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ORANGE COUNTY. N.C. ATTACHMENT 2 <br /> APPLICATION/PERMIT FOR CONSTRUCTION OR OTHER WORK 6 <br /> PARCEL : NuMSEA MAP ,,UR,S <br /> ZONING !LAND LSE WATERSHED. CENSUS ec <br /> RMlT v <br /> PROPER"!DESCRIPTION I 1 <br /> WATER SEWER DATE , <br /> I <br /> PROPERTY ADDRESS <br /> LAND AREA EH PERMIT w EH PERMIT <br /> 1 TYPE <br /> I PROPERTY OWNER NAME/ADDRESS 1 <br /> PHONE <br /> PERMIT HOLDER(IF NOT OWNER)/ADDRESS <br /> PHONE <br /> 1 LICENSER I GENERAL CONTRACTOR ADDRESS <br /> I <br /> LICENSE M ELECTRICAL CONTRACTOR <br /> ADDRESS I <br /> LICENSER 1 PLUMBING CONTRACTOR <br /> ADDRESS <br /> UCENSE R MECHANICAL CONTRACTOR ADDRESS <br /> UCENSE R MH SETUP CONTRACTOR ADDRESS <br /> UCENSE R OTHER(SPECIFY) ADDRESS <br /> _ -- <br /> CLASS AREA S.F. HT. TYPE ROOM BORM BATH PLBG. ELEC. HEAT A/C INSUL. DECK FIREPL CONST,COST <br /> FLOOD MAP FLOOD ZONE BASE FLD ELEV (FT) 1ST HAB FLR ELEV (FT) BASEMENT STORIES IMPERV SURF S.F. 1/2 MI AGR DIST <br /> I I I I SCHOOL DISTRICT IMPACT FEE <br /> The undersigned does hereby declare that the information given above is correct and agrees to comply with RECEIPT <br /> ordinances and regulations,the N.C.State Building Code,and any restrictions as shown below. The applicant furthermore declares that he/she <br /> » TOTAL FEE <br /> is the property owner or he/she does truly represent the property owner. <br /> i <br /> APPLICANT'S SIGNATURE <br /> DATE <br /> APPROVAL BY <br /> RESTRICTIONS DATE <br /> 1 <br /> ti.�•t='_ +-: w^ w:th*' Npa <br /> TYPE REO DATE INSP.DATE ���--~ �'+ ��..S��`:...:� . ..- <br /> �. ACTION TYPE REO DATE INSP.DATE ACTION <br /> - -. 1-1""--.1:-.77:t":,---:: - - _ <br /> Rt F� <br /> � F <br /> MI .v <br /> t .- '- --•_.-- T <br /> kF �*-F• <br /> �- ter--- � .+� � _ <br /> •- <br /> .. a - �„ _ <br /> .. .DATE OF APPROVAL - ._., ,.__ _,e,.> ..,. _:. F;.1-_..�..:_-. ., __. <br /> PLUMBING/MECHANICAL INSPECTOR <br /> This is to certify that the building or work described above has <br /> been inspected and approved as noted. All phases of <br /> construction/work have been completed as of this date,and the BUILDING INSPECTOR <br /> building/site is ready for occupancy. <br /> ELECTRICAL INSPECTOR <br /> APPLICANT'S COPY <br />