JULY 27 2017 BUILD APPffi
APPLICANT'S NAMI
PROJECT ADDRESS:
nd'o,1-1)59\WNEW HANOVER COUNTY BUILDING PERMIT
AP P Ll CATIO N rYPEi RESTDENTTAL
PLEASE ANSWER ALL QUESIIONS APPLICAETE TO YOUR PROJECT
"Project Responsibaliry"
111 t
Date 7 -/9- / 7
,1. /- L-T CITY .L ztr 2r4/?
SU B DIV ISIO N
l>,a"..1 llt '( o,t"l'
LOT H
PHONE H
,n , /,- , " ?l-,,- ztP: ,9 8q./ Z
BIDG UCENSE f: /L'4
PROPERTY OWNER'S NAME:
OwNER's ADDRESS: I '/,
gl (l .<.;*- j J/'C
T CIIY
CONTRACTOR: - S-] {
ADDRESSi
EMAII AD
c\v ic-
(!r.r?i
n
CITY
-\ a L unheated
PHONE
'qa i]0 8q
SI,_ZtP::4_Q
DR T5 5:rtr ( Asic PHoNE 'l \,l
Sunroom (SF) _
:.., Greenhouse (5t) _
'L qe 'lrl) -Ltqt -00, +
EXISIING CONSTRUCIIOfV: X Alteration I-- Renovat,on I General Reparrs
NEW CONSTRUCIION f Erect New Residence f Addition to Existing Residence I Relocation
*.*PLEASE CHECK AND ANSWER BETOW ALL THAT APPTY TO YOUR PROJECT"'
l{ att Garase (sF) Q!!r r' i '2. ., ' L trl Der Gara'e (sF)- I porch (sF)
! Pool (SF)
! Deck (SF)
ll Storage Shed (SF) _
I other (sF)
ts the proposed work chanSing rhe exisring footprint? ! ves j{ ruo
ls the proposed work changrng the number of bedrooms? n yes ${o
rs a.y Electrical, Plumbing or Mechanicalwork beinS done to the Accessory srructure ]9 yes D No
tl the prolect rs a Relocation, is there a Natural Gas Line on the current site? D yes B.-No
ls there Electrical Power on this Building? Ryes tr No
Property Use/ Occupancy; Q Single famlly i Duplex D Townhouse
Description ot Work:&
C,z rn d
DrscrarMEB: r hsreby cerrrt rhar aI rhe ,nrormarron in this appric..rion 6 corect and ar wort wdlcom pty w'th rhe Sr.te Esitdrot Code and a other appticabte Srate and to(at
y chrnSes in the approved ptans and ,pecifi(ation, or ch.
has be le
o,the NC Stat! Bl
''(Ls
p
laws and ordinances aod regul.rions The NHC Dcveloprhenl Services Cenr€. wrI be notified or.n,,rformrtron "'NOTt Any work pertofmod wr{hout the ippropnar€ permiis wrlt be In viotatron 9t*7 ftres up to SSOO 00.'.
Owner/Cont,acto
"Ltcensed Quol|tet'
'+z Signature:
ts the prop(,rry located in a floodplain? C yes E]_ruo
Existing lmpervious Areai //!:'C'a Sq Ft TotalAcres Disturbed: \-"fNew lmpervioui Area Sq Ft Existing Land Oisturbing permit: i yes E ruo
WATER; ! CtpUA fl Community System fl privare we fl Centratwel E_Aqua
SEwtRr E CFpUn D CommunitySystem D privateSeptic D CentralSepric D Aqua
zone: __ Officer: __ Setbacks {F) __ (tH} _ (RH} _ (S) _
Approval: _ Cityi_ Oate: _ flood: (A)_- {V)_ (N)-- BtE+2ft=
Comment:
Permit tee: S
U,D'l-ec.)
cn,A ,
plo-,rS
?L,rn +n@.&-d
&.//-6
lss.,tg Vo(Ln6{dL ag
\ (/,/C
l\
PROJECT CONTACT PERSON
TOTAL Sq FT UNDER ROOF lJor proposed work) Heated:
,I
I t'/
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION IYPEj COMIIIE RC]AL
PLFAsE AN5N'R ALI QUESIION! APPLlC48I I TO YOUR PRO-IT(I
"Project Responsibility"
)ot+_*7 toe
APPL ICATION
Nulnber
APPL]CANT'5 NAi4E
DEVEL0PER: !.r'th
:.loI _-., lliIn Larcl LLC DATE: ) .at),'
ira im i in.l i,L!PHoNr #: , 1r rl i
PROIECT ADDRESS; -,:r,l: 11::Ir'. .i,:..1:CITY: rii l,rr,'.rr:'n
OCCUPANT/BUSINESS NAI1E:
NAIYE:
L)e.,n wr 1r 4 L'-C
PROPERTY OI,]NER,5
Ol,NE R '5 ADDRESS:
To:rence J L+j i :ie: L
3 4 r: Se L t Ejr: l( ri:l
LONTRA'TOII
ADDRESS : l4 a ;.11 r.: k ad CITY: Jn.ksc.rv-11e
E[ATt. ADDRES5i LI.LclilrrrLL"lrI ]fe.ir,.:..'' l
PRO] ECT CONTACT PERSON:
(ahe.k All That Apply)
EXIST CONSTRUCTION ALTERATION R ENOVATION GENERAL REPAIRS
ll Relocalion rs there a Natural Ga:i Line on thc CLrrrenl Srte?No lS BLUG SPR Nl(tEREL)?
PHoNE 6i 9iC .ls-)-L::l
St::ia ZIP l .r:5,.1
fi: ijl {, -r ll 1 li!lPHONI
PHONE
R ELOCATION
f : 910-353. jr-tl
f v"o fl N()
NEI,1, CONSTRUCTlON:
ACCE SSORY 5IRUCTURE
EREcr NE!{ srRucruRE f] rasr rnacx f] sxrrr ff ucrrr f] aoo ro ExISr srRucruRE
'Tf UPFTT Tho Shel1 Permi.t #Is E Lect
*'*}* ]5 TH]s A CHANGE OF OCCUPANCY USE?
It Yes, {hat was the Previous occupancy Type?what is I're Neh O(cupan(y Typel
PH:NC RE6 }
Power on this BLri.l dinB
vrs f-] r'ro *****
Y-" s f-l uo
ARCH DESIGN PROFTSSTONAL :
ENGR DE5I6N PROFISSIONAL I n.: ra;norl!r.e Enq PH : 91 0 - 1 9 : lj'7 0 7 NC REG $: C-2846
DESCRTPTIoN 0F hioRK j Burt.iin.r;-Rertdu:dr! tjlrr qr. unLl LP
ls iood or beverages prepared or served in this structure?I ves I i,to ls Ttro Property Located ln The Floodplain? r: Yes I No
;;--;-:;;:.;,;,r,,;;; . -,,a.n,r"ron' rneNFL bl,veoone,rse^/..asCe-err,.tn"nor,.Ffor ,.ycharec rn rheappro,lrr plrn>\Jnu^u(irii. r"o',\
S,,breLli. li,,es Up lo 1j5i.)0 01]"' : ,
OWNER/CONTRACTOR: Melissa A. Lerfh(rr Stcfr^'r-r rDtr' ln ' ' ' . ^ |
con|atn As beslos or noL you are required ro mll lhe Narional Emissi.n Srandards lor Ha?adoLrs At Polluanls (NESHAP) .l (91 9) 707 595C .l least 1 0 days pr x, lo rhe
demorilion ola.yfac liry orbuildLng. SeeAsbesros Weh silc hlll)rAvY eP.slalc rc.\ls/epilasbeslos/ahmp.hlml
TO TAL PROJECT COST 5Li)J\]C:I., Ji] BUILDING HEIGHT: ]: i:
TOTAL AREA SO FT: !4 r;SO FT PER FLR 4172
TOTAL SO FT UNDER ROOF:t:-42 # oF SIRUCTURES
EXsr LAND DrsruRBrNc pERMrr?EllyES fJ ft(l
SO FT EXISTI NiG IMPERVIOUS AREA: I
[uenceurte ! eouc CONDO OTHER
# OF UNITS!
Ji OF STORIES i
# OF FLOORS: L
-
NEW IIVPERVIOUS AREA: . ,
PFOPERry USE: []OFFICE RESTAURANT
SO FT
WATER: ECFPUA
SEWERj E CFPUA
COMMIJNITY SYSTEM NWELL IJZON]NG USE CLASS]FJCATION:
-.CEN'IRALSEPTIC L-I PRIVATE STPTIC f] COIVi,IUN'ry SYSTEM
PAYIV4ENT METHOD: [CeSn I CHEcK (PAYABLE To NHC)AI\4ERICAN EXPRESS f] MCA/ISA DISCOVEF
ZONE:OFFICER
(FOR OFFTCE USE ONLY) REVISED DA]E 4/11/12
SETBACKS: F:-LH:- RH:-- B:-
Approval:-_- Ci
Con'rmenl
ty:.-'DATE:- FLOOD:--- BFE+
t!
PERMIT 153
drr,
rfl-frail
LrP:2.7)t
CITY: l.1ck.cx,r I l.' ST: f-,a_.7Ip:',ll l
LIC ENSE li: :, ii!,
Ye i s5a Lol:l!r-1 t
ACRES DJSTURBED,
---
eq+7aq"/r,s:rrNEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE: RESIDENflIT
pLLAsL ANSWTR ArL euesrroNs appLrcagLe to rdii
'Proiect Responsibilit/k@oDzoNm
ApplCAN7S NAME: Greenville Pool & Supply ga1s.5l11l17
pRoJEcT ADDRESS: 2328 Ocean Point Dr ctTy. wilmington uP.28409
sUBDtvtS;ON: Pembroke Jones Park
OWTIER'S AODRESS;CITY:zl?
CONTRACT6R: Greenville Pool & Supply ELDG rrcEtrsE r. 15025
ADDREss: 3730 S Charies Blvd 611y; Greenville Sr: NC aP. 27858
EMAtt ADDREssT toddmpw@gmail.com
pRo-tEcr coNTAcT prnsol: Todd Bishton
O(lSTlt{G CONSTRUCTIOT{: E Aheration D Renovation n General Repairs
NEW COI{STRUCnON: n Erect New ResidenceF Addition to ExistinS Residence E Relocation
,,*PLEASE CHECK AiID ANSWER BELOW ALI. THAT APPLY TO YOUR PROJECT*''
Ll Att Garage (sF)-n Det Garage (SF)_Ll Porch (5F)
n Pool (sF)
! Deck (SF)
560
ntOnr252-35l.7'121
p116ps.91G470-1759
E Sunroom (SF)
n Greenhouse {5F)
! Storage Shed (5F)_
n other (sF)
ls the proposed work changing the existinS footprint? tr Ves fi no
TOTAI SQ FT UI{DER eOOa (for proposed work) Heated:Unheated;
TOTA| PROJECT COST (Less Lot): S79,090
ts the proposed work changin8 the number of bedrooms? tr vcs! no
ls any Electrical, Plumblng or Mechankat work beint done to the Accessory Structure I Yes E t{o
lftheproiectisaRelocatbn,isthereaNaturalGasLineonthe€urrentsite?OYesElo
15 there Ele€trical Power on this Building? F Yes tr No
Property Use/Townhouse
Description of attached soa
information. "'NOTE: Any wo* perforfied without the appropriate permits willb€ in violation of the t{C State Bldg Code and s tp 6nes up to 5500.00'''
Todd Bishton
Occupancy:! Single Family E Duplex
work: '16'x32"Concrete Pool wilh 8'x8'
OISO.AIMER: lherebycenify that all $e informatbn in this application is correct and all\fort will comph wth the State Euilding Codeand allother applicabk State and local
laws a nd ordinan es and regulationr. Tha NHC Development Seryices Center will be notified of any change5 in the approved plans and specifications or change in contractor
Owner/Contractor:
"Licensed Quolifiet"
ls the property located in a floodplain? fl V". n U"
Existing lmp€rvious Area: _ Sq Ft
New lmperyious Area:Sq Ft
WATER:
Signature:
TotalAcres Disturbed:
Exining Land Disturbing Permh; E Yes E
a1g Dffas,i
r-a<_
dCepua E Community System E Prirdte Well B central Well O eOua Q jly lns6sfiortSEWER:{creua D E Private Septic tr Central Septic Aqua
zon., R-20 otfrce,
F6&[g.nity system
\($- s.tu.rc trtr{$ trHt *-{RH} + (Bt *
!
Approval:oate:0 ic 'l?Flood: n, VEI(,(vl _ (N)srr+zft= l'-d:
5F 5ot.1 ttsoOvcz--*o b€ rn1 4 'r)a*5
tnt(P f-d
Comment:N
City:
Ccvr.ata ?toi
sh
,, l
#'
LOT f: 8
pRopERTy owI{ER,511114g; Rex Johnson pHoNE s: _
l'<*./H at
ri
U(
c
2atT
,1,:
vsz-
'rr Y x Dyv.t;tr\Il rcOUlteU 9ltl-251{rrg
a
<
NOVER COUNTY BUILDING PERMIT
APPLIcAfioN IYPE: COTTMERCIAL
-L APP
(office Use)
PLEASE ANSI{ER ALL QUESTIOIIS APPLICABLE TO YOUR PRO]€CI
"Project Responsibility''
hAPPLICANT'5 IUfiE:
DEVELOPER:
L DAT E
PHONE #:
PHONE S:)-
o'
t/o/"
PRO]ECT ADDRESS:
occuPANT/BUSlNESS r,lAr'1E :
PROPERTY OIINER'5 tlAt4E:
CITY:ZIPi-
l)
a 'ti
OWNER'S ADDRESS:Zctw:
CONTRACTOR :LICENSE *:
ADDRESS:CITY:
EI{AIL ADDRESS:v
PRO]ECT CONTACT PERSON:
(check A11 rhat Apply)
RENOVATION GENERAL
NEW CONSIRUCTIOTI:
ACCESSORY STRUCTURE:
srglilc:ztzlq(
ST zi? :
PHONE #:
PHONE S:-/
lf Relocation, is there a Nalural Gas Line on the Current Site?trYes E*o
REPATRS l-l nrlocartol,r
rs gloo spnrr'rxreneoz I v"t Ino
ERECT NEI.I STRUCTURE @TAST TMCT I SHELL fI UPFIT E ADo TO EXIST STRUCTURE
If UPFIT - The Shell. Pernit #:
IF Yes, hrhat was the Previous Occupancy Type?
Is Elect Po{er on this euilding ffYLs NO
**+*r rs rHrs A 6HAIGE oF occupApcy uset fives ffi *,*r*
hhat is the Neu Occupancy Type?
ARCH DESIGN PROFESSIOT,IAL:
ENGR DESIGN PROFESSIOMAL:
PH
PH
NC REG *:
NC RE6 *:
DESCRIPIION OF WORK:
ls food or bevoragss prepar€d o. s€rved in this strtlciurg?I v"" [ ruo b rho Propety Locatod ln The Floodddn? E ves @t(c
all
lot-e) CfttNltt )
conGin Asb6slos or nor You ar6 requiaod to call tll€ i,lsdolr6l E nb6bo SlsndarG tor HaztrdqE Ar Polluianb (NESHAP) ar (919)707-5950 4t l€ssl l0 days dot tDtl€
demolil,on of any hdlity or building. Seo Asbes,lcs Wbb Sito: htts rryw*.epi.srate.nc-us/6t{/ssbesb6ratf,ng.hEnl
ToTAL PROJECT COSI: / /,o0e BUILDINGHEIGHT luff
TOTAL AREA SQ FT lb O SQFTPERFLR:/'60
ToTAL SQ FT UNDERR}}F./6 (\#OF STRUCTURES: I # OF FLOORS:
ACRES DISTURBED:EXST LAND DISTURBING PERMIT?YES NO
NEW IMPERVIOUS AREA:SO FT EXISTING IMPERVIOUS AREA:
PROPERTY USE: DOFFTCE DneSrAUnmn -./"I/Z[MERcANTLE [_leouc APT CONDO OTHER:
SO FI
WATER:
SEWER:
@eJeua ECoMMUNTTYSYSTEM flwELL
E,CFPUA f] CENTRAL SEPTIC LJ PRIVATE SEPTIC
flzoNrNc usE
D CoMMUNTTY SYSTEM
$10
PAYMENT METHOD: ECASH E CnecX eavneLE To NHc) ffientceN o<eREss nMcMSA
"' SLPARATE PERMIIS REOIJII]LD fOR ELEC], I,,IECH, PLBG. GAS EQUIP, PREFABS E INSI-RI S ''
DISCOVE
zorue:'i6 oFFrcER: 'oTG .':Jffi'[Lt"J'2s , , o' RH, o' B, tS/
iep,,ua'. pft- cw: lLtA oere:lllfllFLooD: - - X-BFEE
41112
Nl|lus{ rnia
u6k
'ln PERMIT FEE:IComment
C AAt+74 w;th k e4eleoC ldd
on" lvqe ,4.L1 irrdicaBal lcrott- on o(
\s,
I
,t)z
I
EXrST CONSTRUCTION: I ALTERATION n
SIGNATURE:
# OF UNITS:
#OFSTORIES: /
\,\
NEW HANOVER COUNTY SUITDING PERMIT
APPLICATION TYPE: RESIDENTIAL
PTEASE ANSWER ALT QUESTIONS APPLICABLE TO YOUR PROJECT
"Proiect ResponsibiliV'
&ol1-8Z
(office use)
APPLICANT,S NAME: BASS BUiIt, INC Oate:6/9/17
PROJECT ADDRESS: 8200 River Road ctrY.wilmington 71p 28412
suBDtvtstoN: Riveroaks LOT #: 3
PROPERTY OWNER'S NAMEr Greg & Elisa Roels PHONE #: (919) 349-8599
OwNER'S ADDRESS: 8200 River Road ctTY: wilmington z,P: 28412
CoNTRACTOR: Bass Built, lnc s196 1166r't5s s. 55529
ADDRESS: 1003 Bennet Lane, Unit J CIW: Carolina Beach St: NC ZtP: 28428
EMAIL ADDRESS: IN bassbuilt.com
PROIECT coitTAcT pERsoN: Bryant Bass
EXISTING CONSTRUCTION: [-1 Alteration n Renovation [l General Repairs
NEw CONSTRUCTION: 8 Erect New Residence n Addition to Existing Residence n Relocation
***PLEASE CH ANO ANSWER BELOW ATL THAT APPLY TO
PHONE: (910) 367-0874
PHoNE: (910) 367-0874
RPROIECT',T' * *
al Art Garage (sF)_E Det Garage (sF)_
D Pool (SF)
E Deck {sF)846
B Porch {sF)531
E storage Shed (sF)-
n other (5F)
I Sunroom {SF)
! Greenhouse (sF)
ls the proposed work changing the existing footprint? E ves D No
TOTAL SQ FT UNDER ROOF Vor prcposed workl Hs31g{;2,299
ToTAL PROJECT cosT (Less Lot)s 405,125.00
ts the proposed work changing the number of bed rooms? D Yes EI tto
ls anv Electrical, Plumbingor Mechanical work being done to the Accessory Structure E Yes 5! No
lf the project is a Relocation, is there a Natural Gas Line on the current site? fl Yes E No
lsthere Electrical Power on this BuildinE? E Yes En No
Property Use/ occupancy: F" single Family E ouplex E Townhouse
D€scription of worki Sinqle familv residence on piles
DISCLAIM€R: I hereby certify thataltthe information in thisapplication is correctand allwork willcomplywith theSbte Building Code and al,other applicable State and lo.ai
laws and ordinances.nd regulations. The NHC Developfient Services Center willbe notified ofany changes in the apgroved plans and specificatrons or change in contractor
rnformation- T"NOTE: any work performed without the appropriate permitswlllbe io violation of the NC e and subjectto flnes up to SSm.CO"'
owner/contractor: Edgar B Bass signatu
"Licensed Qualiter" Pdnt Nome
ls the property located in a floodplain? Yes E No
Existing lmpervious Area:
-
Sq Ft Total Acres Distutbed:
New lmpervio us area: 2,100 5q Ft Existing Land Disturbing Petmit; ! Yes ! No
WATER: D CFPUA fl Community System E Private Well D Central Well € aqua
sEwER: fl CFPUA E community System E Private septic E c€ntralseptic E Aqua
zone: -- officeri
-
setbacks (F)
-
(l-H)
-
(RH)
-
(B)
-Approval: -.......'-...- city:
-
Date:
-
Flood: {A}
-
(v)
-(N} -
BFE+zft=
-Comment:Permit Fee: S
,ffi
unheated:805
$\ )tto
./...;L:.'..
ffi NEW HANOVER COUT{W BUILDING PERMIT
APPUCATTON TYPE: RESIDENTIAL
PEASE ANSWEF ALL QUEST]ONS APPUCAELE TO YOTJR PRO]ECI
'Proiect RBponsibllM
?at+-'11v3
L#*:p
Ap l€rhn
(oflice use)
AppucA11,s NAME, lqry Logan - Logan Homes
g1n; Wlmington
Date:t\
zt?:pror:o eoonrss, H1 7€ arxrillr.
suBDlVlsloNl ClearwaterTreservd LOT S:
OWNER'S ADDREIS:60 Gregory Rd c|Ty: Bolvllle ztP: 28451
coy1;AcfoRr Logan Homes BtDG LICINSE $: 34408
eooness: 60 Gregory Bd
tmnl nOorrSS: E!99an@loganhomes.com
pRorEcT coilTAcr pensot. Mary Logan
EOSTING COI{STRUCTON! E Alteration El Renoyation E 6ener.l Repai6
NEW COI{STRUSIION: E Erect New Residence El Addition to Existing fiesidence D Relocation
G att earage (sfl LlB O oet Garage tSF) _
tr Pool(sF)-
n Gre€nhou!€ (sF)
-
D Deck (sF)
ls the proposed work changing the eristing footprint? El Yes D No
TOTAL Sq FT UI{DER ROO} llot proposcd wor*) H€atcd:,r38 thheatcd:
g1w. BeMlls 5T; NC 1p. 28451
p11ggg; 91 G452-71 75
PHON9.91H52-7175
Porch (SF)33|o
Il Storase Shed (5F) _
tr other (sF)_
TOTAL PROTECT oosT lt,!s.t-otl s lTEtN
15 the propos€d work ch.ngingthe numberof bedrooms? El Vcs S ffo
ls any El.ctrkal, Plurnblng or McdrrnLal work beint done to th€ A;ssory Structure. tr Ves fr lo
Itthe projectlsa R.bc.don, istherea llaturalGas Line oathe currlnt site? Cl Yes E No
ls there ElectrlcalPowcr on this Bullding? D Ves {.Xo
ProreIty u'e/ ocrupancy: El slnfl fanfly EI ouplcr EJ TowDhou.c
oescriptlon q1g1e1; SFR - new conslrudion
1.v,. .rd ordh.nc?s ard rrtuhrbns. The NXC Dor.iopmc^t S€rviEli Ccdrr wlll b. noilfied of rny .hrhg6 ih tllc .lproved pbnr .fld ipedi(ttloarJ or ctln3a In .ontr.ctoaIormrtlon.'.'NOT[:Arryurortperfonn€dwirhouiricrpproFrht.pl'Inttswtllbrhvlohtbnofth. CSt t.BUg to ftr.s up to $sm.m.r.
0wner/Contnaon D Logan **tr".'Uensrd Quatltler' P ht No,i,e
lsthe property located ln a {oodplaln? fl Vot F no
Erlstirrg lmprvlous Arca: 0 Sq Ft Tool Acrcs Dlsturbed; . ? t
$15
$\f?z
A!
nL bo
1o
Ncw lmpervioutm",3{J3 sq Ft Edrtlng Land Dlsturblng peImhr n yes EI llo
WAIER: El CFPUA El Communtty System E private Well fl Centrslwcll C Aqua
SEWE& E CFPUA E Community System D prtvate Septic E Centralseptic EI Aqua
Zone: _-- Omcer _ Setb.cls (fl _ (rfll _ (IHl _ (Bl _
Approy.l! .- Cityr _ D.ter_ Flood: (A)_M_ (N) _ BFE+2tt _
C;ommeht:permit Fee $Z+
rc(
I
tl
pRopERryow EpsnAME. Clearwater Preserve LLC pHqIE f. 910-452-7170
[] sunroom (sF)_
l)
A\r.lun1?till^Klro .Jcr? *lqTl-
RECEIVEDAPR242OlT
NEW HANOVER COUNTY BUILDING PERMIT
AP P Ll CAT I O N TYPE; RESIDENIIAt
PTTASE ANSWER ALL OUESTIONS APPLICASLE TO YOUR PROJECT
"Project Responsibility"
U
CITY
PHONE #:
APPTICANT'S NAMEI
PROJECT ADDRESS:
Date '2t t"t
ztP
SUBDIVISION:
PROPERTY OWNER'S NAM!;
OWNER'5 ADDRESS:
CONTRACTOR
ADORESSI
PROJECI CONTACI PERSON
Lt9& tr4o ea*^J 23t- g46b
tVe.N ,tr24c?C'TY / att4 ,
O/\)sLoc LrceNsr *r32{3S-
c\rr, f.L,lc-.t \ .srr(LztP: r') <4o2-
prolrr; -39) a9B?
PHONE
EXItTING CONSTRUCTION: n Alte.atlon 6"norntion Ll Gereral Repairs
NEW CoNSTRUCTION: E Erect NewResidence fl Additionto Exlstint Residence C Relocation
IT'PLEASE CHTC( AND ANSWER BETOW ATLTHAT APPLYTO YO
6- Det carase (sr) /lS-2tr Au Garage (SF)_
lJ Greenhouse (sF)-
tr Pool (sF)
fl Porch isF)
I I storage Shcd (51 ) _f:l Sunroom (sE)
tr Deck (SF)D other (sF)
ls the proposed work chaneing the existing footprint? ! Yes d No
TOTAT sQ FT UNDER ROOt lfot proposed wolk) Heated:8OO unheated: )/S?*
TOTAT PROJECI COST iLess Lot): S @,ur,.oo
ts the proposed work changinB the hunber of bedrooms? E ves d ruo
ls any Electrical, Plumbing or Mechanlcal work being done to the Accessory Structure .6 yes Q lto
lf the project is a Relocation, is there a Natural Gas Line on the current site? O Yes Ef No
ls there Electrical Power on this Build ing? dy"s D t',to
ancyr S single Family E D ex E Tolvnh
A4
Property Use/ Occup
Des.ription of Work:
upl
/.4
ouse
tr
DlSCtAlM ER I I herehy ce(i(/ lhat allthe lnrormation ln this appllcation is corectand allwork willcoriplywi0r the st.rte Bulldlng C
l.\rs.nd ordinances and retulatio.s. Thc NHC Devc lopm.nt 5e rvices Center wiilbc notified olanychan8er in the approvcd plan
ioformation. l'NoTt: A
Owner/Contractor:
nv wolk performed w.thout the ?rrop, aie pu mls will b" in
&s ,l-toeta^t Signature
"Licehsed Quol\ier" Print None
ls the property located in a flooclplain? D ves ( f'ro
Existing lmpervious Area: _ Sq Ft TotalAcres Disturbed:
rhe Nc sr.rre Bldg
and allolhcr aprrlicable state and local
specifications or change in contraclor
to llnes up to 5500.00"+
New lmpervious Area:Sq Ft Existin8 Land Disturbing Permit: E Yes D No
WATER: E CFPTJA O Community System D PrivateWelt D CentralWell E Aqua
SEWER: E CFPUA D Community Svstem fi Private Septic E Centralseptic fl Aqlra
zoner _ orficer: _ Setbacks (F) . -_ (l,H) _ (RH) _ {Bl __
Approval: _ Cily: _ Datei _ Floodr (A) _ (V) _ {N) . BFE+2ft= _
Commentr permit Feei $$.lt o -
l''l l'ttL
Lof 4: 3
EMATL AoDREss 8,in, eA*/OA P,+e QUp d)//-*+'r+C2r-i?.1', CD +^
'.