LAND USE SCANNED _
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Initial-Application Date: Z I 1 1 R '061 DATE Application #
CU#
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 /permits
LANDOWNER: I V; IIA , e_ 67,...„.k. aJ W �"� Mailing Address: PO box 29 71
City: /t1�.IL.�G C/ State: /`"L
ate: _ Zip: 2 8/0(0 Home #: Contact St 7o Y s
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APPLICANT*: /A., . J % M e.-C, b , s,i t•V c ✓`('� Mailing Address: a9 0 • �e Jr' 24 71.
City: /1T
.. v S State: FL Zip: Zk) Home #: 70 2 81 3 -759 Contact #: 9 RD - 7 2- 7 -
'Please fill out applicant information it different than landowner I
CONTACT NAME APPLYING IN OFFICE: JAA44. -s 0 J rA/a V i-A- - Phone #: ti AO —7 2 2- 5 2-73
PROPERTY LOCATION: Subdivision w /phase or section: C <•ra /I ee_ jw X^P. 4 i 10 /AL Y Lot #: 32 Lot Acreage: / Q
State Road #: State Road Name: Map Book &Page: Z / /J 7
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Parcel: d /7 /�a 7 7 PIN: 957 7 7 12/ (9C5
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Zoning: � Z✓ Flood Zone: 1 Watershed: ,V , l Deed Book &Page: 2y `/ 8 1 / 7 Power Company':
'New homes with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS a / ONS TO THE PROPERTY FROM LILLINGTON: 9.! ivi A -h, v I ""L' /....k- es
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USE:
SFD (S x S p SFD (Size S$ z_s 1) # Bedrooms y # Baths 2 k. Basement (w /wo bath) Garage 2- Deck C
Crawl Space / Slab
(Is the bonus room finished? Y.44 w/ a closet if so add in with #bedrooms)
❑ Mod (Size x ) # Bedrooms # Baths Basement (w/wo bath) Garage Site Built Deck ON Frame / OFF
(Is the second floor finished? Any other site built additions? )
❑ Manufactured Home: SW _ DW TW (Size x ) # Bedrooms Garage (site built? ) Deck (site built? )
❑ Duplex (Size x ) No. Buildings No. Bedrooms /Unit
❑ Home Occupation # Rooms Use Hours of Operation: #Employees
❑ Addition /Accessory/Other (Size x ) Use Closets in addition(_)yes (_)no
Water Supply: (/) County (J Well (No. dwellings ) MUST have operable water before final
Sewage Supply: (J New Septic Tank (Complete Checklist) (J Existing Septic Tank (Complete Checklist) ( 'County Sewer
Property owner of this tract of land own land that contains a manufactured home w /in five hundred feet (500') of tract listed above? (_)YES ONO
Structures (existing & proposed): Stick Built/Modular i' Manufactured Homes Other (specify)
Required Residential Property Line Setbaclw: Comments:
i// S o f '
Front Minimum - 7 Actual
Rear 2 J' 1
Closest Side i 6 11. L)
Sidestreet/corner lot
Nearest Building .
on same lot
If permits are granted I agree to connf' to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state ih .1 forego, - :te and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
��. .� " apw! `2179 lot
Sign - • Owner or Owner's Agent Date
"Tills 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
LAND USE 5108