LAND USE R c a 1 Z io g s cmINED e
Initial Application Daft I / Application # I 0 b a s a s5
COI
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. Front Street, Llllington, NC 27548 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.hamett.org/permtls
LA D O W E L '4rry LAJ l 1 l _
l2 layld 7$70 OW U.S: va(
LANDOWNER: Maltin A ddress:
cit /1'1a' ` M er S State:ALC• Lip: /9)S Contact# 9 906 y 0(fl Email:
APPLICANT': ^ 5 T et C Til oC S 4
Mailing Address: ' • 0 . 13G &' ?S'
r2
Cit /3r&G. we (/ State:/ ( *Zip: r?7S Contact# 9a `toe 5 Email:
'Please nil oul applkaM Infordiatlon if different than landowner
CONTACT NAME APPLYING IN OFFICE: Phone # /
PROPERTY LOCATION:: Subdivision: / ^. 9 ■ Lott Lot Size: �! ��
State Road it Cl �S � State Road Name: t J \ c\ t A .S c 4 < L Map Book &Page: v�sl
Parcel: I?) C7l7l0 6C Da PIN: ID LD 1 b - S7" d3) 6 o w
Zoning: 'R3 OFlood Zone: X Watershed: 1\1 Deed Book &Page: 1 yi S/ 7-4 0 Power Company:
'New sbuctures with Progress Energy as service provider need to supply premise r number from Progress Energy.
SPECIFIC DI TO THE PROPERTY FROM ULLINGTON: TG? It' Q n Fran
yY d t; 1 GI D r O M if eS
out a Of L: (( .s IDrI .14-0 use_ ( 5 are tit. acro$S V'ran
rc-1ferso.JS A,A40 Me c6a.r.0 SA6
PROPOSED USE:
et T ° I �
Monolithic
SFD: (Size d0__k SO) # Bedrooms: 3 # Baths:_a Baeement(wAvo bath): Garage: Deck: Crawl Space: V Slab:
(16 the bonus room finished? Li yes Lino w/ a closet? Li yes Lino (8 yes add In with 0 bedrooms)
❑ Mod: (Size _ x ) # Bedrooms # Baths Basement (w/wo bath) Garage: Site Bulit Deck: On Frame Off Frame_
(Is the second floor finished? Li yes Lino Any other site built addlllons? Li yes Lino
❑ Manufactured Home: _ SW _ DW _ TW (Size x ) # Bedrooms: _ Garage: (site built?_) Deck: (site bullt?_)
❑ Duplex: (Size x ) No. Buildings: No. Bedrooms Per Unit:
❑ Home Occupation: 0 Rooms: Use: Hours of Operation: *Employees:
❑ AddhlonlAccessory/Other. (Size ) Use: Closets In addition? (___) yes Lino
Water Supply: ✓ unty ^ Existing Well _ New Well,(# of dwellings using well ) 'MUST have operable water before final
Sewage Supply: New Septic Tank (Complete Checklist) 1 Existing Septic Tank (Complete Chec/dtsf) County Sewer
Does owner of ththisss of land, own land that coMelns a manufactured Lame within five hundred feet (500') of tract listed above? Li yes Lino
Structures (existing or proposed): Single family dwellings: 1 Manufactured Homes: Other (specify):
Required Residential Property Line Setbacks: Corn/ions: n /
Front Minimum 'S Actual �(. 9, t / it/b, -y' r b Cx 4- Tin ir
7 �r �/ c
Rear � � J 1 SL�' p D !/ ! ! . �/ :, 47 j i �
Closest Side , V lJ p f 6 , It - /Z -/o 'S J *
SldestreeVCOmer lot '
0
Nearest Building
on same lot
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.
Signature of Owner or Owner's Agent Date
"This application expires 6 months from the Initial dab N permits have not been issued"
A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) ANC PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION
SFD, Addition, Modular Application 3 o(8 08110
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