FEBURARY 5 2017 BUILD APPS2"otr,tl33t8444-
Appliaation
Number
(office use)
ii NEW HANOVER COUNTY BUILDING PERMIT
AP PLICATION WPE; RESIDENTIAL
PLEAsE ANSWER ALL QUESIIONS APPTICABTE TO YOUR PRO]ECT
"Proiect Responsibility''
AppgCANT,S NAMEr Pulte Homes oate: 1-22-18
SUBDIVTStON: Del Webb Riverlights
pRopERTy owNER'5 114y16; Pulte Homes PHoNE#: 843-353-5119
CoNTRACToR: Pulte Homes 9196 u6gx56 s. 1931 1
ADDRESS: 3504 Faringdon Court 6g1y; lVlyrtle Beach ST: SC zrp: 29579
EMAIT ADDRESS:Tiffany.Dunn@Pulte.com
pRoJEcT coNTAcT pERsoN: Tiffany Dunn
EXISTING CONSTRUCTION: n Alteration n Renovation n General Repairs
NEW CONSTRUCTION: !4rect New Residence n Addition to Existing Residence n Relocation
pHONEj 843-353-5119
PH0NE: 843-353-5'119
a*
) .-_ryAtt Garase lsF) 455V-
*P E CHECK AND LY TO P
n Sunroom (SF)_
I Greenhouse (SF)_
El Det Garage {SF)
n Pool (sF)
D Deck (sF)
orch (sF)tao
ls the proposed work changing the existing footprint? n yes n No
TOTAT 5Q FT UND€RROA| Uor proposed workl Hs11g6;1756
TOTAL PROJECT COST {Less Lot): S 114218
lstheproposedworkchangingthenumberof bedrooms? E ves E tto
lsanyElectrical,PlumbingorMechanicalworkbeingdonetotheAccessorystructureEyesnNo
lf the project isa Relocation, istherea Natural Gas Line on the current site? ff yes D No
Isthere Electrical Power on this Building? D Yes E trto
/
Property Use/ occupancy: d Single Family D ouplex Cl Townhouse
Oescription of Workr Castle Rock Elev LC2B with screened porch
OISCIaIMER; Iherebycertify that a,lthe inrormation in this applkatioo is.orrect and allwork willcompty with the State Buitdlng Code and altother appli€able Stale and locallaws and ordinan€es and regulalions. The NHC oevelopment Seruiaes center will be notified of any chenges in the app.oved plan5 and specifications or change in aontractorinformation. ***NOTEi Any work performed without the appropriate pe(mits wllt be in violation of the NC Stat€code to flnes up to 5500.0O+*i
Owner/Contractor;Tiffany D Dunn Signature:
"Licensed Quolifier"
ls the property located in a floodplain? D yes
Existing lmpervious Area:
--
Sq Ft
New lmpervious Area:
--
Sq Ft Existing Land Disturbing permit: fl Ves n Xo
WATER; I CFPUA D Community System n private Well E Central Well E Aqua
SEWER: f] CFPUA fl Community System fl private Septic n Central Septic E Aqua
Zone: _ Officer; _ Setbacks (fl_- (LH)
-'
(Rt{}-*- (B) _
Approval:
--
City: _ Date: _ Flood: (A) _ (V) _ tN)_- BFE+2ft= _
\/No
Total Acres Disturbed:
b0
(.l
$\
Commenti Permit Feei S
l l12
pROJSCT ADORESS: 4107 Passerine Ave CtTy. Wilmington g1p. 28412
tOt s: 01124
OWNER'S ADORESS: 3504 Faringdon Court ctfi: Myrtle Beach zI.D: 29579
Unheated:631
fl Storage Shed (sF)--
D other [SF] ------
+
NEW HANOVERCOTINTY
DEPARTMENT OF BUILDING SAFETY
230 GOVERNMENT CENTER DRIVE - SUITE 170
WILMINGTON, NORTH CAROLINA 28403
Te lephone: 910.798.7308 Fax: 910.798.7811
Int e r ne t : vt wu'. nhc gov. c om
4 to 7 WORKING DAYS TURNAROUND TIME FOR PERMIT ISSUANCE
STATEMENT OF UNDERSTANDING
Tiffanv Dunn (Pulte Homes), am submitting an application for a residential
a knowledged an approval of the payment made to CFPUA.
I 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.
tr 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.
If 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 dateltime
notation made by the Building Safety Department on the application or submitta!
document). I understand that the 4 (four) to 7 (seven) working days only begins
when the aDDliCation is submitt do nor to 4:30 pm on any working-daY.
Signed in acknowledgment:
t,
Tiffany D Dunn 1-22-18
Signature Printed Name
4107 Passerine Ave
)
Address for the proposed residential work:
Date
building permit to New Hanover County. And, as the applicant or person submitting
the application, I check the box/boxes below to acknowledge that:
d I have attached an official CFPUA receipt or document that has
\s -q1
T{81{ HAIOVER Cq,T{TY BT'ILDIT{G PERITTITAPPLXCArT TDf,.. RESXDEI{TIALpLE sr a{sa{m Alr (llt5rlo6 AgpLICrSL[ TO m,l pf,o)f.r
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-Proj.ct n spoGtblLlg/.
APPL ICATTOT
fL*Gr
(ofrl ,APPLICA'{T'S }TAflG:
DEVELOER I
PnoJECT Aotrr
SIEDITl"TSIOI:
DATE:
PNOP€iTY 6iEr,
oaEl,S ArrorEss
corriacTox:
AOmESS:E :tt aoorEss:
EXTSTIIG I'?ENMIq,5 ANEA :
XATER:CFPUA
SETER :
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f]stnnmr -.--sF D poo.PORC,H 010 sr
SF fI STORAGE SHED SFncREtrHo]st SF fl oecx SF OTHER:
TOTAI TGATED tA ,rr.1\ *7 rOTAL SQ FT UT9ET
E CHECT 2ff.E oer cannee .__ sF
AIY GARIGE
ocLff ALt r r llPlY ro mrn PiOJ ECI I5f
IOTAL PiOTECT C0ST rr*r-orr I q76,&D
1_:--I5 Aoy EtECrttCAt, pLl|atx o..If the proJect ls a nelocrtlon, ls there , aturrl G.s
.---......--_
w,4t/{{ ror^r
^rEA \r ()f STOnItS 3ECll&Cf taork tclrt Do.rc to the Accastory StructuEl I vesfs thane Elcctrlcal porcn on thls Bulldtngt f-I yes on th€ curr.ent s1t€l fl Yes
tYopteErw usE / occllp
DCSCNIPTIo.I OF Ifi(:,/'-)
D€Cq*R I h.E6y c.rlty trn hb.rnrbi h lth +rft.lon b co.rrcl and d wo* ,d oonply rlth ta Sbr A,utgnd o rlrarcra dd N+lC frartaopnxnt 3.rvbc. C.ni{ w{ b,noald otmy dEE! h 'l.
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rr.+.r + r,|.,,.r + a..r r....** Jli.l!*a a,&*r.ra i a.at aIS Nl€ PfiPEirY LOCATEO tI A F E ttaa tt at *aa a aarti|liat+a
A6
'rcr: p'ttrctE F$lrry I urrex f] romrusr
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ZO|E: OFFICER:
YES ,o
sQ Fr TOIAT ACRE' DISTURBED:
ETPNTSSa]}+ a* a+a *+*arrr +air a aattatttrraar
R!\4SIO OAI} ,a/11/1)
B
BFE.r2ft-
an npEnvlqJs AnE :SQ FI EXIST LlE DISIUTSIi|G PERITIT;E YES Ero
crnn I cEilrRAr scprrc
I cortt nrw svsreu n PRTVAT€ I{ELL I carrnal rrr-r-PRrvarE sEprrc I corurw svsrrr $t qwstp^t^lt PEnllI
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SETaACkS; F:LH:RHArrproval :Clty;DATE:FL@O:
|'l' l .,.\.
i,m.;NEW HANOVER COUNW BUILDING PERMIT
APPLICATIO N ryPf., RESIDENTIAT
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROIECT
"Project Responsibility"
9o1K -ti5r
Application
Number
(ofiice use)
APPLICANT'S NAMEr Porch Conversion Date:1-12-18
PRoJEcT ADDRESS: 3767 Old Sand Mine Drive CITY: Wilminqton ZtP:28405
SUBDIVISION: River Liqhts AQ PH 2 LOT il:121
PROPERTY OWNER'S NAME: Romesh & Rosema Amin PHoNE #: 215-385€797
OWNER'S ADDRESS: 3767 Old Sand Mine Drive CITY: Wlminqton, Nc ZtP: 28405
coNTRAcToRi Porch Conversion BIDG LICENSE f;76247
ADDRESS: 6821 Market Skeet CITY tn ton ST: NC ZIP: 28405
EMAIL ADDRESSi Dorchconversion(Aomail.com PHoNE: 910-777-3363
PROJECT CONTACT PERSON: BTian WaIsh PHoNE: 910-777-3363
EXISTING CONSTRUCTIONT ! Alteration n Renovation ! General Repairs
NEw CONSTRUCTION: E Erect New Residence gtlAddition to Existing Residence fl Retocation
***PLEASE CHECK AND ANSWER BELOW AI.t THAT APPTY TO YOUR PROJECT*1
/sunroom {SF)204
I Greenhouse (SF)a Deck (5F)
ls the proposed work changing the existinB footprint? /Yes n Uo
TOTAL SQ FT UNDER ROOF Aor proposed work) Heatedr Unheated:
TOTAT PROJECT COST (Less !ot): $19,686
ls the proposed work changing the number of bedrooms? tr Ves #lo
ls any Electrical, Plumbing or Mechanlcal work being done to the Accessory Structure fg/yes 3 No
lftheprojectisa Relocation, istherea Natural Gas Line on the current site? a yes [,No
ls there Electrical Power on this Building? EaYes a No
Property Use/ Occupancy: g/Single Family fl Duplex ! Townhouse
Description ofWork:s€f€€nf€|€H+-ad€|ili€Hl+6ts€xi6ti{€-
n Att Garage (5F)_
information. "'NOIE:Any wo.k performed without the .ppro
Owner/Contractor:
DISCIAIM€R: Ihereby certifythat allthe information tn this application is cor.ect and al
laws and ordinances and regulattons. The NHC D€velopment Services Center willbe not
lwork wlllcomply with the State Building Code and a otherappticable State and locat
ified ofany chanSes in the approved plans and spe(ifications or change in contractorviolation ofthe NC State EldgCode and subjecl to fines up to SSCb.m...
$65-
nt Je Martin Signature;
"Licensed Quolilie/'
ls the property located in a floodplain? tr ves /trto
ExistinS lmpervious Area: 3054 Sq Ft Total Acres Disturbed: 0.002
New lmpervious Area: 68 Sq Ft Existing Land Disturbing permit; D yes I No
WATER: traCFPUA D Community System E private Well n CentratWefl E Aqua
SEWE
Zonei
Approval:
R: rf crpues.igl n Community System i private Septic n Centralseptic E Aqua
cer:
City:
DT-G setbacks(F)A// {ttrt o,^,tftzi;;a
tutN/A t*il at/AtstNA
s
Comment:vt ln €ac-3l,rr?
(A)_(V)-.(r'll j( gre+Zft=
Permit Fee;
E Det Garage (SF)_
! Pool (sF)-_*=-
n Porch (SF)_--.--
I Storage Shed (5F) _
I Other (SF)
-=--
REGULAR RESIDENTIAL BUILDING APPLICATION
STATEME NT OF UNDERS ANDING
I,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:
tr I did not attach an official CFPUA document that acknowledged approval of
the payment made to CFPUA.
I did not attach 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
tr ldid n attach 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.
And because ! did not attach the official proof of approvals along with my
apptication for permit; New Hanover County cannot 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)
Signed in acknowledgment:
Agent Jeremy Martin
Sign
,,. ;:r;i'l :'.:1:;.I/ ,:- .'r:
: "&r,ffifr-:
,{f E.:
3767 Old Sand Mine DriveAddress for lhe proposed residential work
Date
NEW HANOVER COI.INTY
DEPARTMENT OF BUILDING SAFETY
230 GOVERNMENT CENTER DRIVE . SUITE I70
WILMINGTON, NORTH CAROLINA 28403
Telephone: 910.798.7308 Far: 910.798.781 I
Internet : www.nhcgov.com
Printed Name
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATIO N ryPE.. RESIDENTIAI
PLEASE ANSWER ALL QUESTIONS APPLJCABLE TO YOUR PROJECI
"Proiect Responsibility"
htv.-ub/
Applicition
Number
(office use)
APPLICANTS NAME; Michael Evenson Datet 1126.12018
PROTECT ADDRESS: 18 Hobie Run CITY: Wilminqton
SUBDIVISION: l\4arina Villaoe River Liohts
PROPERTY OWI{ER'S NAME: Catherine Finkbiner PHONE #: 610-574-5875
OWNER'S AODRESS: 18 Hobie Run CITYr Wilminoton
ZtP: 284O9
ztP 28412
PROJECT CONTACT PERSON: Michael Evenson PHONE: 9'10-524-0963
EXISTING CONSTRUCIION:'Ef Alteration n Renovation E General Repairs
NEW CONSTRUCTION: E Erect New Residence n Addition to Existing Residence E Relocation
**.PLEASE CHECK AND ANSWER BETOW AI.T THAT APPTY TO YOUR PRO'ECT'I*
n Att Garage (5F)_E Det Garage (SF)_
n Pool(SF)
n Greenhouse {5F}! Deck (SF)
Unheated:
TOTAL PROJECT COST (Less Lot)s20.000.00
ls the proposed work changing the number of bedrooms? I Yes \ o
ls any Eledrical, Plumbing or Mechanical work being done to the Accessory Structure \Yes I No
lf the project is a Relocation, is there a Natural Gas Line on the current site? n yes RNo
ls there Electrical Power on this Building? Eles 3 ff o
Property Use/ Occupancy: n Single Family tr Duplex!_Townhouse
Description of Work:
laws and ordinances and regulations. The NHC Development Services Centerwillbe notifled of any changes in the approved plans and specifications orchange in contractorinformataon. 'r'NOTE: Any work performed wlthout the appropriate permits will be in violation of the NC State Bldg Code and subject to fines up to SSOO.m...
sisnature: -/ I I ,t l, uf
26J8H tg 914gF
Owner/Co ntractor: Michael Evenson
"Licensed Quolifrer" Print Nome
ls the property located in a floodplain? D Ves b-{to
€xistint lmperviousArea: NA Sg Ft TotalAcres Disturb€d: NA
€r* --,\.-
New lmpervious Area; NONE Sg Ft Existlng Land Dlsturblng permlt: n yes
WATER: .\CFPUA n Community System E private Well ! Central Well D Aqua
SEWER: b\CFPUA E Community System n private Septic n Centratseptic n Aqua
Zone: R7 Officer: _ Setbacks (F) _ (rH) _ (RH) _ (B) _
\No
_ City: _ Date: _ Ftood: (A| _ (V) _ {N) _ BFE+2ft=Approval:
Comment:Permit Fee:s
LOT #: I
CO TRACTOR: l\4ichael Evenson Customs lnc BLDG LICENSE S:-
ADDRESS: 6107 Lvdden Rd CIW: Wilminoton ST: NC ZIP: 28409
EMAIL ADDRESS: customwoodartist@live.com PHONE: 9'10-524-0963
! Porch (SF)_
! Storage Shed (SF)_
n other (SF) 40
n Sunroom (SF)_
ls the proposed work changing the existing footprint? n Yes E No
TOTAT SQ FT UIIIDERROOF (Jor proposed wotk) Heate* 2062
?s-
\rt"t?pt8"lj16
#4sv
'sl1;
DEVELOPER;
PROJECT
RECEIVEO JAN 17 2018
NEW HANOVER COUNTY BUILDING PERIvIIT
APPLICATIOi| rrPE; COIIIIERCIAL
pr-EAsr Airsl{ER AtL QUEsTro s AppLIcaBtE To yorJR pRolEcT
'Projcct ResponsibilityD
a,
,
aFFfi.fAffoN
Number
((Xfl<. use)
APPLICAI,IT'S NAIIE: sharon creer . DATE :L/ 11 /Le
PHONE *:
: {101 MasoDboro Loop Rd $i. Lni ZIP r2g409
OCCUPANT/BUSII{ESS tlAl'lE : scotchman #3096
PROPERTY OUI{CR'S tlAltE I cpM Inve6rnenrs LLc
Ohlt{ER' S ADDRESSi rnro commonwealrh Dr, sre 202 - CITY: wilmingtson
CO TRACTOR: B&lr Roofing contracrors _ LICENSE *: ssozz
ADDRESS: 2a41 N chur:ch s!CITY: x661, y6-[
_ PHOt{t *: 804 730-1S6s
ST: pg ZIP:26a63
ST: NC ZIPr 2?Bo4
ENATL S; "ecr@bmroofin conLractors. con
PRoIECT COI'ITACT PE : Sharon Greer x3 03
(Check lU ftlt Apply)
lf Relocation, is liere a Natural Gas Line on the
ALTERATIOI{E REM)VATION
nent Sile? f_
GENERAL REPAIRS
l-_ No rs BLDG ses
PHONE *i 2s2-442-s3oo
PHOiIE *z zsz-sqz'szoo
nPRIN
RELOCATION
KTERED?r_ Yesf_
NoEr{ co srRrrcrro : ! EREcr Er. srRUcruRE E FAST TRACK
ACCESSORY STRUCIURE:E SHELL f] upFrr f] Arx, ro Exrsr srRucruRE
If UPFIT - The Sh€lI Permit #:Is Ekct PoHen on this BuildinB f. yes f.NO
l.the l{ex Occupancy
trc REG *i
NC REG #:-
.*r** rs THrs A otatEE oF occupaltcy usElr yEs
IF Y.s, rhat vas the Prevlous occupaocy Type? _ Uhat ls
IXEfi ?oesro PnoFEssrouL:PH
PH
conteln A.besros or not. You are rcqrlr.d ro calllh€ NatonrlEmi.sion Standards h HEzrdNs AIr polutsnrs (NESltAp).t (S19)707-S9SO 5l t€asl iO days Plior lo rhedemollon of.ny taclliy or building. Sae Asbssbr W€t Sie: h[p:/,1^rrw.epi.srar€.nc.us/spi/ssb6sros/ahmp.hlml
ET{6R DESIGN PROFESSIOiIAL
DESCRIPTION OF trORK: Roof ovellay insrall 1/2tr ilrgulation rhen ncw 4omi.t Durolast PVC Membrane sys
TOTAL PROJECT COST: 22811. oo BUILDING HEIGHT # OF UNITS
TOTAL AREA SO FT SQ FT PER FLR:# OF STORIESi
# OF FLOORS:TOTAL SO FT UNDER R # OF STRUCTURES
ACRES DISTURBED
NEW IMPERVIOUS AREA:SO FT
pRopERry usE: EoFFtcE ! nesmunaNr f] MERCANILEI-I EDU cf-I APTD coNDo orHErconv store
E IFICATIONWATER:
SEWER:
SYSTEM
CFPUA
CFPUA
.., s
E33$+iXU[31:'=fl .Efi i!:.,,,"D8o,,o#,iLf,ysEcLAss
EPAFATE PERMITS REOU]RED TOR ELECT, MECH PTEC, GAS EOUIP, PNTTAAS & iNSEFTSf cAsH f cHEcK (PAYABLE To NHc) f_ AMER|CAN ExpREss fi_ r,,lcrutse J-_ orscovrR(FOR OFFTCE USE ONLY)
PAYMENT METHOD
ZONE: OFFICER SETBACKS: FApproval:_ City: DATE_ FLOO BFE+2ft,
N-
_ PERMIT FEE: I
Comment
oz lsP6.
EXIST CO STRUCTION:
OWNER/CONTRACTOR:snaron c!eerlB&l,t Roofinq
ExsT LAND DTSTURBTNG pERMtT? r yEs r NO
EXISTING TMPERVTOUS AREA:_ Se FT
LHRHB
)ct? I tVLffiNEW HANOVER COUNTY BUILDING PERHIT
APPLICATIoII ryPF.. COD iIERCTAL
PLEASE ANSWER ALL QUESTIONS APPTICABLE TO YOUR PRO]€CT
"Project ResponsibiLi.ty,,
AFFIITET--IoI'I
Number
(office Use)
PRO]ECI
occUPANr/BUsINEss tlAnE: BI iS s C\A-i &f6-n
zlP :
PTIONE #:
- CITY:q9nSraisu ST:na ZrP:i
c_- LrCENSE #:552rJ-1 st:'|/'tLzrp:AgqE- clw: hj\ I n^\
ttHr'z*PHONE *:qb-+11qtag
PHONE S:
(Cne.k A1.l lhat Apply)
RELOCATId{
KLEREDf - Yesf-_
ERECT NEl.l STRUCTURE FAST IRACK SHELL UPFIT ADD TO EXIST STRUCIURE
cL.
PROPERTY O NER'S NANE :
OU ER'S ADDRESS:
G<n m;l\ev-
CONTRACTOR:
ADDRESS;Al
EMAIL ADDR 55:
e.
PROJECT CONTACT dt)n \€e-v- L-ay:y3.a--.,l-e--r-
Exrsr co srRucrro : ErALrERArroNlf Relocation, is there a Natural Gas Line on the
T-l REI{OVATION T] GENERAL REPAIRS T-'1
bJrrent Sire? f.#f - Ho ,s e.oosrH,
No
t{Ehl cor{sTRUCTloN:
ACCESSORY STRUCTURE:
rs Elect Po{ er on this Euilding fr2lyes tr- NO
**..* r5 THrs A CMI{GE OF OCCUPAI|ICY USE ? r yEs {-y'XO *****
IF Yes, what was the prevl.qus occupancy Type? B'U5ir\e g, _ $hat 1s tie ttew Occupancy
Tvoe?AREI{ OESIGN PROFESSIOTIAL:A NC
If UPFIT - The Shell Penmit #:
ENGR DESIGN PROFESSIOi]AL PH
DESCRIPIION OF WORK:nail 5; tc.i-\
OWNER/CONTRACTOR: JuTn '€w L/.rcas+<-n STGNATURE:
NC
REG #:
tec *;-
ls food or beverages prepared or seNed in this slruclure?f . YesflNo ts The Property Located tn The Ftoodptai n/vey _NooISCLAIME!: I hereby c€nity lhat all intormariori in this apptication b corecl and a work wijl compty wim the Slale Buitding Code and a olher appticab,e Stateaid local E\rs and ordinances and requlatirns. The NtlQ Oevebpmer1 Services Center will be noffied of anv chanoes in th; EDomvft; .r6frb iri ooiitiedd fi' ;6#fr*?.fffi;r,i.i.. Eiitiisl -drifvvoii Ffioiiffi Virb*dr; epprorxiare permirs $dl Ee in viorarion or # Bl"iEgB ;ffi8#;.Sutiedlo Fines up To $500.00'"
llole: llemolltion nodfaatiois & astrestos r6moval permir spdicllions ara to b€ submited using rtE apptication fonncellaln Asbestos or not. Yolj ar€ requirod ro ca the t{a(ana{ Emtssion siandards h{ }tazardous Air pothna s (NESdernolition ot aoy facllity or building. See Asbonos Web Sjte: htp://verwv epj.srate.nc.utepi/ssDesros/shrnp.html
TOTAL PROJECT COST
TOTAL AREA SQ FT :
J5 DO BUILDING HElcHT, t4l
SQ FI PER FLR
TOTAL SQ Fr UNDER ROOF: 1,46O #OF STRUCTUR
ACRES DISTURBEO
NEW IMPERVIOUS AREA: O
PROPERTY USE gorrrce I
EXST LAND DISTURBING PERMIT?-r YES J;,TIO
SQ FT EXISTING IMPERVIOUS AREA:
MERCANTILE ED APT CONDO orHrr fll.l6 .
(OHH$3768) whelher fie tacjlity or bu;tding was tound to
hAP) at {919701-5950 al loast 10 days prjor to the
# OF UNITS: I
# OF STORIES:
# OF FLOORS;
SQ FT
E CLASSIFICATION
I
COMMU
RESTAURANT
NITY SYSTEMWATER: f,ICFPUASEWER; FdCFPUAsYsrEM t-r CENTRAL SEPTIC
EPARATE PERMIIS REQUIRED FOR ELECI, MECH. PLBG, GAs EQUIP, PREFAES & INSERTS
OFFICER:SETBACKS: F
nwELL nzoNlNG US
F'RIVATE SEPfl c gldorrart,|uu rw
pAyMENr METHoD: r cAsH f- cnecr leavrsll].g_ltgl I-: eMERtcAN ExpREss r: Mc /rsA r_ DtscovER(FOR OFFICE USE ONLY)
ZONE:
Approval:_ City:B
--- DATE-BFE+2ft,
NComment
FLOOD:
LH RH
- PERMIT FEE:
t}iI't v,t,t: Jenn't{-pr LO-ncas-t<.-,- _DArE: tZlZSln
I rv-r
rtusirv5s
I
NEhI HANOVER COUNTY BUILDING PERTVIIT
APPLICATION TYPI.. COI1MERCIAL
PLEASE ANsI,IER ALL QUISIIONs APPTICAOLE TO YOUR PRO]ECI
"Project Responslbility"
AppLrcANT,s mr'rr; $5 6.f-a7 Lo,nc a s-++_o-
M $us- yottr-llvZ
APPLICATION
Numbea
(offl.e Use)
DATE::rzlzsln
of'tr
DEVEL0PER I . -.. PHONE f :
PROPERTY oI,JNER'S uAUe , &n e; rn;l\ o"-
PROJECT
OCCUPANT/8USINESs NAI.4E : :CtI i5's C\zi i
CONTRACTOR:e.e
ADDRESS:Al
EMAIL AOD 5: s+on
PRO]ECI CONTACI PE e-n n
t-lj 'ffi
6-r-)
rPHONE S: i
. CfTYI \t13n+svil sT:nazxPri
LICENS
P
. CITY;
E fl: .<..,<-7rT-7rr-r,rffi .s'ttnLztP':atqo1
. PHONE #:ilb'+frDt K6ttlh,z*
l-ar.lc,-asr*<---^
(ch.(,< all rhat Appry)
No
NEW CONSTRUCTION:ERECI NEW STRUCTURE FAST TRACK
ACCESSORY STRUCTURE:
SHELL UPFIT AOD TO EXIST STRUCTURE
i PHoNE #:
ExrSr coNsrRUcrroru: g(rrremrroN
lf Relocation. is there a NaturalGas Line on the
r-] RENOVATION T-] GENERAL REPAIRS T-'] RELOCAIION
Hrrenr Sire? ;. #;"-- ,'r" ,s eroo s"HNr,-eREoz.f*- yes[--
If UPFIT - The 5he11 Penmit fl:
A
ENGR OESIGTI PROFESS]ONAL
*++** IS THIS A CHANGE OF OCCUPANCY USE
IF Yes, what lras the Previous occupan.y lypel B\\5tf\-L5, -
I{Efi ?oes.cru pnoFEssroNAL :
Is Elect Power on this Bullding ftlYes f. NO
? r; Y€s ri". o "...*
l,Jhat 1s the Helil occupancy fau r;nzSS
. PH:NC REG dr
rc aeC *:l-
DESCRIP'T]ON OF U]ORK:na;l aja t 6r^\
led ln The Floodplain {-des}--
uilding Code and allolher appllcable Stal€
s rn he sooroved olans on soccillaotionsinVololjon ot rhe NC Srare Bldq Codo cnd
owNEri/cON'rRA"rO*', ;laraniQr L-avf-aS*<r' SIGNATURE:
(ourltre) (P6t.J.tu)
Noier Oemolidon noulicauofls E asbcsros ,emova, qormit apgllcations are lo bo Eubmtled osln0 lh8 Eppll€tioo loam 768) wnoher he facillry or buildlng ea6 louno lo
contain Asbotlos or not Yor aro ,equ[ed !o crtr tle Nalonal Emlsslon SEnda.ds tor H8zardout A]r PollltanE {NESHAP) 3l (919}707'5950 al leasl l0 days prlicr lo the
r,emdiUon or sny rrclilry or bulrdlr1g. See Asbesros Wab Slte: htp:/l[v'a.€pi ,.ro.nc.urcprosbesros,l6hrrp. hlml
TOTAL PROJECT COSrr i6,606 BUILDING HgtcHT: l+ t
PH
#OFUNITS: J- - I
I'OIALAREA SO FT: -Il-Toci ' SQFTPERFLR:
TOTAL SO FT UNOER ROOF: _lilDg s OF STRUCTUR
ACRES DISTURBED: O
NEW IMPERVIOUS AREA:
EXST tAND DISTURBING PERMIT? ]riYEs J;A]o
SQ FT EXISTING IMPERVIOUS AREA:
SIFICAlION
RrcAN EXPRESS l*l Mcl/rsA f _ DISCOVER
{
o SO FT
TrcFPUA
ffircun
WATER
SEWER
SYSTEM
COMMUN]TY SYST
CENTRAL SEPTlC
EM T-I WELL Tl ZONING USE CLAS
D FRlvArE sEPrc a?ourr',rururrv." SEPAR^TE PETTMITS IIEQU1REO IOH ILECT, MECII,PIDO, OAIJ EQUIP, PNTIA'JS& INS€R]$
PAYMENT ITETHOD; ; CASH f".CneCrle
ZONE:
Approval
FFIC ER:\(,LHdA,nH^/A a-AlA
FLOOD X : BFE+zfl
N
PERMIT FEE
TL
Comment DY'
v DATE
eiil lnspeclion Requrco, 91 0'254'mtll
rtS-
O}^INER 'S ADDRESS:
HOFSTORIES:i l
,I OF FLOORS:, I
pRopERrYUsEj DoFFrcE I nesreunar.rr I ueacarur[eI eoucl-lnerf-lcoruoo oftre1ftU{L__
\aV-lt
NEW HANOVER COUNTY BU]LDING PERMIT
APPLICATION W PE. RESIDENTIAT
PLEASE ANSWER ALL QU€SIIONS APPTICASLE TO YOUR PRO,IECT
"Proiect Responsibilit/
Application
,{umber
{ofiice use}y-tt -
AppLtcANT's NAME: Pulte Homes Oate. 1-?2-18
pRoJEcT ADDREss: 3425 Laughing Gull Terrace CITY: Wilmin ton zt?. 28412
SUBDtVtStON: Del Webb Riverlights lot s: 01065
pRopERw owNER,s NaME: Pulte Homes pHoNE *: 843-353-51 19
owNER's ADDRESS: 3504 Faringdon Court ctw rtle Beach y1p. 29579
coNTRAcToR: PulteHomes 9196 UggN5gs l931 1
ADontss: 3504 Faringdon Court CITY:rtle Beach sT: SC ztP: 29579
EMA - ADDRtsS: Tiffany.Dunn@Pulte.com
PROJECT CONTACT PERSON : Tiffany Dunn
EXISTING CONSTRUCTION: D Alteration n Renovation E General Repairs
N€W CONSTRUCTION: /Erect ttew Residence f) Addition to Existing Residence I Relocation
pxorur. 843-353-5119
pHONE: 843-353-51 19
d rtt earace (sr) 573
V sunroom (SF)
ER BELOW ALT THAT APPLY
E Det GaraBe (sF)
I Pool (sF)
n Deck {sF)
Porch (SF)266
E
240
n Greenhouse (sF)_
ls the proposed work changing the existing footprint? n Yes n No
TOTAL SQ fT UNDERROOF \for proposed work|tleated: 2670 Unheated:839
TOTAT PROJECT COST (Less Lot)170342
lstheproposedworkchangingthenumberof bedrooms? E yes D ]{o
ls any Electrical, Plumbing or Me€hanical work being done to the Accessory Structu re D yes E No
lfthe projectisa Relocation, is therea Natural Gas Line on the current site ? E yes E No
lsthere Electrical Poweronthis Building? E Yes E o/
Property Use/ Occupancy:d Single iamily [J ouplexD Townhouse
DISCLAIMER: I hereby certify that all the infotmation in this appli.ation is correct and allwork will compty with the state Building Code and afl other applicable State and locallaw5 and ordinances and regulations. The NHC Development Serviaes Center will be notafied of any chanSe5 in the approved plani and specifiGtionr or ahange in contractorinformation. *'+NOTE: Any work performed without the appropriate permits will be in violation of the NC Sta Code and subject uP to $500.00"r
Owner/Contracto 1; Tiffany D Dunn Signature:
"Licensed Quolifief' print Nome
/
ls the property located in a floodplain? El yes V No
Existing lmpervious Area: _ Sq tt Total Acres Disturbed:
New lmpervious Area:5q Ft Existing Land Disturbing Permit: D yes D tt
WATER: E CFPUA n Community System E private Well E Central Well 0 Aqua
SEWERT D CFPUA D Community System E private Septic E Centralseptic E Aqua
zone: _ Officer: _ S€tbacks (Fl _ (tHl _ (RH) -- (B) _
Approval: _ Cityr
--
Date: _ Flood: (A) _ (V) _ (trt)
--
BFE+2ft=
Comment:
I 5
b
51
b0
)I
Permit Fee: S
E Storage Shed (SF)-_
n orher (sF) _
Description ot Work: Dunwoody WaV Elev LC2G with sunroom and screened porch
)
NEW HANOVER COUNTY
DEPARTMENT OF BUILDINO SATETY
230 COVERNMENT CENTER DRIVE . SUITE 170
WILMINGTON, NORTH CAROLINA 28403
Telephone: 910.798.7308 Fm: 910.798.781 I
Internet : www. nhc gov. com
I,
4 to 7 WORKING DAYS TURNAROUND TIME FOR PERMIT ISSUANCE
STATEMENT OF UNDERSTANDING
Tiffa Dun n Pulte Homes), 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:
7a
I have attached an official CFPUA recei pt or document that has
cknowled ged an approval of the payment made to CFPUA.
I 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.
tr 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 ctarifications 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 apDlication is submi d orior to 4:30 pm on any workingday.
Signed in acknowledgment:
Tiffany D Dunn
Signatu re Printed Name
3425 Laughing Gull Terrace
Address for the proposed residential work
Date
6
1-22-18
?ot?.-ll ?L
APPLICATION
Number
(office Use)
z:
1
1.
NEhI HANOVER COUNTY BUILDING PERMIT
APPLI.ATIoN IYPE: COIVIMERCIAL
PLEASE ANSI/ER ALL QUESTIONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibility''
APPLICANT'S llAIvlE : MsK1n1sy Buildlng corporati.on
//
- DATE: 1- 1o - 1B
PRO]ECT A : 3 512 oleander Drive : wl lmington
_ PHONE #: e7a '3s2'3300
ZIP 228403
5T: Ng ZIP:2sap3
OCCUPANT/BUSINESS NAIiIE :
PROPERTY O[,JNER'S NAfiE: rhe o-Leander Company, rnc
S ADDRESS:1303,A Independence Bt vd - CITY: q116i1g6e1
CONTRACTOR: McKintey Buj.lding corporar ion _ LICENSE *: :oege
ADDRESS: 3807 peachtree Ave., suite 2oo CITY:
_ PHONE #: 910-392-3300
OWNERJ
Wi lmington ST: nc ZIP:26a63
-PHONE #: e1o 3es 6036EI4AIL ADDRESS : bl isk@mckint eybu i 1ding. com
PROIECT CONTACT PERSON: Brandon Lisk . PHONE #: 910-39s-660s
EXIST CONSTRUCTION:ALTERATION RENOVATION
lI Relocation, is there a Natural Gas Line on the rrent Site? f -ES
(check all rhat Apply)
u
GENERAL REPAIRS
li- No lS BLDG S
RELOCATION
KLERED'{i_ Yesf_
No
NEI^l CoNSTRUCTION:
ACCESSORY STRUCTURE:
If UPFIT - The Shell Permit #:Is Elect Power on this Building f. Yes F NO
r'**** rs THrs A CHANGE OF OCCUPAIICY USE?r vES Ji. NO *****
fF Yes, what was the Previous Occupancy Type? _ What is the New Occupancy
IX8fi ?oesrcn PRoFEssroNAL: corhran Harris Arci t.ecture - PH:91s-793,3433 NC REG #:4296
ENGR DESIGN PROFESSIONAL :-David Sims Assoc iates -PH 910-?91-8015 NC REG #:7136
DESCRIPIION 0F f,/oRK : sh;f- Buitdins consrrucrion
ls food or beverages prepared or served in this structure?J-. Yesl-- No ls The Property Located ln The Ftoodplainli_ yef _No
DISCLAIMER: I hereby cenify rhal all informatron in
and local laws and ordinances and regulations. Theor chanee in contrador or contractor informauon. -'Suqed'lo Frnes Up To $500.00"'
WATER
SEWER
SYSTEM
CFPUA
CFPUA
this application is clrrecl and all work will clmply with lhe Slate Building Code and all other applicable StateNHC
NOT
OWNER/CONTRACTORi aranaon Lisk
NEW IMPERVIOUS AREA: 12, 04s
DeveloDmenl Services Center wlll be not iec, of anv chaE' Any Work Performed w/O lhe Approp ate Permils wtl
SETBACKS: F
FLOOD:
SIGNATURE:
EXST LAND DISTURBING PERMIT? -r YES T NO
SQ FT EXISTING IMPERVIOUS AREA:14 , e46 Se FT
the a ptoved s and
of the C State soecificationsBldg Code and
contain Asbestos or not. You are requi.ed to call the National Emission Standards for Hazardous Air Pollurants (NESHAP) at (919)707-5950 ar least 10 days prior to lhe
demolition ol any facilily or building. See Asbestos Web Sitei hrrp://wu {.epi.stare.oc.us/epi/asbeslos/ahmp.hrrnt
11Jfifl 16 3:15PltTOTAL PROJECT COST: ?oo,ooo BUILDINGHEIGHT: 20,-8, #oFUNITS:
TOTAL AREA SO FT : 414s SQ FT PER FLR # OF STORIES: r
TOTAL SO FT UNDER ROOF: 414 s # OF STRUCTURES: r # OF FLOORS: 1
CONDO OTHEF
COIV]MUNITY SYSTEIV
CENTRAL SEPTIC E WELL
VATE SEPTIC
ZONING USE CLASSIFICATION
MUNITY
", SEPARATE PER[,1ITS REOUIRED FOR ELECT, IT,4ECH, PLBG, GAS EOUIP PREFABS A iNSERTS
PAYI,4ENT METHOD f CASH li. cuecx lenvaBrE ro NHc) f_ AMER|CAN EXPRESS f-- nrcnrrsa f-_ orscovER
(FOR OFFICE USE ONLY)
ZONE: OFFICER
Approval e?E'rr,, $\)518 -
Comment
City DATE
LH RH
N
PERMIT FEE: I
DEVELoPER: The oleander company, rnc.
ERECr NEr^r STRUCTURE E FAsr rRACK E SHELL E UpFrT E AoD ro Exrsr srRUcruRE
ACRES DISTURBED:
PRopERry usE: EoFFrcE I nrsreuRnnr @ vrencnnrrr-el-1 EDUCI-] Aprfl
i)
_:
z
]E
i)N rt
a'
a
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION IYPE: COMMERCIAL
PLEASE ANSI./ER ALL QUESTIONS APPLICABLE TO YOUR PROIE(T
"Project ResponsibiU.ty"
ffi.
APPLICATION
Number
(Office Use)
APPLICANT'S NAME:
DEVELOPER:
Cindy Key on behalf of AT&T AT&T South 17th St (BWE) 478-171 DATE:
PHONE #:
pRorEcr aDDREss: 2555 17th Street South crrv: Wilminqton
occUPANT/BUSINESS NAME : AT&T Mobility
pRopERry owNER, s NAr'rE : cape Fear Public Utility Authority
or.rNER's ADDRESS: 235 Government Center Dr. CrTY: Wilminqton sr: NC zrP : 28403
a1 /)/78
ZIP:. 28403
CONTRACTOR: l\,4asTec Network So utions
ADDRESS: 1000 Centre Green Way, Ste 300
CONTRACTOR:
EIVIAI L ADDRESs:Bradley.Conn@mastec.com
PROJECT CONTACT P5P5g1; BTAdI Conn
LICENSE S:
CITY:
70037
cary ST: NC ZIP:27513
PHoNE f: 919-674-5901
PHoNE B: (678)-995-6314
(check All rhat Apply)
Exrsr coNsrRucrror: I atr:mrror
lf Relocation, is there a Natural Gas Line on the
NEW CONSTRUCTION:ERECT NEW STRUCTURE
ACCESSORY STRUCTURE:
RENOVATION GENERAL REPAIRS RELOCATION
KLERED? [ v"r flroCurrent S te?Yes tr No lS BLDG SPRIN
FAST TRACK SHE LL f] urrrr I aoo ro Exrsr srRUcruRE
If UPFIT - The Shell Penmit #:Is Elect PoHer on this Building E Yes E ,o
ARCH DESIGN PROFESSIOiJAL:PH:NC RE6 f:
NC REG #:ENGR DESIGN PROFESSIONAL: FDH VEIOCiIEI PH:fi3755riT'iZ
DESCRIPTION OF WORK: swap (3) antennas, add (l) RRUS-32 82, (l) RRU 814 447a, (t) htcs Filten, (1) squid, (2) power
Cables
ls food or beverages prepared or served in this struaure? ! ves I No ls The Prop€dy Located ln The Floodplain? [ ves I No
DISCLAIMER : I hereby certify lhat all information in
and ordrnances and redLlatrons Theontractor or contractor itormarron "'
lhis applcation is correct and a I work will comply with the State Building Codo andNHC Development Services Cenrer wrll be notrfred of anv chanoes in lhe aoorovedNOTt Any Work Pelormeo W'O t1e Aooroolale Permils witl 6e in Vrclation of the
all other applicable State
Subjeci io Fines Up To $500 00'*.
OWNER/CONTRACTOR:Bradley Conn SIGNATURE:
(Oualfiol) (Pdnt Namo)
Not€: Demollton notfcalions & asbeslos removal pemh applicadoG ar6 to b€ subrnitbd using ttle sppllcslion fom (DHHS-3788) wiouLr tl6 o. b0ildho was found to
contaln A3b€slo6 or mt You 6ro required to csll the Nadoml Embsion ScandeEls io{ Hszardous Air Pollutant6 (NESHAP) st (919)70?-5950 at t66at 10 dsys Ftor b d,lg
demolition of any fucility or building. S€€ Ast!€slos W6b Site: htlpri/v\Nw.opi.stat6.nc.us/€pi/asbssbs/ahmp.hAnt
TOTAL PROJECT COSI: $20,000
TOTAL AREA SQ FT :SQ FT PER FLR:# OF STORIES:
# OF STRUCTURES:
ACRES DISTURBED:
PRoPERTY usE; lorrtce I nesreunnr'tr lrr/lencerurLe !eouc lnnr lcoHoo orHER:Existing water
WATER
SEWER
nCFPUAE CFPUA
EcoMMUNTTy SYSTEM flwELL fIZON|NG USE CLASS
LJ CENTRAL SEPTIC LJ PRIVATE SEPTIC E COMMUNITY SYSTEM
tFtCATtoN: Tank Tower
". SEPARATE PERN1ITS REQUIRED FOR ELECT, MECH, PLAG, GAS EOUIP. PREFABS & INSERTS -'
PAYMENT I\4ETHOD ficnsn flcnecK (eAvABLE ro NHc) EAMERIcAN ExeRESS fiucnrrsn I orscoven
(FOR OFFTCE USE ONL'REVISED DATE 4/11/12ZONE:_OFFICER:SETBACKS: F:-LH:- RH:- B:Approval:_ City:_ DATE:_ FLOOD: __ _ BFE+2ft=AVNComment PERMIT FEE: $
\)ott -ilgo
Pxorue r:9'10-322-6739
*l.*** IS THIS A cHAirGE OF oCCupANcy usef flves fiiO *****
IFYes,\hatwa5thePrevious0ccupancyType?-whati5the[eUoccupancyType?-
Tr139-o-
BUILDING HEIGHT: '1 35.6' # OF UNITS:
TOTAL SO FT UNDER ROOF:# OF FLOORS:-
EXST LAND oTSTURB|NG pERMtT? n yES E NO
NEW IMPERVIOUS AREA:_SQ FT EX|ST|NG TMPERVTOUS AREA: SO FT
ffi
(NEW HANOVER COUNTY BUILDING PERMIT
APP L,CATIO N TY PE, RESIDENTIAT
PLEASE ANSWER ALT QUESTIONS APPLICABTE TO YOUR PROJECT
"Proied Responsibility''
Zot6-1134
{ofiice use)
APPLTcANT'S NAME . 'P L4 'a-'?- a .'<-Ee ) z-Zf -2.,4_ 1:? <- -
PROJECT ADDRESS: I7 I '2-2-z-
Date
ztP
SUBDIVISION:/ L_ j///€j z-4}z-2214./ 6 LOf H: 7- I
PROPERW OWNER'S NAME 4(4,a22'ct '2' eL/ / '-v'7-/'2e) / 1'z-<:PHONE H 7/a - -2.4? *<e I <z.e>
owNER'S ADDRESS:74 0 - eO )< '? (-+ z-nP:Z-6?z>z
Sz <-'<:CIT!: w 2 L4
911y, uz r e --1
CONTRAgTOR a.Q--z--7'aa-.L /-'1'C-BLDG LICENSE f -7 -7 7€/
*.,,l/z-ztp -z- 6 7 dz;ADDRES* r.o -' F o y -7 )'z-z-- ct"
EMAIL ADDRESS: -).- f t '-z *r" iGl,PHONE: v/z->-6?-- 6-7.?o
PHON E ?tC> ->2.<a(- o"7a
r4./ ,/ L--j<2
pRoJEcr C9NTACT p 2x5gN Z€E; 9 €(-4,-z----c>,--2..,
.,,.
EXISTING CONSTRUCTION: trAlteration E Renovation n General Repairs
NEW CONSTRUCTION: D Erect New Residence n Addition to Existing Residence ! Relocation
,I'}PLEASE CHECl( AND ANSWER BELOW AIL THAT APPLY TO YOUR PROJECT*'i*
! Att Garage (5F)E Det Gara8e (SF)_! Porch (SF)
! Storage Shed (SF)_I Sunroom (5F)_
! Greenhouse (5F)_
! Pool {SF)
D Deck (sF)I Other (SF).r-/ .2 4--V a> Z.z--
ls the proposed work changing the existing footprint? ! yes D No
TOTAI SQ FT UNDER ROOF Aot proposed work) Heated:Unheated:
TOTAI" PROJECT COST (Less Lot): S 2orJ,d)
ls the proposed work changing the number of bedrooms? A yes Wlo
ls any Electrical, Plumbing or Mechanical work being done to the Accessory Structure ! yes ! No
lf the project is a Relocation, is there a Natura]J;as line on the current site? ! yes n No
ls there Electrical Power on this Building? fyes fl No
Property Use/ Occupancy: d-single Famity tr Duplex ! Townhouse
t -,,/ 2zZ2 <-- 7Z*L 4.<:*..-r-.-..--, =-
Description of Work
DISCLAIMER: I hereby certify that aI the information in thas apptication i, correcr and alt work willcomply with the State BuildanB Code and allorher app,icabte State and locatlaws and ordinances end re8ulations. The NHC Oevetopment Services Center wiI b€ notafaed oI any chantes rn the approved plans and specifications or chang€ rn contracrorinformation. ...NorE, A,t: i!/S!2,9" leryywpppyayynirs wt| be in violation of the NC State Bldg Code and subject to fines up to SS0O.00,.,
Owner/Contractori E 44't''z'-''z- F lr't ''e''--A,Signature:
<..A=--"Licensed Quolilier"
lsthepropertylocatedinafloodplain? ! yes ! No
Existing lmpervious Area: _ Sq Ft Total Acres Disturbed
New lmpe.vious Area Sq Ft Existing l"and DisturbinS permit: ! yes ! No
WATERT D CFPUA ! Community System E private Well U Central Well D Aqua
SEWER: ! CFPUA D Communjty System n privateseptic!CentralsepticEAqua
Zone: _ Officer:
--- Setbacks (F) _ (tH)
--
(RH) -- (B) _
Approvali _ City: _ Date:
--
Flood: (A) _ (V) _ (N) _ BFE+2ft=Comment:
sPermit Fee