Partitioner Jonesboro_368-415_DEVELOPMENT IMPACT ANALYSIS copy 2APPLICATION FOR NON-RESIDENTIAL CONDITIONAL USE PERMIT Page 1 of 4
Non-Residential Conditional Use Permit
Planning Department
108 E. Front Street
P.O. Box 65, Lillington, NC 27546
Phone: (910) 893-7525 Fax: (910) 893-2793
Total Fee:
Receipt:
Permit:
Date:
Case #:
Applicant Information
Owner of Record: Applicant:
Name: Name:
Address: Address:
City/State/Zip: City/State/Zip:
E-mail: E-mail:
Phone: Phone:
Property Description
PIN(s): ____-__-____ Acreage: acres
Address/SR No.:
Directions from Lillington:
Deed Book: Page: Plat Book: Page:
Zoning District: Township:
Flood Plain & Panel: Watershed Dist:
Water: Public (Harnett County)
Private (Well)
Sewer: Public (Harnett County)
Private (Septic Tank
Requested Use:
Conditional Use for
Required Information: (Applications will not be accepted without this information)
1. Is an Erosion and Sedimentation Control Plan required? No Yes
If yes, is one on file? No Yes (Please attach a copy to your application)
2. It is recommended that all non-residential developments have preliminary discussions with NC DOT
concerning driveways and other traffic issues for each project. Has this been done? No Yes
Date of Meeting: NCDOT Contact:
3. Is a Driveway Permit required? No Yes
If yes, is one on file? No Yes (Please attach a copy to your application)
4. Have you contacted applicable local, state, and federal agencies regarding building, fire, and other
possible code compliance issues? No Yes
APPLICATION FOR NON-RESIDENTIAL CONDITIONAL USE PERMIT Page 2 of 4
Sketch Plan Required: Provide a sketch plan along with application. It is strongly encouraged
that sketch plans be prepared by a NC Professional Land Surveyor and that it meet the following (as
applicable):
TITLE BLOCK INFORMATION
Name of Project & Date (Including all Revision Dates)
Applicant/Owner(s) Contact Information (Name, Address, & Phone)
Surveyor/Engineer Contact Information (Name, Address, & Phone)
Parcel ID Number/Tax ID of Tract(s)
Deed Reference of Tract(s)
Zoning Classification of Tract(s)
Location (Including Township, County, & State)
Flood Plain Depicted & Noted (Zone, Map Number, & Effective Date)
Watershed District Noted & Extent of Coverage Depicted
GENERAL REQUIREMENTS
Map Size 22” x 34” & Scale 1”=100’ or Larger
North Point, Graphic Scale, & Vicinity Map
Name(s) & Location(s) of Adjacent Property Owner(s) & Use(s)
Existing Boundaries of Tract(s) Showing Bearings & Distances
Gross Acreage of Development
Name(s) & Right(s)-of-way of Streets & State Road Number(s), Including
Notation of Public or Private
Name, Location, Width, & Acreage of Additional Easement(s) &
Right(s)-of-way Within or Adjacent to Site
Building Envelope & Required Setbacks
Existing & Proposed Utilities
Signage Location, Easement, Type, & Size
Existing Structure(s) Located on Site
SITE PLAN
Fire Hydrant(s) & Street Light(s) Noted
Erosion Control Plan Submitted
Hours & Days of Operation
Impervious Surface (% Coverage of Lot)
Hazardous Materials to be Stored on Site
Existing & Proposed Mechanical Areas
Existing & Proposed Trash Containment Areas
Existing & Proposed Utility Areas
Parking Space Typical
Parking Lot Material
All parking areas on site (Based on Type of Business and/or Sq. Ft.)
Existing & Proposed Fencing, Screening, Gate(s) and/or Dock(s)
Spillage & Pollution Prevention & Response Methods
BUFFERING REQUIREMENTS
Buffering Regulations (Per Harnett County Zoning Ordinance)
Signatures
I, as the landowner, hereby CERTIFY that the information contained herein is true to the best of my
knowledge; and by accepting this Permit (if approved) shall in every respect conform to the terms of this
application and to the provisions of the Statutes and Ordinances regulating development in Harnett
County. Any VIOLATION of the terms above stated immediately REVOKES this Permit. I further understand
this structure is not to be occupied until a CERTIFICATE OF OCCUPANCY is issued. This Permit expires 12
months (1 year) after the date the Permit is granted by the Harnett County Board of Adjustment.
Property Owner Signature Date
APPLICATION FOR NON-RESIDENTIAL CONDITIONAL USE PERMIT Page 3 of 4
Written Statement
** Applicant is required to answer the following questions under oath at the Board of Adjustment Meeting – Please print answers **
Public Convenience & Welfare
1. Why are you requesting this use?
2. How will this use benefit the citizens of Harnett County?
On-site & Surrounding Land Uses
3. How will the use you are requesting affect the surrounding properties, residents and businesses in the
area? Describe in detail why and how it will or will not affect the surrounding areas?
Utilities, Access Roads, Drainage, etc…
4. Describe the driveway (width and surface) that you will be using to enter and exit the property.
5. Describe the drainage of this property.
6. How is your trash and garbage going to get to the landfill?
Traffic
7. Describe the traffic conditions and sight distances at the State Road that serves the property.
8. What is the approximate distance between your driveway and the next nearest driveway or
intersection?
General
9. How many employees will this development employ?
10. What is the estimated investment of the development?
11. What experience do you have in the proposed field?
Conditions
12. State any conditions that you would be willing to consider as part of the approved Conditional Use
Permit.
13. Additional comments the Board should consider in reviewing your application:
APPLICATION FOR NON-RESIDENTIAL CONDITIONAL USE PERMIT Page 4 of 4
Action by the Board of Adjustment
The Board of Adjustment shall approve, modify, or deny the Application for Conditional Use Permit
following the Public Hearing. In granting a Conditional Use Permit, the Board of Adjustment shall make
written findings that the applicable regulations of the district in which it is located are fulfilled. With due
regard to the nature and state of all adjacent structures and uses, the district within which it is located
and official plans for future development, the Board of Adjustment shall also make written findings that
the following provisions are fulfilled:
3.1 The requested use is in harmony with the surrounding area and compatible with the surrounding
neighborhood.
3.2 The requested use will not materially endanger the public health and safety.
3.3 The requested use will not substantially injure the value of adjoining property, or, alternatively,
the requested use is or will be a public necessity.
3.4 The requested use will meet all required conditions and specifications.
3.5 The requested use is in general conformance with the Harnett County Unified Development Ordinance (UDO), Land Use Plan, and other relevant adopted plans.
Note: There must be four (4) Board of Adjustment members present at the meeting to hear a request for a Conditional Use Permit. Four (4) out of the five (5) board members must vote in
favor of granting the Permit. If only four (4) board members are present at the meeting then all
four (4) must vote in favor of granting the Permit. If three (3) or fewer members vote in favor
of granting the Conditional Use Permit, the request is denied.
** I have received and read the above statement:
Signature Date