LAND USE R `j - Z 3 - !d SCANNED D
•
•
•
/1 4 a4 -1 / S �30�/(
/ Initial Application Date `� DATE Application # S
DRB CU
COMMERCIAL
COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting X1 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.harnett.org/permits
R
LANDOWNER: , 5 co It pi; ckr= 1 Mailing Address: 1 O. Sox 57 5
City: 4ran5P.JO state:ic..zip: 21176 Home #:(20) Sib / /5lo Contact #: (51'03) 7e7- 9S
APPLICANT': /Q . Sc-o Ni r%kc 1 Mailing Address: P 0 , B. 575
City: O rtanc rlowck State:S C, zip: 291/6 Office #:(S03) S3[. -- /I Sicontact #: (803) 707 7556
*Please fill out appttcant informition it different than landowner
CONTACT NAME APPLYING IN OFFICE: 1 n b nn y slen n 7 � Phone f 0/0 / 1 g`72 - 5157
PROPERTY LOCATION: Subdivision: N / Lot n Lot #: .1 eq. Lot Size: --- 6 G ' 0€2 State Road #: I 7 556 State Road Name: g. a! tie y R oa ci Map Book &Page: (TS,S
Parcel: 0 x- /5N1 - oo*b -0 } OA-/$ / - oo e2 PIN: / Slit - 17- 6113.euo, I Sal - /h.- S70o.ace
Zoning: Ccbks[Yl=1a ( Flood Zone: l 14 Watershed: /4/14 Deed Book &Page: 9i67 ' feg. - Wviird ipei{i•: Reci -Lrw'i Enr►'y'7
New structures with Progress Energy as service provider need to supply y
premise number .4.101 from Progress - ri Energy. i 1. . '
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: ! p ro c ee d Fr c.r i 0 5 7 m /
a / o
,...f c-nn n No. Hwy -if .2- I . Pea cee. to soitii an J+f rskle 95
..- rr vcx i An+ S r 'q. 9 mi. les ro in fors ectlen 4.441 Ne.SR /k /1 . Proc.
J i eaS f" nn \ 5R /fill Orr (.4 rcx:n... 7�oo , // a 'ley- in�'er i s l e- d-r'on „, i ti., S/? /'7
(KrAiney Ann r i) a gocec cl OA � I I 0 6 Urea; ey RaR) �pv7 L /000 .4 sift .
PROPOSED USE:
/ \ \\ / s.S
❑ Multi- Family Dwelling No. Units No. Bedrooms/Unit
❑ Business Sq. FL Retail Space Type # Employees: Hours of Operation:
❑ Daycare # Preschoolers # Afterschoolers # Employees Hours of Operation
❑ Industry Sq. Ft. Type # Employees: Hours of Operation:
❑ Church Seating Capacity # Bathrooms Kitchen
1
ill n k Accessory/Addition /Other (Size x ) Use / City 4 1 .. Murk vi pis sizta a yo r e
Water Supply: (J County (__ j Well (No. dwellings ) MUST have operable water before final tinST
Sewage Supply: (J New Septic Tank (Complete Checklist) (J Existing Septic Tank (Complete Checklist) ( )County Sewer �j/‘
Comments: 5i fe does not /love doµte /-lc. wcrf-er Se -rvice
S; 4 £e f c Any i eyvlc u )
7— 23 —w ` / � v 2 we r 4 �A,' � Per e
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 statements are accurate and correct to the best of my knowledge. Permit subject to revocation if false information Is provided.
„--- 2. 5 can/VfcksD 4/. 7//0
$tgneture of Miiinei.oi Owners ADDS DeteS
"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