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APPLICATION/PERMIT FOR CONSTRUCTION UFi U I 'ILK Wursn •
<br /> • PARCEL 1.D NUMBER 'MAP JURIS. ZONING LAND USE FLOOD MAP WATERSHED CENSUS PERMIT
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<br /> pRopiATy DESCRIPTION /� WATER SEWER - PATE
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<br /> PROPERTY ADDRESS LAND AREA S.F-CERT• CERT• TYPE
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<br /> PROPERTY OWNER NAME/ADDRESS
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<br /> PE IT HOLDER(IF NOT OWNER)/ADDRESS - RHONE
<br /> LICENSE GENERAL CONTRACTOR ADDRESS
<br /> LICENSE• ELE Z RICAL TRACTOR ADDRESS
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<br /> L ICENSE PLUMBIN CONTRACTOR ADDRESS
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<br /> LICENSE• MECHANICAL CONTRACTOR —ADDRESS •
<br /> LICENSE• 'INSLT CONTRACTOR ADDRESS
<br /> LICENSE• 'GRADING CONTRACTOR ADDRESS
<br /> L ICENSE• OTHER(SPECIFY) ADDRESS 7'
<br /> •- - - '
<br /> • - CONSTRUCTION INFORMATION L V i\
<br /> CLASS AREA S-F. HT. TYPE ROOM BATH PLBG. ELEC. HEAT A/C - INSUL. CONST.COST L - FEE
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<br /> P F C SC V'" '/PC '1 1' /D
<br /> • The undersigned does hereby declare that the information given above is correct and agrees to comply with all state and local laws,local RECEI• • TO LL
<br /> ordinances and regulations.the N.C.State Building Code.and any restrictions as shown peiow.The applicant I urthermore declares that / Cf il��
<br /> he/she is the property Owner or he/she .oes truly represent the property•wner_ a - QQ�`
<br /> APPLICANT'S SIGNATURE �' ��- - DATE _ .2/ V
<br /> APPROVAL BY 1 1-LL_ _ ,r_....L :...r ,.,___.• / DATE - =2—/ — ?(°
<br /> RESTRICTIONS. •
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<br /> ,�,_• : INSPECTIONS HiCORD - .
<br /> - 1 I I I
<br /> TYPE - DATE INSP. ACTION FEE RECEIPT IECEIPT
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<br /> 0 • - • C,CERTIFICATE OF OC
<br /> • DATE OF APPROVAL
<br /> This is to certify that the building or work described
<br /> • • above has been inspected and approved as noted.All
<br /> phases of construction/work have been completed as BUILDING IN$PEGTOR
<br /> of this date, and the building/site is ready for
<br /> occupancy.
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<br /> OFFICE COPY,
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