df lU Frood: (Al (v)--.. - (Nl /- aFE'?rr:
Totb- ?5ro
NEW HANOVER COUNTY BUILDING PERMIT L-'**J
AppLtcAflor ryPE:REstDENrrA L ?€1 l6-?\51 ,.,,,,-;;
,\
comm ent: NO-SXC-611SIU1
t
Perrnit Fee: S --r 5, lb
&orto-lstzRECEIVED SEP .8 20ffi
NEW HAN',ER couNTy BUTLDTNG pERMrr lJ-'rr I r''l"ll M-?l
AP PLI CATION W PE: RESI DENTIAL
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROJECT
-Prorect ResponslbllV
AppLlCANT,s NAME: Etrqlge fools Of Wilmington lnc
a\
Application
Number
(office use)
619' $$2016
pROJECT ADDRESS: 5600 Lands end ct gryy. Wilmington ztP. 28405
SUEDIVISION:LOT *:
pROpERTy OWilEn,S fitAME: PArker Southerland pHoNEs: 910€19-2126
OWpER,S ADDRESSI 5600 Lands end court gn. wilmington 71p.28405
CONTRACTOR. Prestige Pools Of Wilmington inc.BIJG SCENSE s. 54579
ADDRESS: 5307 South Collqge rd gsy. wilmington s. nc 2gp. 28412
EMAtt ADDRESS: prestigepoolsofi^/ilmington@g-mail.com pHONE: 91&.50*237G.
PROJECT CONTACT PERSON: ShANC pHoNE: 910-232-5375
EXISTING CONSTRUCTION: fi Alteration fl Renovation [] General Repairs
NEWCONSTRUCTION: [) ErectNewResidence G ndditiontoExistingResidence fJ Relocation
***PIEASESHECK AND ANSWER BErc ***
[3 Att Garage (SF) --__--
fl sunroom (SF)_
fl Greenhouse {SF) _
n Det Garage (SF) _E Porch (sF)
El Pool (sF) 464 fl Storage shed (sF)
fl Deck (sF)n other (sF)
ls the proposed work changing the existing footprint? [ Yes E ruo
TOTAL 5Q FT UNDER ROO9 lfor proposed workl Heated: !Unheated: 0
TOTAT PROJTCT COSI (Less Lot): $48000'00
ls the proposed work changing the number of bedrooms? E Yes EI No
ls any Electrical, Plumbing or Mechanical work being done to the Accessory Structure E yes E No
lf the project is a Relocation, is there a Natural Gas Line on the current site? E Yes E No
ls there Electrical Power on this Suilding? E Yes E No
Property Use/ Occupancy: [tr Single Family E Duplex f] Townhouse
Description of Work: lnstallation of in qround fiberqlass swimming pool
Iaws and ordinances and reSu,ations. The NHC Development Servkes C€nter will be notified of any changeg in the s and specifications or chanSe in contractor
information. t++NOTE: Any work performed without the appropriate permits will b€ in violation of the subject to fines up to 5500.00'"'
Owner/Contractor:
"Licensed QuqIifier"
Shane Kosnik
Print Name
ls the property located in a floodplain? E Yes El ruo
€xisting lmpervious Area: _ Sq Ft
New tmperviou, nr""' 4ES sq rt
Total Acres Disturbed:
Existing Land Disturbing Permit: D Yes E l,to
WATEfi: E CfpUn D Community System D Private Well E Central Wetl E Aqua
SEWER: E CFPUA D Community System D Private Septic I Central Septic fl Aqua
Zone: _ Officer: Setbacks (Fl _ ttH) _ (RH) _ (B) _
Approvalr City:* Date:_ Flood:(A)_(V)_(N)_BFE+2ft=
Comment:Permit ,"",, ?S-
!
ffi
futo- ?sz{16-2648
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE : RESIDENTIAL
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibility"
NAvlE: Mark .lohnson
PRO]ECT ADDRESS: 1516 D e Place CITY: wi Iminqr-on IJC
SUBDIVISI0N: Lanclfall BLOCK #:
PROPERTY OWNERJS NAME: fi n Hea 1e
OWNER,S ADDRESS:CITY:
CONTRACTOR: mark iohnson custom homes LICENSE #: 5A5)1
ADDRESS: 1319 militarv' cutoff suite cc #2lL CITY: ',riInrin
EMAIL ADDRESSI rnarkGmarkiohnsoncustomhomes . con
PROIECT CONTACT PERSON: mark 'lohnson
APPLICATION
Number
(Office Use)
DATE: 5/:3/16
DEVELOPER:PHoNE #: 9rr.4u).242t
ZIP | |ii411
PHONE
LOT f:
#:
ST:
-
ZTP:
-
ACCOUNT #: 365r1
ST: nc ZTPi 281:5
PHoNE #: )ta . 44 r .5422
PHONE #: 91,-r.4{3.5122
sF EPoRCH
-sF
SF
EXTSTTNG CONSTRUCTTOru: f] ALTERATTON I nrruOVnrrOru f Crrrrennl REPATRS f] nrlocnrroru
NEW CONSTRUCTTONT I enrCr NEW RESTDENCE or f] AOOTTTON TO EXTSTTNG RESIDENCE
**PLEASE CHECK AND ANSWER BELOId ALL THAT APPLY TO YOUR PRO]ECT:
sF I orr GARAGE
I eooL _ sFtrI
I nrr GARAGE
I sronncE sHED
-SF
SFSF OTHER:
TOTAL HEATED SQ FT: O TOTAL SQ FT UNDER ROOF:TOTAL AREA SQ FT:
TOTAL PROIECT COST(lesst-ot) I $ 90,000 # OF STORIES: i
Is Any ELECTRICAL, PLUMBING or MECHANICAL Work Being Done to the Accessory Stnucture? [ V"t B *o
If the project is a Relocation, is thene a Natural Gas Line on the Cunnent Site? [ V"t E *o
Is there Electrical Power on this Building? [Tlves il ro
pRopERTy usE / occuPANcYr I srruclE FAMTLY ! ouer-rx I rowruHousr
DESCRIPTION OF WORK: renovating baths and kitchen, hardwood addltion where carpet was
and ordinances and regulations. The NHC Development Services Center will be notified of any changes in he approved plans and specifications or change in contractor or
confactor information. -.-NOTE:AnyWork Performed W/O he Appropriate Permitswill be in Violation of the NC State BIdg Code and Subject to Fines Up To $500.00..'
OWNER/CONTRACTOR! nark jobtlqsn SIGNATURE:
**r<*********r(***tr<**********(ii'lllii:i***{<***>F*,i<>k***********>k******************************
IS THE PROPERTY LOCATED IN A FLOODPLAIN? f,*] VCS ['FI T.TO
SUNROOM
GR E ENHOUS E sF I oecr
TOTAL ACRES DISTURBED: r,9r,S-
EXIST LAND DISTURBING PERMIT: Ii*l YCS !*] ruO
wATERT I creua f corvNulrrry sYSTEM f, enrvarr wrll ! crrurnaL hJELL
SEWER: E] creun I crrurnal sEPTrc f enrvarE sEPTrc E comNurvrrY SYSTEM
**:* SEPARATE PERMITS REQUIRED FOR ELECT, MECH, PLBG, GAS EQUIP, PREFABS & INSERTS **'*
PAYMENT METHoD: fl cnsH fl c}recx (PAYABLE To NHc) [ arr-r- AccouNT ffi mcZvrsn FI orscovrn
***1.*r<****r(***********,k**)k*r(*********r(*r(*******:k***********************r.r<***************
(FOR OFFICE UsE ONLY)
SETBACKS: F: LH: RH: B:
REVISED DATE O4/!L/72
EXISTING IMPERVI0US AREA: no chanqe SQ FT
NEW IMPERVIOUS AREA: no chancle SQ FT
ZONE : OF FICE R:
Appnoval:_ City:DATE:F LOOD :BFE+2f ,= 9?7, ID
-.,i}'r:i; ..
ffi?
APPLICANT,S NAME:
PROJECT ADDRESS:
SUBDIVISION:
PROPERTY OWNER,S NAME:
OWNER,S ADDRESS:
CONTRACTOR:
ADDRESS:
EMAIT ADDRESS:
PROJ ECT CONTACT PERSON :
NEW HANOVER COUNTY BUILDING PEKMI I
APPLT cATtoN TYPE : RESIDENTIAR E C E I
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR
"Project Responsibility"
H'n
rJ"\
Lo'#t\tb
ztP: 2-6q1\
*-
+
nr
PHONE:
PHONE:
EX|STTNGCONSTRUCTION:u Atteration I Renovation ! GeneralRepairs y'acce=rrrl Qc,n]brL)c].n/
NEW CONSTRUCTION: n Erect New Residence n addition to Existing Residence D Relocation
***PLEASE CHECK AND ANSWER BELOW ALT THAT APPLY TO YOUR PRO'ECT***
tr Porch (SF)E att Garage (SF)-
n Sunroom (SF)
E Greenhouse (SF)
-
D Deck (SF)
ls the proposed work changing the existing footprint? n Ves;fro
TOTAL SQ FT UNDER ROOF (/or proposed work) Heated:
rorAL pRoJEcr cosr (Less Lot1, S{c.c.(i . oc ,/
ls the proposed work changing the number of bedrooms? D Yes {"' /
ls any Electrical, plumbing or Mechanical work being done to the Accessory Structure M Yes E tto
lf the project is a Relocation, is there a Natural gas fingzdn the current site? D Ves Qzdo
ls there Electrical Power on this )rildine? E Yes Q/ruo
Property Use/ Occupancy:V Single Family fl Duplex E Townhouse
D oet Garage (SF)-
fl Pool (SF) _-Gr"r"Shed (sF)
tr otner (sr;
Unheated:
Description of Work:
Owner/Contractor:
"Licensed QuoIiJier"
applicable State and local
Print Nome
Signature:
Total Acres Disturbed:
ls the property located in a floodplain? f] Yes
Existing lmpervious Area:
-
Sq Ft
New lmpervious Area:Sq Ft Existing Land Disturbing Permit: D Yes ! ttto
WATER: E CrpUa E Community System fl Private Well E Central wett t aqua
SEWER: E CrpUR E Community System / erivate Septic E Central Septic fl Aqua
Zone: Officer:Setbacks (F)
-
(LH)
-
(RH)
-
(B)
-Approval:.
Comment:
in contractor
City:
-
Date:
--
Flood: (A) (V)
-
(N)
-
BFE+2ft=
Permit
2'C-\ r-,ree:S I J
r"nl1 il
BLDG TICENSE #:
information. ***NOTE: Any work performed without the appropriate permits will be in violation of the NC State gu8fod?Jnd subject to fi(t up
(\l
NEW HANOVER COUNTY BUILDING PTRMI I
APPLICANT,S NAME:
PROJECT ADDRESS:
suEDlvlsloN:
PROPERTY OWNER,S
OWNER,S ADDRESS:
CONTRACTOR:
ADDRESS:
ctTY I t, ,, I 4 t'tlf. k, zlP: #^t/?
T
StDG LICENSE #:
ut*,"n L" - srt Lul 2"*/ Z
-
P HINE: -?1-Q--9:1-: 33-4- 7
ExlsTlNG CONSTRUCTION: n Alteration E Renovation E General Repairs
NEw CONSTRUCTION: n Erect New Residence I Addition to Existing Residence n
sncrl delac!rccl
**,iPLEASE CHECK AND ANSWER BELOW ALL THAT APPLY TO YOUR PROJECT'**
E Det Garage (5F)D Porch {sF)
E storage Shed (5F)
Relocation
tr Att Garage (sF)-
tr 7boE Sunroom (sF)
n Greenhouse (SF)
-
tr
ls the proposed work changing the existing footprint? E
TOTAL 5q FT UNDERROOT (lor proposed lvork) Heated:
TOTAL PROJECT COST (Less Lot): S-rLZ
Pool (SF)
Deck (sF)n other (sF)
Yes n No
unlrearca, 7GO
ts the proposed work changing the number of bedrooms? E yes M ruo
ls any Electrical, plumbing or Mechanical work being done to the Accessory Structure U yes 1[no
lf the pro.iect is a Relocation, is there a Naturat Gas Line on the current site? E Yes E-No
lsthere Electrical Power on this Building? n Yes ElNo
Property Use/ occupancy: E Single Family E Duplex E Townhouse
o",.,iptionoiwo,i, +ha&- P;'- ;i-;\i +' +rol9
laws and ordinances and regulations. The NHc Development iervices Center wilt be notifaed of any changes in the approved plans and specifications or chanBe in coniractor
rntormalion. ...Nort. any work performed withour the approp are permnr wrll be in vrolalion of lhe Nc slate ElAcode a/tublect to frnes up
1s500
00"'
owner/coniractor, ?aa:tJ U)r"r^g, sisnature: f \/ uy /L' LA-/-H9
"Licensed Quolilier" Ptint Nofie
ls the property located in a floodplain? fl yes B-ruo
Existing lmpervious Area:
-
sq Ft
New lmpervious Atea:Sq Ft Existing Land Disturbing Permit: D Yes fl No
E Private Well E Central Well E Aqua
Total Acres Disturbedi
WATER: fl CFPUA ! Community System
SEWER: BCFPUA E Community System E Privateseptic (Central Septic fl Aqua
Olficer:setbacks (F)
-
(tH)
-
(RH)
-
(B)
Approval: _ City:
Comment:
Flood: (A)
-
(v)
-
(N)BFE+2ft=
Permit Fee:,+S
\,/)
pRoJEcr coNTAcr PERsoN: L>P/ tE LUA.,/t/Tr) PHoNE'q,o q'7/ 4soz
AppUcANfs NAME. Dudley Builders, lnc Date. 9-7-2016
PRorEcrADDREss. z *.@l-
SUBD|V|S|ON. Tract 4 ol The M.C. Boyette Lands
PERMTT --"rG q52+
LS--ffit
LOT #:
NEW HANOVER COUNTY BUITDING
AP PLICATION rYPEi RESIDENTIAI
PTEASE ANSWER ALT QUESTIONS APPLICABTE TO YOUR PRO.IECT
"Proiect Responsibility"
pRopERw owNGR,s NAME. Joshua & Jennifer Mihaly
OwNER,S ADDRESS. 7225 Airlie Place
PHONE #: 910-547 -3222
ctTy. Wilmington 7lP.28403
coNTRAcToR: Dudley Builders, lnc BLDG uCENSE f. 30550
4pppg55. 207 Antilles Court ctw. Wilmington 5T:
EMA1t ADORESS: parker@ dudleybuilders.net PHoNE. 910-859-8105
PROJECT CONTACT PERSON:Parker Dudley PHONE. 910-279-'1648
EXISTING CONSTRUCTION: n Alteration n Renovation n General Repairs
NEW CONSTRUCTION: E Erect New Residence n Addition to Existing Residence n Relocation
*** ***
! Att Garage (sF)_tr Det Garage (SF)tr Porch (5F)
E sun room (sF)tr Pool (sF)
tr Deck (SF)
n storage Shed (sF)
E Greenhouse (SF)_! other (sF)
ls the proposed work changing the existing footprint? E Yes E No
ToTAt sQ FT UNDERRO}F lfor proposed workl Heated:2715 sl Unheated: 1 152
ToTAt PROJEcT COST (Less Lotl; $350,000
ls the proposed work changing the number of bedrooms? E yes E No
lsanyElectrical,PlumbingorMechanicalworkbeingdonetotheAccessoryStructurenYesENo
lf the project isa Relocation, istherea Natural Gas Line on the current site? ! Yes E No
ls there Electrical Power on this Building? E Yes E No
Property Use/ Occupancy: E Single Family ! Duplex E Townhouse
Description of Work' Construct New Single-Family Besidence
]4P.28405
laws and ordinances and regulations. The NHC Development Services Center will be notified of any chanSes in the approved plans and specifications or change in contractor
information. r'*NOTE: Any work performed without the appropriate permits will be in violation of the NC State BldS Code and subject to fines up to 5500-00t**
owner/contractol Parker DudleY Signature:
"Licensed Quolifier" P nt Nome
ls the property located in a floodplain? E Yes !
Existing lmpervious Area: 0 sq Ft Total Acres Disturbed: 35
New lmpervious Ar.r, !]!Sq Ft Existing l-and Disturbing Permit: E Yes E No
WATER: E CFPUA E Community System E Private Well E Central Well E Aqua
SEWER: E CFPUA E Community System E Private Septic ! Central Septic E Aqua
setbacks (F) _ (tH) _ (RH) _ (Bl_
Approval:_ City: _ Date:_ Flood: (A)_(V)
-(N)Comment:
BFE+2ft=*",))+lb
APPLICANT' S
DEVELOPER:
NEI^I HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE : RESIDENTIAL
PLEASE ANSWER ALL QUESTTONS APPLTCABLE TO yoUR PROIECT
"Project Responsibility"
NAIv1E : McKee Hornes, LLC
PROIECT ADDRESSi I2A2 Traditional Lane CITY: wirminston
SUBDIVISION: Ilinds Harbor BLOCK #:
PROPERTY OWNER'S NAvIE: NlcKee Homes
OWNER'S ADDRESS: 101 Hav screet CITY: Fayettevl-1le
CONTRACTOR: GML Development, rNC LICENSE #: 5391.
ADDRESS: 101 Hay street CITY: Favettevilfe
EMAIL ADDRESS: .rpartonGmckeehomesnc. com
PROIECT CONTACT PERSON: Josh Parr-on
SUNROOM
DATE: B/24/I6
PHONE #:
ZTP. )8:al
LOT #: 14
PHoNE #: 9rA-415-1Laj
ST: q ZIPi 283ar
sT: xc zIP: 28301
PHONE #: gtaqt5ttoo-t2t
PHONE #:
SF
SF
&clta- Q5Zq1ffis-
APPLICATION
Number
(Office Use)
EXTSTTNG CONSTRUCTTOru: I ALTERATION ! nrUOVarrOru ! Cerurnnr REPATRS I nelOCarrOr\
NEW CONSTRUCTTON, I enrCr NEhJ RESTDENCE or ! nOOrrrON TO EXTSTTNG RESTDENCE
**PLEASE CHECK AND ANSWER BELO}I
SF
SF
ALL THAT APPLY TO YOUR PRO]ECT:
Inrr GARAGE ]q)
SF
E oer GARAGE
! eoor _ sF
SF E PoRcH LSF
! sronncE sHEDtrtrGREENHOUSESF OTHER:
TOTAL HEATED SQ FT: 2301 TOTAL SQ FT UNDER ROOF: i44 TOTAL AREA SQ FT: 3o4s
TOTAL PROIECT COST(t-esst-ot) ! $ rrs, oso # OF STORIES: z
Is Any ELECTRICAL, PLUMBING or MECHANICAL Work Being Done to the Accessory Stnucture? [ Ves E ruo
If the project is a Relocation, is thene a Natural Gas Line on the Cunnent Site? [] ves H to
rs thene Electrical Power on this Building? l-lv"t Flruo
pRopERTy usE / occuPANcYr @ srruclE FAMTLY ! ouer-rx ! rowruHousr
DESCRIPTION OF hIORK: Const.rr,rct sinsLe famrly home from dirt to finished home.
and ordinances and regulations. The NHC Development Services Center will be notfied of any changes in he approved plans and specifications or change in contractor or
conractor information. --.NOTE: Any Work Performed W/O he Appropriate Permits will be in Violation of the NC State Bldg Code and Subject tc Fines Up To $500.00"-
O[^INER/CONTRACT0R:SIGNATURE:
(Print Name)*********************r.********xx***xr(**x*************************r(****x***r(*{.xr.*{.****r<**
IS THE PROPERTY LOCATED IN A FLOODPLAIN? f]I VCS FI ruO
I.IATERt ! creun ! coNllururrY sYSTEM I enrvare well ! crr,rrnal wELL
sEr,JER: @ creun ! crrurnal sEPTrc ! enrvarE sEPTrc ! commururrY SYSTEM $\,zbq-
*** SEPARATE PERIIITS REQUIRED FOR ELECT, MECH, PLBG, GAS EQUIP, PREFABS & INSERTS ***
J cmn Elcrecr (nAvABLE ro NHc) [ ru'renrcnN ExpREss E tcurrso I orscovenPAYMENT I'IETHOD: I.
*r(*:k*XX*****i<**,k*.***r.r<X**r(**i(*****r.***************r(***********d(X*********i<,kX****r.******X
ZONE: _ OFFICER:
Appnoval:- City:
EXISTING IMPERVIOUS AREA:
NEId IMPERVIOUS AREA:
! orcr
sQ FT
sQ FT
(FOR OFFICE USE ONLY)
SETBACKS: F:
TOTAL ACRES DISTURBED:
EXIST LAND DISTURBING PERMTT: I-l ves l-l ruo
REVISED DATE 04/LT/Lz
BFE+2ft=DATE:F LOOD :
LH : RH: B:
'ir\',i\
t:ti