FMFW Initia Dale: r ` -_ ✓ �(/ - Application # 10 Z. Z /,2
K COMMERCIAL RB CU
COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting nn 108 E. Front Street, Lillingtonn, NC 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.hamett.org/permits
LANDOWNER: ANK-0 S Eat) elK6 it Rie-71 t( Mailing Address: 135 U HS S ftL-3n/t traiE S. bit.
City: G Pazn A try LA [e e State: rJI L. Zip: 2,X3917 Home #: SLo - 1d N-t& Contact #: r'l l 'l - 3 6 9- - n 4 t0
APPLICANT: NNOCNS / eAl• l ILCSL Pelebbart33, Mailing Address: 0.5 or-1 ;t PearAI[ thist (St.
City: Sf(l..ktt1 LA K-E State: tut Zip: 26 3gn Office #: qt0- if 19'2b11 Contact #: gt9 - 3 69 - Z7.`lo
'Please fill out applicant information it different than landowner A '' II
CONTACT NAME APPLYING IN OFFICE:_ 13 e l- M. i 1f'.nf I`C I s- Phone #(9iD) 8 /.4 2.
PROPERTY LOCATION: Subdivision: AnrpF'+LSO AZ CQrc,t Cl. a t . Lot #: Lot Size: Z • 22 a °n s
State Road #: 1%lrI State Road Name: 4i1 Zit , Map Book &Page: ?OM f 1.-/D
=amol% OtO *Is 0 too OJ 0 .9 - 3 61 71 NO 2 4 PIA 6505 VI 8 .Ot
?onIng: t4 74; R Z Flood Zone: X Watershed: P 42 Deed Book &Page: 1346 / 4 i�
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: L% rf N MArrg itr ON 27 CeJ ES r
LPr ON kla- It' eel . 60 V Mr lif aeu Re i 24 . 1 .fro
4 1 1>r - ss (2ECK- r %% re H(va /v en ;. ON PT 6 ,t r Pia I. .
'ROPOSED USE:
i Multi - Family Dwelling No. Units No. Bedrooms/Unit
i Business Sq. Fi. Retail Space Type # Emplox ees: Hours of Operation:
T Daycare # Preschoolers • 62 a Afterschoolers„ ZS # Employees lit Hours of Operation 5 : SMYI - 6 =os r r q ,
J Industry Sq. Ft. Typo # Employees: Hours of Operation:
J Church Seating Capacity # Bathrooms __Kitchen
] Accessory/Addition/Other (Size _x_) Use
Nater Supply: ( o<CCrity ( ) Well (No. dwellings ) MUST have operable water before tin
image Supply: (_) New Septic Tank (Completes New Tank Checklist) (_) Existing Septic Tank 1 ) County Sewer
•
:omments: 1 3 6 9 /5 '\\ (k , - - -
)— 114'7der ,V, ft, —
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' permits are granted I agree to con orm to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
hereby stale It> oregoi state : nls are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
a - 2 - ( o
tignature of Owner or Owne ate
"This application expires 6 months from the Initial date If no permits have been Issued•'
A RECORDED SURVEY MAP, RECORDED PEED (OR OFFER TO PURCHASE) AND PLAT ARE REOUIRED WHEN APPLYING FOR LAND USE APPLICATION
Please use Blue or Black Ink ONLY
• 2/08
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