DOCUMENTS Initial Application Date: q - q D I L4 Application# J(..4 1. 0o3 (-t! I
DRB Cu
COMMERCIAL
COUNTY OF HARNETT 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: 2'P ofif t LLG- Mailing Address: F Iicoc )\l¢V
City: FU )qti -Vaa,iA State: t Zip: 2752to Home#: Contact#:
APPLICANT':G)Loo.vOoiS V 2e--r Eat:i- e, LLc, Mailing Address: 39+70 2t0
City:V-ALWt 1-t State: AC-- Zip: 2-7( O Office#: /(91- 145'9- 244/ Contact#: 9/9- '159- 260)
'Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE: Phone#:
PROPERTY LOCATION: Subdivision: Lot#: Lot Size:
State Road#:1-)C 14tM LIZ. State Road Name: Map Book&Page: 2007 1 027 3
Parcel: b5-bl,35 r>t5 PIN: CXs3s-$9-1887
Zoning: I t-VC. Flood Zone: • Watershed:LP__Deed Book&Page: 01'IYL / OWS Power Company':
New structures with Progress Energy as service provider need to supply premise number` from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: ILEAD l•4Oti 14 c)..1 .1+1.11,144-1*. M.19 -rL ) L&-f- 04 }y'SCkblAtE`f
Prif is W A`(. TAKE 246 LsFT ol.ITo us lio l TtxrA th-Fr•nr3 cuutsrTw rS t.i.n 'RofiP. To LGPr O1 OAVIZ4v4E
tus)CA 'Ropy. Tutz,J Left o4 1C-42 1a65t. Phopa -r iS A-t 711E I4 oil of $.14.-LIZ.,A41 liZbdfzESS UR.
PROPOSED USE:
! 0 Multi-Family Dwelling No. Units No.Bedrooms/Unit
Business Sq.Ft.Retail Space 110f,U Type R.EGow #Employees: Hours of Operation: _
❑ Daycare #Preschoolers #Afterschoolers #Employees Hours of Operation
❑ Industry Sq.Ft. Type #Employees: Hours of Operation:
❑ Church Seating Capacity #Bathrooms Kitchen
❑ Accessory/Addition/Other(Size x )Use
Water Supply: ($) County (_J Well (No.dwellings ) MUST have operable water before final
Sewage Supply: ( )New Septic Tank(Complete Checklist) (i Existing Septic Tank(Complete Checklist) (X)County Sewer
Comments: C� �i1�e� V -��YT�„t -
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.
I hereby state that foregoing stateme—are ac urate and correct to the best of my knowledge. Perm' subje t to revocation if false information is provided.
' iS' 1
OE er s Agent KPoNE�LtG Date
Signature of Ow r •caner s Agent
"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
LAND USE 5/08