Revised 4/16/2020 2
Inspections/Permitting: (910) 947-2221
Planning: (910) 947-5010
Transportation: (910) 947-3389
Fax: (910) 947-1303
County of Moore
Planning and Transportation
ATF Day Care Group/Therapeutic Home Bulkhead/Dock Sign(s)
ABC Demolition Swimming Pool Other: _____________________
Application Date:
Description of Proposed Work: __________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
Applicant: Phone:
Owner: Phone:
Owner Address: Zip: St: City
Location/Address of Property:
General Contractor: License: Phone:
Address: City St Zip
Electrical Contractor: License: Phone:
Address: City St Zip
Design Professional: License: Phone:
Address: City St Zip
Pool Contractor: License: Phone:
Address: City St Zip
I hereby certify that all information in this application is correct and all work will comply with the State Building Code and all other
applicable State and local laws, ordinances and regulations. The Inspection Department will be notied of any changes in the
approval plans and specications for the project permied herein. I understand if this application is incomplete, no inspections will
be performed on the project.
Owner/Agent Signature: _____________________________________________________________ Date: ___________________________
Miscellaneous Permit Application
If the project is a bulkhead or dock please list the estimated cost of the project Total Estimated Cost $
Please list the names of the contractors who will be performing the work for this project. If the work will be performed by the owner
just write owner or self in the name eld. Please put N/A in any elds that are not applicable to the project.
Type of Permit:
click to sign
signature
click to edit
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