LAND USEInitial Application Date:_//Zb 09 Application If 01 ~ Z!5 ✓l
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893-7525 Fax: (910) 893-2793 www.harnett.org
LANDOWNER: BILL C&A ILK Ae tES or AY&ZEvv"ailing Address: 4/00 L✓BSrwPOA X~ 6"MIL fw.rlC 7-10
City: -~e{ 9,vi /le State: NG Zip: 28344 Home 910 -4210 -1998 Contact 4 %0.263 -9 0Zlo (n
APPLICANT': ti1'4 ( Mailing Address:
City: State: Zip: Home Contact
'Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE: T. T. aaa.NNO'"a Phone 9/0-2463-90Z&
PROPERTY LOCATION: Subdivision: PAqrer.+rs ?v,../r Lot /OZ Lot Size: 0.3y7 acrc-
State Road H J 2 State Road Name: n /fl"' Map Book&Page: oOS/ 547
Parcel: 039 547 0039 9/o PIN: 9547-10 -9016, Doe
Zoning: /Z4-204 Flood Zone: NO Watershed: & LA Dead Book&Page: 2177 _?SB.q
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
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PROPOSED USE: (Include Bonus room as a bedroom R It has a closet) Circle:
SFD (Size` x 35 t # Bedrooms 3 If Baths Z Basement (w/wo bath) Garage 2 CA.R Deck .vo Crawl Space Slab
❑ Mod (Size_x-_) # Bedrooms- # Baths` Basement (w/wo bath) Garage Site Built Deck ON Frame / OFF
❑ Manufactured Home: _SW DW _TW (Slze_x_J If Bedrooms Garage_(Site buik?---) Deck_(site built?__j
❑ Duplex No. Buildings No. Bedrooms/Unit
❑ Home Occupation # Rooms Use_
❑ AdditiorVAccessory/Other (Size_x____j Use
Water Supply: L/-) County L-) Well (No. dwellings
of Operation: Employees
in additlon(jyes (ono
MUST have operable water before final
Sewage Supply: ( New Septic Tank (Complete New Tank Checkf/so (J Existing Septic Tank L_) County Sewer
Property owner of this tract of land own land that contains a manufactured home Win five hundred feet (500') of tract listed above? OYES (_&NO
Structures (existing or proposed): Single family dwellings Manufactured Homes Other (specify)
Required Residential Property Line Setbacks:
Front Minimum 35' Actual 1/6_
Rear 25 /
Closest Side /0
Sidestreet/corner lot- &
Nearest Building
on same lot
If permits are granted I agree to conform to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing statements are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
6?6-_ 9 &--Z
Signature of Owner or Owners Agent
~z6 0'9
Date
"This application expires 6 months from the Initial date If no permits have been Issued"
A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION
Please use Blue or Black Ink ONLY
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