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ORANGE COUNTY. N.C. ATTACHMENT 2 <br /> APPLICATION/PERMIT FOR CONSTRUCTION OR OTHER WORK 6 <br /> ?ARCE_ ' NOMEER MA. ,UR S <br /> ZONING i LAND USE WATERSHED CENSUS "ac <br /> RMIT a <br /> PROPER"!DESCRIPTION 1 <br /> WATER SEWER DATE <br /> PROPERTY ADDRESS I <br /> LAND AREA EH PERMIT a EH PERMIT;r TYPE <br /> i PROPERTY OWNER NAME/ADDRESS <br /> PHONE <br /> PERMIT HOLDER(IF NOT OWNER)/ADDRESS it <br /> PHONE <br /> LICENSE# GENERAL CONTRACTOR ADDRESS - ! <br /> LICENSE M ELECTRICAL CONTRACTOR ADDRESS <br /> LICENSE PLUMBING CONTRACTOR ADDRESS <br /> UCENSE# MECHANICAL CONTRACTOR ADDRESS <br /> UCENSE k MH SETUP CONTRACTOR ADDRESS <br /> UCENSE B OTHER(SPECIFY) ADDRESS <br /> CLASS AREA S.F. HT. TYPE ROOM BDRM BATH PUSS. ELEC. ---� HEAT A/C INSUL. DECK~ FIREPL CONST,COST <br /> FLOOD MAP FLOOD ZONE BASE FLD ELEV(FT) 1ST HAS FLR ELEV(FT) BASEMENT STORIES IMPERV SURF S.F. 1/2 MI AGR DIST <br /> SCHOOL DISTRICT IMPACT FEE <br /> The undersigned does hereby declare that the information given above is correct and agrees to comply with <br /> ordinances and regulations,the N.C.State Building Code,and any restrictions as shown below. The applicant furthermore declares that he/she <br /> RECEIPT k TOTAL FEE <br /> is the property owner or he/she does truly represent the property owner. <br /> APPLICANT'S SIGNATURE <br /> DATE <br /> APPROVAL BY <br /> RESTRICTIONS DATE <br /> K <br /> —•_=•-�° ° 114---. .. -_-7.,-;z,-,-.±7,47,, ,_:„._,-„_:::,,- <br /> TYPE RED DATE INSP.DATE ACTION TYPE RED.DATE INSP,DATE ACTION"i. a L-'_ ITS --t .- -.' <br /> I. <br /> � r <br /> - - - -- - .� _ .�-.,Z- ,_- � ,,2.,E,12,2_..,-,-4,-.:-...:°, <br /> IIIIIIIIIIIIIIIIIIIIIII <br /> r _ <br /> ; ,,--,;-::?5"--7.- <br /> �,5^ ,.-yes ••_ -' s. ._--- _ _ <br /> - +ru .°";c . _ . fir.. �P'.'?st+- - 4 'e'': ���--.• ��'�deg"�"�t 714.!,.47.----`-. <br /> _- •� _ _ ;v— ;.,,..T_"T -:`,i•L Y',a. :: e'+..ee�..► .. .eT . `* ' 7 <br /> DATE OF APPROVAL 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 conpleted as of this date,and the BUILDING INSPECTOR <br /> building/site is ready for occupancy. ELECTRICAL INSPECTOR <br /> APPLICANT'S COPY <br />