MAY 31 2017 BUILDING APPSgrr( Z+{"nr Wri}on W'fi"g.!frW
N EW HANovE* .or^R9l,Hili,'#f{fr
APPLICATIO N TY PE.. RESIDENTIAL
prrasE aNswER ALr QU::l 3i,t#,i,:l.fiilro
youR pRorECT
orr", $1/, 117'aoo<APPI-ICANT'S NAME
PROJECT ADDRISS:
SUBDIVISION:
CITY ztP
LOT H
PHONE #.23q /PROPERTY OWNER'S NAME:
OWNER'S ADDRESS:ztZJ<*Lko
a00 LCONTRACTOR 8I.DG TICENSE H
ADDRESS {t UzUfz-t*ST
EMAIL ADDRESS:PHONE
PROJECT CONTACI PERSON )e/ro/ aoak PHONE
EXISTINGCONSTRUCTION: E-flteration B'Renovation ll General Reparrs
NEW CONSTRUCTION| ! Erect New Residence E Additionto ExistinB Residence D Relocation
* **PTEASE CHECX AND ANSWER BEI.OW ALL THAT APPI.Y TO YOUR PROJECT* **
D Att Garage (S F)o6 E Det Garage {SF)_
;"2-t4rnZ
Qft.fuo. zrTr
al Sunroorn (SF)
[ ] Greenhouse (SF)
tr Pool (SF)
D Deck (St)
ls the proposed work changing the existing footprint? E 'Yes E No
TOTAT SQ FT UNDER ROOF lfor proposed work) Heated ?,, fl unheated
TOTAL PROJECT COST {Less Lot)i S
'7r o?JD &itian
ls the proposed work changing the number of bedrooms? a yes 8/no
ls any Electrical, Plumbing or Mechanical work being done to t he Accesso ry Struct ure d/yes tr trto
lf the project is a Relocation, is there a Natural Gas Line on the current site? n Yes .Ho
ls there Electrical Power on this Building? E-ies tr, No
Property use/ occup"n.y, Pfingl. t".ily I Dudlex I Townhouse F,
D€scription o, Work:
nyLLtl
laws and ordinances and retulatrons The NHC Development Services Center will be notfled of any chantes in th€ approved plans and specfications or change rn contractor
11,,,
information. '*'NOTE:Any work performed wthoul the appropriat€ permlls will be n violation of the Nc slate 8 code and subiect to fines up to 5500 00"')etuztOwner/Contractor
"Licensed Quoliret"
ls the property located in a floodplain? n Yes
Existing lmpervious A r"", /f,Qlsqrt
New tmpervious Are ", \'l 4 * sqtt
WATER: n CFPUA I CommunitySystem
TotalAcres Disturbed:
Existint Land Disturbing Permiti ! Yes : No
f Central Well a Aqua
PO"
ivate Well
SEWER| E CFPUA E Community system gd*ate Sept, D CentralSeptic n Aqua
zone:
-
officer:
-
setbacks (F)
-
(LH)
-
(RH)
-
(B)
-Approval:
-
City:- Date:- Flood: (A)
-
(V)
-
(N)
-
BFE+2ft=
-
Comment:Permit Fee: S
I ffi
Aot+-.tlrt,
1q_4%
D Porch (St)_
D Storage Shed (St)_
E Other (st)-
,$1'.1] prl r
RgcitvEoAPRoozolT 3+31nA
ffi
NEW HANOVER COUNTY BUILDTNG PERMTT
APPLICATION IYPE j RESIDENTIAL
PLEASE ANSWER ALL QUESTIONS APPL]CABLE TO YOUR PRO]ECT
"Project Res pons ibil ity"
APPLICATION
Number
(0ffic€ Use)
APPLICANT'S NAIVIE: Rock Sotid construcLion LLC DATEi 4 /5/ 2at'7
Z\P i 2e4a5
DEVELOPER:PHONE f:
PRO]ECT ADDRESS:
SUBDIVISION:
202 ADolfo Drive CITY: wi lminqton
BLOCK *:LOT #: .il scc: 4
PROPERTY OWNER'S NAI,IE: 'rimothy worman PHONE #:
OI4INER'S ADDRESS: 202 Apol10 Drive
CONTRACToR: Rock solid consLrucLion LLC
ADDRESS: Po Box 13 24
LICENSE *: ?4ee7
CITY: shallotre
CITY: wi lmincton sT: ll zIP 28445
ST: NC ZIP: 28459
970 77'/ -3744
Ei!AIL ADDRESS; rock. sof idconstr.uction@yahoo.com
PROIECI CONTACT PERSON: Rocky Doan rr
EXISTING CONSTRUCTION :A LTE RATION R ENOVATION GENERAL REPAIRS RE LOCATION
NEW CONSTRUCTION;ERECT NEW RESIDENCE or ADDITION TO EXISTING RESIDENCE
**PLEASE CHECK AND ANSWER BELOW ALL THAT APPLY TO YOUR PRO]ECT:
! eoncH
-
sFATT GARA6E
-
SF
suNRoot"l _ 5F
GREENHOUSE SF
DET GARAGE
-
SF
POOL _ SF
DECK SF
PHONE *:
PHONE #:
9ta 231 7476
STORAGE SHED 5F
5FOIHER
ToTAL HEATED SQ FT: .rzo TOTAL SQ FT UNDER ROOF: l:!_ TOTAL AREA SQ FT:
TOTAL PROJECT COST tress ror) : $ 4o,gzo # OF STORIES:
424
inc I ude 1full bathroom and an open room. (See additional info aEtached.)
DTSCLATMER: thereby cerr,V hal arr rnkrrmalion m his applicarion rs corecr and allwork willcomply wih lhe Slale Burlding Code and alloher applicable Slale and locar laws
conrractor rnbrmaton "'NOTE AnyWork ed w/O he Appropriare Permils wrl be r Violation ol the NC Slate Bldg Sublecl to r nes up To $500 00"'
OTJNER/CoNTRACT0R :SIGNATURE
* * + * * * * * * * * * * *,r x * * * * * * ** *,t
I5 THE PROPERTY LOCATED IN A FLOODPLAIN?
EXISTING IMPERVIOUS AREA: :I3J1- SQ FT
NEW II'IPERVIOUS AREA: +420 SQ FT
YES
sEr^JER: ! creul ! CENTRAL sEPTrc E pnrvarE seerrc fl coMiquNrrY sYsrEM
*** SEPARATE PERI']ITS REQUIRED FOR ELECT, I4ECH, PLBG, GAS EQUIP, PREFABS & INSERTS ***
pAyrirENr r4ErHoDr I casH I cxrc( (payABLE ro tuc; I mrnrcAN ExPREss n ,./rrso I orscovrn
* )r,*,* *** * t ,i,t **** * )t *,t ,t *)* **** *,t,t* )*** * *,f ,t *,t** )****,*)** ** r( 't *+ '* )* '*** * * )t '** )i't*'* )* )* '* '** )* *** * ** 'i 'i *'*i('f 'f*
WATER ! creul E coMr4uNrrv svsrrm ! pRrvATE wELL
ZONE:OFFICER:
CENTRAL WELL
(FOR OFFICE IJSE ONLY) REVISED DATE O4l11/12
SETBACKS: F:- LH:- RH:- B:-
BFE+2
N
PERI4IT FEE: $
Approval:- CitY:- DATE:- FLOOD:
-
A
comment :
ls Any ELECTRICAL, PLUMBII,IG or ECHrlr.lICAL l.lork Being Done to the Accessory Structure? [ Ves f] ruo
rf the project is a Relocation, is there a Natunal Gas Line on the current site? [ves fl lo
rs there Electrical Power on this BuiLding? [El ves l-l ruo
pRopERry usE / occupA rcyr Isrrucre ramrrv ! ouerex ! Toh]NHousE
DESCRIPTION OF WORK: Add addltion at back of house on a slab with roof to maLch existinq. wiLl
Ero
TOTAL ACRES DISTURBED: .o'r.
EXIST LAND DI5TURBING PERI'IIT: E YE5 I-iI rc
GtlR014
AppLtcANTs NAME: H & H Constructors of Fayetteville, LLC
NEW HANOVER COUNTY BUILDING PERMIT
A PPL,CATION IYPEi RESIDENTIAL
PTEASE ANSWER ALL OUESTIONS APPLICABTE TO YOUR PROJECT
"Project Responsibility''
0,ct1---W,bx
t7-L707 -Application
Number
(ofil.e use)
s1s 0512412017
pRoJEcT ADDRESS: 7861 Bristlecone Drive
sUBDlvlsloN: Gable Run
pROpERTy oWNER,S NAME: H & H Constructors of Fayetteville , LLC
OWNER'S ADDRESS: 8209 Market Street, Suite C
6;1y; Wilmin lon 71p.28411
tOT #: 014
pxorur e. 910.219.1485
CtTYr Wilmington 71p. 28411
CONTRACToR: H & H Constructors of Fayetteville, LLC s166 116gx5p 4. 74158
ADDRESS: 8209 Markel Street, Suite C g;1y; Wilmington sr: NC zrp: 28411
pRoJEcT coNTACT pERsoN: JJ Brenning p116xs.910.219.1485
EXISTING CONSTRUCTION: tr Alteration E Renovation E General Repairs
NEW CONSTRUCTION: E} Erect New Residence E Addition to Existing Residence E Relocation
***PLEASE CHECK AND ANSWER BE ALT THAT APPLY TO YOIJR PROIECT** *
A Att Garage (SF)521 E Det Garage (SF) _@ Porch (sF)2?4
tr Pool (5F)E Storage Shed (SF)_
E Greenhouse (SF)E Deck (sF)
ls the proposed work changin8 the existing footprint? E Yes A No
TOTAT SQ FT UNDER ROOE l,fot proposed work)gqs1s6;2310
TOTAT PROJECT COST (Less tot): S 137,105
ls the proposed work changing the n umber of bedrooms? D Yes EI ruo
ls any Electrical, PIU mbing or Mechan ical work being done to the Accessory Structure fl Yes EI No
lf the project is a Relocation, is there a Natural Gas Line on the current site? E Yes E No
lsthere Electrical Power on this Building? E Ves EI No
Property Use/ Occupancy: E Single Family E DuplexE Townhouse
Descripti on of work: SINGLE FAMILY DWELLING
laws and ordinances and reSulations. The NBC oevelopment Servic€t Center lvillbe notifled of any chanSer in the app.oved pl3nsand specificatlons or change ln contractor
lnfo.mation. "'NOTEi Any work performed without the appropriate permits vvill b€ in violation of the NC State Bldg Code and subject to fines up to 9500.00".
Owner/Con1136gs1; JJ Brenning Signature:
"Licensed Quoltlet" Print None
ls the property located in a floodplain? E Yes E No
Existing Impervious Area:Sq Ft Total Acres Disturbedr .23
New lmpglyisu5 tryg3; 2883 Sq Ft Existing Land Disturbing Permit: EI ves E t'to
WATER: E CFPUA El community system E Prlvate well n central Well E Aqua
SEWTR: O CFPUA E Community System E Private Septic E CentralSeptic E Aqua
zore:
-
offlcer:- setbacks (F)
-
(LH)
-
(RH)
-
(B)
Approval:
-
City:
-
Date:
-
Flood: (A)
-
(V)
-
(N)
-
BFE+2ft=
-
s \
)Comment: Permit Fee: $
338
EMA|LADDRESS: iulicafferty@hhhomes.com/ jerrybrenning@hhhomes.com pHoNE:910.219.1485
E Sunroom (5F) _
tr other (sF)_
gn1,"s1g6;745
t,
NEW HANOVER COLINTY
DEPAR'IMENT OF BUILDINC SAFETY
230 GOVERNMEN'I'CENTER DzuVE - SUI'I'E I70
WILMINGTON, NORTH CAROLINA 28403
'l'elephone: 910.798.7308 F ox: 910.798.781I
I nte rne I : wtt u,. n hcgov. cont
4 to 7 WORKING DAYS TURNAROUND TIME FOR PERMIT ISSUANCE
STATEMENT OF UNDERSTANDING
JuliCafferty , am submitting an application for a residential
building permit to New Hanover County. And, as the applicant or person submitting
the application, I check the box/boxes below to acknowledge that:
a have atta h an official CFPUA receipt or document that has
acknowledged an approval of the payment made to CFPUA.
n t have attached an official proof of a Zoning sign-off from the City of
Wilmington, for this work that will be done in the City of Wilmington.
n I have attached an official proof of an approval granted by the New Hanover
County Environmental Health Department, for this work that requires an approval
from Environmental Health.
lf the application is correct and complete with the required drawings, and if
there are no corrections or revisions to plans and drawings, and if there are no
further clarifications required by New Hanover County; New Hanover County
can guarantee that the building permit will be issued within 4 (four) to 7 (seven)
working days after the official submittal date/time (the stamped date/time
notation made by the Building Safety Department on the application or submittal
document). I understand that the 4 (four) to 7 (seven) working days only begins
when the application is submitted prior to 4:30 pm on any working-day.
Signed in acknowledgment:
iuliCafferty 5/24/2017
Signature Printed Name
7861 Bristlecone Drive
tqk:ez-
Address for the proposed residential work
Date
rl N] Y;
z
T
$t
NEhI HANOVER COUNTY BUILDING PERMIT
APPLICATI T IYPE; COtlli1ERCIAL
PLEASE ANSIiJER ALL QUESTIoiIS APPLICABLE fO YOUR PROJECT
"Project Responslbtlity"
CLt-,-.9t;.5 4 P-\. I
?ot+5u;f
APPLICATION
Number
(Office Use)
APPLICAIT'S ltlAltE :
DEVE LOPER:
D^rE. t- ll. l'7
PROJECT ADDRESS:(s Lr
OCCUPANT/BUSINESS Na t: 6 +ca-L <.
CITY: \,lt ^^tr.+
PTONE f :J ztP: '2- ? I oJc-
o..l-
OttlNER'S ADDRESS: 'zs ,-l (<oc.t lu-vt ClfY i
PHoNE *: Z36'1)2ol
Sf t/.L Zi,P;Z ('t <>>
ut-
sr,: t!=zptZglos
PIffCNE *:
PTONE f :
n t,>' 21 a.\l'tL
CONTRACTOR :( L- *5t::s +R-s. /
ADDRESS : (-t C \-., I
LICENSE *: /S
C ITY:I.:)
-r-\il'c.r-EIiIAIL ADDRESS:-1,,
PRO]ECT CONTACT PERSON:w .^-1, : c\o^-'l- L: r;t (Check All That Apply)
EXIST CONSTRUCTION:
lf Relocadon. is there a Natural
aLTERATToN I-l nercvarrot l-l cr
Gas Line on the -Current Siteu [vF[
reml neearns !No IS BLDG SPRIN
RELOCATIOI'I
KLERED? fl ves I No
NEr.l coNsTRucTro'r: I enrcr NEt{ STRUCTURE I rasr rmcx I srrr-l UPFIT E ADD To ExIsT STRUcTURE
ACCESSORY STRUCTURE:
If UPFIT - The Shell Penmit #:Is Elect Power on this Building /v"' E Ho
***** rs rHrs A CHATGE oF occupaNcy uset fivesIF Yes, ttfiat was the Previous Occupancy Type?What is Type?
ARCH DESIG1I PROFESSIOTUIL: T,T'{. T !. J C \P,.^./.. I T PH
PH
F&ro n, 19;,/
ENGR DESIGN PROFESSIOI,IAL: ,<'td ? Nc REG #: iL 1, al e t
-fu.****the ew Occupancy
31G r-8q - t]
DESCRIPTION OF WORK:1
ls food or berrg€gos prepol€d o( sen ed in th4s €tudurc? EY No b Tho Prop€rty Located ln Th6 Ftoodptatn? E yes
ilding Code and all other applicable Slale
in tha )tc state soecrficationsBldg Code and
: Z'l o-
Note: D€ ol6on nodilcado.rs , 8sb€6t06 rqnovsl p€Imh appllcaiions arE to b€ submhtd uskE tho appltceto.l6nn (DHHS3768)
(
conteh Arb€atoa or not You are G4ulrBd b call the Nstknsl
dentolldon ot Eny fadllty o( bulldlng. S€€ Asbeslo6 Web Site:
Emts lon S't&d.(! br l&n ou. Ar Po0utsnE (NESHAP) at (919)m7{950 ai t*r 'tO (by! Ftor b tle
hnpJ nvw epi.staie.nc.us/epi/asb€stotshmp.htrnt
ToTAL PROJECT COST: 7 o. oc-'>BUILDING HEIGHT
SQ FT PER FLR:
TOTAL SQ FT UNDER ROOF:
ACRES DISTURBED
NEW IMPERVIOUS AREA:
PROPERTY
# OF STRUCTURES:
EXST LAND DISTURBING PERMIT?
SA FT EXISTING IMPERVIOUS AREA
# OF STORIES
# OF FLOORS:
fllzoNrNG usE ctIsstFtcATtoNfl coMMUNrrY S\4STEM
NO
SQ FT
usE24FFrcE Enesrnunnxr luencmrnc leouc nApr EcoNDo
WATER: FICFPUA -COMMUNITYSYSTEM T-'IWELL
sEwER:'E cFpuA -CENTRAL sEprrc E P-RMATE sEpnc
SEPARATE PERMITS REQUIREO FOR ELECT, MECH, PLBG, GAS EOUIP, PREFABS & INSERTS -'
PAYMENT METHOO Ecesn pj,6+cK (pAyABlE ro NHc) EAMERIcAN D<eREss I ucrvrsr I orscown
(FOR OFFTCE USE O[LY)REVISED DATE 4/1 V12
{#f
PROPERTY OHTER'5 iIAI{E:
I
VJo= CLJ \;ss
# OF UNITS:
ToTAL AREA SO FT: iToo S9
OTHER:
ZONE:_OFFICER:_SETMCKS:F:_LH:_RH: B:Apsovd:_clty_DArF. FLooo'_______i_BFE+tr_Sl4t .--Cornmont PERM|TFEE:$_____: - I
AIMF
Iarl- *t"cZ
,
-L
a
?
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE: COMMERCIAL
PLEASE ANSHER ALL QUTSTIONS APPLICAEI-E TO YOUR PRO]ECT
"Project ResPonsibilitY"
rJ_
ISt'tf,Y l? 4:28P
APPLICATION
Number
(Office Use)
APPLICANT'S NAME:
DEVE LOPER :
oerc:5'12
PHoNE $: A l\6 t8</)-
zrPi LSLI o 5-
PHONE #:
PRO]ECT ADDRESS: I(O€JK 3r_t crTY:t-^)it^
occUPANT/BUSINESS NAI4E: G GI-
PROPERTY OWNER,S NAME:
OWNER,S ADDRESS: IqO
d Otre,.s
€a.sJ.r>:r>o Il.f,qriCITY:I ST: _ ZIP: _
b
PRO]ECT CONTACT PERSON:
EXIST CONSTRUCTION:
lf Relocation. is there a Na
l$2 LICENSE #:\t6 7\CONTRACTOR:
ADDRESS: 2_>!4 L',ua$aa1
EI'IAIL ADDRESS:a cITy: c.), t,,,,-'w st:ppzw: LALI I Ig. yoc> ffil.lLo .. .- *
(check AlI rhat Apply)
RENOVATION
PHONE
PHONE #: at c, 8(
ALTERATION
Gas Line on the
GENERAL REPATRs l-l nrlocerrouE"o rs sloc spii xleneou Iv". flruoturalCurrent Site?Yes
NEII.J CONSTRUCTION:ERECT NEr,'r STRUCTURE ! rasr rmcr fl sxer-r- [ urrrr I aoo ro Exrsr srRUcruRE
ACCESSORY STRUCTURE:
If UPFIT - The Shell Penmit #:
,.^ro.J A(c-
Is Elect Power on this Building Yes Eruo
PH:1ro t(A Ltqbl NC REG +: IO ^.UNC REG *:PH:
r,**** rs rHrs A cHANGE oF occupANcy usrl flvrs N0 *****
ARCH DESIGN PRoFESSIOi'IAL:
ENGR DESIGN PROFESSIONAL:
ex{e^l { (e-co,^ (.t-o "4Ci..o sDESCRIPTION 0F l^iORK
ls food or bov6rag6s proparod or sorvod in this structure? EYes ffii- rc rn" e.porty Located ln The Floodptain? [ ves [ ruo
ilding Code and allother applicable State
Notei Demolilion nolific6lions & asbestos re.noval permit 6pPlbstjons are io t€ submiled using the aPpl
conEin Asb€stos or nol You aro requirsd lo call the Nslional Emisslon Standards for Hazsrdous Ar Pol
demolition of any Iacility or building. S€€ Asbestos Web Site: htp/$tw.epi.state.nc.us/epuasb€stos/ahmp hEnl
TOTAL PROJECT COST: '\o ooC)BUILDING HEIGHT
SO FT PER FLR:
zoNE: oFFICER:
in the
SIGNATURE:
ication form (DHHS-3768) whether the hcility or building w6s found to
lutanb (NESHAP) at (919)707-5950 a! least 10 dsys p.ior to th€
# OF UNITS:
on in thrs aooftcalion rs co(ecl and all work w,tlcomply with lhe Stale Bu
The NHC DeveloDmenl SeNrces Center wll be notified of any chanoes
n. "'NOTE Anv Work Performed w/O the Applopnale Permits will tje in Viola approvedlion of the and soecilcatlons
Bldg code and
OWNER/CONTRACTOR:A.
{Ou.llfor) (Pitt
TOTAL AREA SQ FT :
TOTAL SQ FT UNDER ROOF:
-
# OF STRUCTURES:
ACRES DISTURBED:EXST LAND DtsrunstNo peRt trt n Yes NO
NEW IMPERVIOUS AREA:- SO FT EXISTING IMPERVIOUS AREA:
pRopERryusE: firrrce flnesreunerur [uencmtrtle [eouc f]epr ECONDO OTHER:
WATER:
SEWER:
rzlcrput Tl coMMUNtrY sYSTEM T-lwELL EzoNlNG usE cLASSlFlcATloN:
ficreua fr cer',nner- seertc Ei-RlvArE sEPTlc DcoMMUNlrysYsrEM
,",SEPARATE PERMITS REOUIRED FOR ELECI, [4ECH PLBG GAS EOUIP PREFAAS 8 INSERTS -'
pAyMENT METH9D: EcAsH f]cHrcx leavneLE TO NHc) fieuentcnn excnesS I ucnrtse E otscoven
(FOR OFFTCE USE ONLY)
SETBACKS: F:-LH:- RH:- B:
Approval:- City:- DATE:- FLOOO, - o --- , N
BFE+2I=
# OF STORIES:
# OF FLOORS:
SQ FT
REMSED DATE 411/12
Comment PERMIT FEE: $
\5
i:Y
IF Yes, what was the Previous Occupancy Type? *...-- What is the New occupancy Type?
-
--:i . \.
'..
'
Clear Form Print eMail
NEW HANOVER COUNTY BUILDING PERMIT
APP LI CATION ryPE., RESIDENTIAT
PLEASE ANSWER ALL QUESTIONS APPLICAELE TO YOUR PROJECT
"Project Responsibilih/'
Aot+-zt*a+
Application
NLrmber
loffice use)
ItrBiFl
3
APPTICANT'S NAME:
PROJECT ADDRESS:
,4^zA.o A / rztx<*
ztP 2-Et/z
PHONE #: 33o o;u 555/-
Date s;/t r/ 77i \ctw
SUBDIVISION:
PROPERTY OWNER'SNAME: tApt'' J- l r-,t-,
OWNER'SADDRESST Z3 3
CONTRACTOR
ADDRESS:
crw ztp794aL
Rn<ll,k.BLDG LICENSE #:ali R l Fer n CITY:,t sTl/r ztP zo4r9
EMAIL ADDRESS:
n Sunroom (SF)
o r.r lZ-rtr i cleu.d. COrnr PHONE 7 rc3g/L - z>? -
EXISTING CONSTRUCTION: E Alteration n Renovation n ceneral Repairs
NEW CONSTRUCTION: E Erect New Residence n Additionto Existing Residence ! Relocation
,}**PLEASE CHECK AND ANSWER BETOW AtL THAT APPTY TO YOUR PROJECTT**
E Att Garage (SF)_E Det Garage (SF)_tr Porch (SF)
I Greenhouse (SF)_
n Pool (sF)
n Deck (sF)
Unheated: :-qv
g Storage Shed (5F)L.Y Zo
n Other (SF)
dno
ls the proposed work changing the existing footprint? n Yes n No
TOTAT SQ FT UNDER ROOF lfor prcposed work) Heated:
TOTAT PROJECT COST (Less Lot)S .?coc. ,-
ls the proposed work changing the number of bedrooms? 3 v"r ffruo
ls any Electrical, Plumbing or Mechanicalwork being done to the Accessory Structure t yes
lf the project is a Relocation, is there a Natural Gas Line on the current site? E yes ff lo
lsthere Electrical Power on this Building? n Yes n No
Property Use/ Occup
Description of Work:
ancy:ingle Family E Du lex n TownhouseI ari//e/u,
DISCI-AIMER: I hereby certify that all the rnformation in this application is correct and allwork willcomply with the state Euilding Code and all other appticable State and local
laws end ordinances and regulationt- The NHc Development services Centerwillbe notified ofanychanges in the approved plansand specifications or change in contractorinformation. "*NOTE: Any work ed withoutthe appropriate permits willbe in violation ofthe NC State B e and subject to fines up to S500.00...
/Contractor:Signature:
"Licensed QuoIifier"e
ls the property located in a floodplain? ! yes No
Existing lmpervious Area: _ Sq Ft Total Acres Disturbed:
New lmpervious Area:Sq Ft Existing Land Disturbing Permit: fl Yes tr No
WATER: tl CFPUA tr Community System E private Well a Central Well f, nqua
SEWER: tr CFPUA n CommunitySystem E Private Septic E Centralseptic d Aqua
Zone: _ Officer: _ Setbacks (F) _ (LH)_ (RH) _ (B) _
Approval: _ City: _ Date: _ Flood: (A) _ (Vl _ (N) _ BFE+2ft=
-_
o
Comment:Permit Fee: S {ls-
LOT #:
PROJECT CONTACT PERSONT //,t ) L, Z'LyLrn qHONE: 3 \u t2i-p 5 , S L