UDO Administrative Manual - Currituck County Government

Contractor of RecordContractor of RecordMH Set-up Contractor Name NC License #AddressPhoneCity/StContact NameMoving Contractor Name NC License #AddressPhoneCity/StContact NameBuilding Contractor Name NC License #AddressPhoneCity/StContact NameElectrical Contractor Name NC License #AddressPhoneCity/StContact NameMechanical Contractor Name NC License #AddressPhoneCity/StContact NamePlumbing Contractor Name NC License #AddressPhoneCity/StContact NameGas Contractor Name NC License #AddressPhoneCity/StContact NameOther Contractor Name NC License #AddressPhoneCity/StContact NameOWNER CONTRACTORAs owner of the property, I intend to retain the finished project exclusively for my own use and will occupy theproperty for at least one year following the completion of construction. I understand that it is my responsibility toobtain workers’ compensation insurance, if necessary. I will contract with a North Carolina licensed electrical,plumbing, mechanical, and gas contractor for this project unless otherwise noted. As owner of the property, I willcomplete the following:□ Set-up □ General/Building □ Electrical □ Mechanical □ Plumbing □ GasSignature of Property OwnerDateAdministrative ManualPage 2.27Manufactured Home Building Permit ApplicationPage 3 of 7