LAND USE - Initial Applicatbn Date: — / _ it Application # ir ro `. 3 tin
DRB# CU#
COMMERCIAL
COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting 1088 Q E. Front Street, Lillington, NC 27548 Phone: (910) 893 -7525 Fax: (910) 893 -27993 www.hamett.org /permits
LANDOWNER: S A' P e eef , e% A r Mailing Address: / 11 (1 11 U(.0 ""Lt' 1 4 v/1
City: rl /4.,c - . <- L J State: / w Zip: 2- Contact # ! ia- 14( ^I�fI Email: 7.j..kker 0 es-- 4, w'^^^ 1. c
APPLICANT': 6 ( l am- L ("t ,W I , Mailing Address: ''F'� /f / 91 c".. j i t. 0 n /`
1 City: J 2 1't-Y / State: k!` Zip: 2'7 1 Contact # � ` I fi / �t r Email: 1 L 4 ' t € '� / • t..,,„___ 'Please fill out a pitcant Information if different than landowner //
CONTACT NAME APPLYING IN OFFICE: / � 14.kc J e'G I phone # 0 [7 3(,..i 1,S-5-- PROPERTY LOCATION: Subdivision: /44.-W O � e' lY%t�t0 f c^-✓i Lot #: - 1 Lot Size:
State Road # / State Road Name: I ? ' i' t L LI"ne_ 74 Map Bo &Page02 / 0113
/� Y /
Parcel: 93 / ( 03 7` / C .7) PIN: _ 7 74 — 77, / 7 COC
Zoning' Flood Zone: _k Watershed: /1 /7/4 /[ / / 7 Deed Book&Page: �Y, p / 3, Power Company':
New structures with Progress Energy as service provider need to supply premise number f fro om m � Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: J c(se 1 11 w -ft I j•� (O " "' e g
ce-
1 k4 . t1 4D AKi.,. .n.1io I., , -41-“ v":11.--4. . L./4- 1 i 5 0-'. ,-, .
PROPOSED USE:
❑ Multi - Family Dwelling No. Units: No. Bedrooms/Unit:
O Business Sq. Ft. Retail Space: Type: # Employees: Hours of Operation:
❑ Daycare # Preschoolers: # Afterschoolers: # Employees: Hours of Operation:
❑ Industry Sq. Ft: Type: # Employees: Hours of Operation:
❑ urch Seating Capacity: I.` # Bathrooms: ,y Kitchen:
Accessory/Additi /Other(Size 40 x S0) Use: A ethx., - - -x.-- 1
Water Supply: L County _ Existing Well _ New Well (# of dwellings using well ) 'MUST have op rable water before final
Sewage Supply: New Septic Tank (Complete Checklist) _ Existing Septic Tank (Complete Checklist) unty Sewer
Comments:
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.
1 hereby state that foregoing statements are accurate and correct to the best of my knowledge. Permit subject to revocation if false information Is provided.
a Ai 4- f ee—r— /0
Signature of Owner or Owner's Agent Date
"This application expires 6 months from the Initial date If permits have not been Issued"
A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE)) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION.
Commercial Land Use Application Page 1 of 1 33110