LAND USE RInitial Application Date: 16) Application # LJ ` I
~-L r COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893-7525 Fax: (910) 893-2793
iVL'R~ Mailing Address:
City: C)- r\t State: 14c-- Zip: 2 9 33s Home RI o •-SL7 - 4 (Pg 4 Contact G a -23 7 - 1 9s 3
APPLICANT': JTLLVJ C-L L F-D4"P S Mailing Address: =5 i4
City: State: Zip: Home Contact
'Please fill out applicant information if different than landowner
PROPERTY LOCATION: State Road I 14 State Road Name: I- E"A u G L 3 I-A•c. K C
Parcel: d
OJ a DI &C, S bU
PIN: /O
Zoning: IQA -2 o 2
~a ' E ~S S- 7
Subdivision:
Lot
Lot Size: Z
Flood Plain: X
Panel: .7 Watershed:
Deed Book/Page:
Plat Book/Page:
/
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f
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
14,4 \l 2 / o VJ 4
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1+ 1
PROPOSED USE: /jx
Circle:
X
SFD (Size x (Q o ) # Bedrooms 3
# Baths;?- /Z Basement (w/wo bath) N C
Garage !g S Deck
14 rawi ~ /Slab
❑
Modular: _On frame ,Off frame (Size
-X-) # Bedrooms # Baths
Garage (site built?
Deck (site built?`)
❑ Multi-Family Dwelling No. Units
No. Bedrooms/Unit
❑ Manufactured Home: _SW _DW -TW (Size x ) # Bedrooms Garage (site built?`) Deck (site built?_)
❑ Business Sq. Ft. Retail Space Type # Employees: Hours of Operation:
❑ Industry Sq. Ft.
❑ Church Seating Capacity
Type # Employees: Hours of Operation:
# Bathrooms Kitchen
❑ Home Occupation (Size x___) # Rooms Use Hours of Operation:
❑ Accessory/Other (Size x_) Use
❑ Addition to Existing Building (Size x ) Use Closets in addition(_)yes (ono
Water Supply: a) County Well (No. dwellings Other
Sewage Supply: 4) New Septc Tank (Need to fill out New Tank Checklist) Existing Septic Tank County Sewer L) Other
Property owner of this tract of land own land that contains a manufacture horse wn five hundred feet (500') of tract listed above? (_)YES ()NO
Structures on this tract of land: Single family dwellings 4~~ ufaJctu, rd Homes Other (specify)
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual Ah Gk &J - CA k ' 1012 '
Rear _25_ 1 Q , C' -x.`. SAO IGaJt. C1
Side 1_
Corner/Sidestreet 20 c LS- `-EA-7
Nearest Building 10
on same lot
if permits are granted I agree to conform to all ordinances and the laws of the State of North Carolina regulating such work and the specifications of plans
submitted. I hereby state that the foregoing statements are accurate and correct to the best of my knowledge. This permit is subject to revocation if false
information is provided on this form.
D Z d f y 5
a
Signature r o 7ner's Agent 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
www.hamett.org
Please use Blue or Black Ink ONLY
8/06
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NO STRUCTURES OF ANY KIND SHALL BE
PLACED IN SEW 0. EASEMENTS,NOR SHALL THEIR
BE ANY GRAD
JW E EP 'iC SYSTEM .
SITE PLAN
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