LAND USE Initial Application Date: • (,..-7 - A pplication # �� 2 I , �7
DRB # CU # 99 - 8
COMMERCIAL
COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting 108 E. Front Street, �( LiIIiin ng gton, NC 27546 Phone: (910) 893-7525 Fax: (910) 893 -2793 www.hamett.org /permits
LANDOWNER: / 1 (Jh i 0, BCC s --c 9 Mailing Address: 4 ,C? j . -'I /7 N/
City: F e Y'C C . 7 / 1/7 State: 4G' /Zip: 2 ' D / /Contact # / Email:
APPLICANT*: \ Y'1 �7 rA \"\ '-e Mailing Address: ( //C
City: !A YC Stater,/ '/ Zip: 4f � Contact # ii/-[ Email: y�
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*Please fill out applicant Information if different than landowner ( \�� / 7`�'
CONTACT NAME APPLYING IN OFFICE: �\ V'r\ i' 2 i` \k 6- Phone # V /
PROPERTY LOCATION: Subdivision: • of / Lo • /5 Lot Size: ,Q / `
State Road # n / State Road Name: I L'.L / / i : p B B ook & �f/!7/ 7// —q
Parcel: 0/ i/ Y L J 1? (2,49 g 2 PIN: g 2G — 70 _ h ,7G S U-i
Zoning: (444i Flood Zone: �[ Watershed: [1 /ADeed Book&Page: 74,1 !' Z Power Company *: G
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROP RTY ROM LILLINGTON: s O J ■ 4 r d ` 1 ,
_t •IA # : . Du (-) CI 11 ' ` ter - - t- 1In
. a r kom o-)
PROPOSED USE:
❑ Multi- Family Dwelling No. Units: Np. Bedrooms /Unit:, -
❑ Business Sq. Ft. Retail Space: Type # Employees: Hours of Operation:
❑ Daycare # Preschoolers: # Afterschoolers: f # Employees: Hours of Operation:
❑ Industry Sq. Fl: Type: # Employees: Hours of Operation:
o Church Seating Capazly: # Bathrq / o h ms: it
/ J ` 1 - 1 \ ' / Accessory/Addition /Other (Size Use: bo 4 4 Si�4A/! to 5,94,45_ f J 1�9 // S / - q / 1 4
Water Supply: my Existing Well _ New Well j91 o dwellings using well ) 'MUST have operable water before final
Sewage Supply: New Septic Tank (Complete Checklist) _ Existing Septic Tank (Complete Checklist) _ County Sewer
Comments:
I//14// s;in5
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 foreg oirments are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided. n
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 ?MEN APPLYING FOR LAND USE APPLICATION
Commercial Land Use Application Page 1 of 1 03110
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