LAND USE Initial Application Date: CL2 11 — / p Application #= /II-7 z ' Z4 4 / 4J
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. Front Street, NC 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.harnett.orgfpermits
LANDOWNER: MPS'+ $ K L t eII, H T Mailing Address: 34 4JPnri IfIP / n
City: 01VA9 .r State: N.1 c.... Zip n5O _Horne #: -5V -137/ Contact #: 9jQ-319-62-W
APPLICANT*: Mailing Address:
City: State: Zip: Home #: • Contact #:
'Please fill out applicant information if different than landowner A �},,
a CONTACT NAME APPLYING IN OFFICE: 6e_f1 / Phone # /� I! "S99 I37
PROPERTY LOCATION: Subdivision: I+L e rS P(HI l+ Lot #: 19 `l Lot Size: ' r, I I i ,, �1 �j
State Road #: 15 (B5 State Road Name: S t f l4 o Map Book &Page:gOV(V / '/ °( D
Parcel: 07 (;l0q I bOa3 18 PIN: tt-f 9 1 — SS"— Lot 9.00
Zoning:l (� t Tl b Flood Zone: x Watershed: NA Deed Book &P ! a 3 / 10 Power Company: - G
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 1 A. C) "I0 ( /rnTJ Ie-P4 OV)
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PROPOSED USE: (Include Bonus room as a bedroom if it has a closet) Circle:
❑ SFD (Size x ) # Bedrooms_ # Baths_ Basement (w /wo bath) Garage Deck Crawl Space / Slab
❑ Mod (Size x ) # Bedrooms # Baths Basement (w /wo bath) Garage Site Built Deck ON Frame / OFF
❑ Manufactured Home: SW DW TW (Size x ) # Bedrooms Garage (site built? ) Deck (site built? )
❑ Duplex (Size x ) No. Buildings No. Bedrooms /Unit
❑ Horne Occupation # Rooms _ Use - Hours of Operation: #Employees
X Addit on/Accessory/Other (SizL,1 x 3L) Us i l / �/19 p / ..- Closets in addition(jyes (_)no
Water Supply: (County ( ) Well (No. dwellings ) MUST have operable water before final _
Sewage Supply: (J New Septic Tank (Complete New Tank Checklist) (,p Existing Septic Tank (__) County Sewer II //'�
Property owner of this tract of land own land that contains a manufactured home w /in five hundred feet (500') of tract listed above? OYES
Structures (existing or proposed): Single family dwellings I/ Manufactured Homes Other (specify) 5lrh n PGk
Comments:
Required Residential Properly Line Setbacks: OW 'rk (tune! pnrA C _`A'_ A 1 A rp, ,,,/ ,, (l r' /L,
Front Minimum 35 Actual .'J .) ^ _M,.\c f� -4" 1F\ l f S S \ 1 SI /71[Jf CS
Rear . 5 W , � 9 'C Sn
k QX)f `J1zsL pl
Closest Side }l_r) P-l 014 a'Z2 Z ' jl
Sidestreet/corner lot P, f a * D (.) a as \ (.R oo& / f't.k Adcb
Nearest Building V! t t Z 7ti:.
on same lot 1CV,k -o Pa . t - ta /097,0
If permits are granted I agree to conform to all ordinances and laws of the S to 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.
Signature of 0 r or Owner'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
Please use Blue or Black Ink ONLY
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