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LAND USE
Initial Application Date: 1/ - l ✓ " /© APpBcalfon # 7v 6� 2 L' 3— 7 L CU# COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION Central Permitting 108 E. Front Street, Lillington, NC 27548 Phone: (910) 883 -7525 Fax: (910) 893-2793 www.hamett.org/pennits LANDOWNER: t . ! :, tir'.rn C 314; 44' r� MailingAddress:f tiff 7 q City: D\, U \ (x State:.. ZI � # Email: �-( APPLICANT': L:e� �h w � 'YQr Mailing Address: ti . 0 k)(2-di-i-4- 35O %f� F -� -Z4 -- City: State: Zip: Contact # Email: C c �M e Y� r L J 3 (� *Please fill out applicant Information If different than landowner CONTACT NAME APPLYING IN OFFICE:. 'iri/Yh -P Phone # 1) )3 y 1— (aCaU' _ PROPERTY LOCATION: Subdivision: / Lot #: r Lot Size: ��i4- i3 D State Road* 9 2'L State Road Name: /O✓J,�I& /.I �j l� / / /� Map Book&Page: 64/ Parcel: ,9q � 94 ✓ f�" 2 z1 PIN: ! Cy7 7 ., ��y� , �0. Zoning:/ l' 7 l j Flood Zone: �f/ Watershed: `° 4 Deed Book&Page: 7147731 Power Company: `New structures with Progress Energy as service provider need to supply premise number rase F�ler SPECIFIC DIR- IONS TO THE PROPERTY FROM ULUNGTON: 2 / ! �/ ��'�"i'� / / � 1 '9n� 44 ! pD . gall .,f 1 ) firm ' - PROPOSED USE Monolithic ❑ SFD: (Size x ) # Bedrooms: *Baths: Basement(wM'o bath) Garage: Deck Crawl Space: Slab: Slab: (Is the bonus room finished? Li yea (Jno w/ a closet? (J yes (_,no (if yes add In with # bedrooms) ❑ Mod: (Size x ) # Bedrooms # Bathe Basement (w/wo bath) Garage: Site Built Deck: On Frame Off Frame_ (Is the second floor finished? Li yes Lino Any other site built additions? (J yes Lino ❑ Manufactured Home: SW DW 1W (Size x ) # Bedrooms: _ Garage: (site built? ) Deck: (site bui8?_) ❑ Duplex: (Size x ) No. Buildings: No. Bedrooms Per Unit: ❑ Occupation: # Rooms: Use: Hours of Operation: #Employees: Addition/Accessory/Other: (Sfze�iS x 7. Use: chit- Closets in addition? ( ) yes Cl i Supply: /unty — Existing Well ,Now Well (# of d�sp)r.�o� using well ) *MUST have operable water before final Sewage Supply: _ New Septic Tank (Complete Checkllaf) Ex isting Septic Tank (Complete Checklist) _ County Sewer Does owner of this tract of land, own land that contains a manufactured home within f ve hundred feet (500') of tract listed above? (__.) yes Lino Structures (existing or proposed): Single family dwellings: / Manufactured Homes: 9ther (specify): Required Residential Property Line Setbacks: Comments: LA / /P�r ,f .I . f 1 /»'t/ Front Minimum Actual Rear Cbsest Skis Sldestreet/comer lot r 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. 3, AI. L./4,w,,.* C -4 r/, /1-10 - 10 Signature of Owner or Ovmer's Agent Date "This application expires 8 months from the Initial date If penults have not been issued" A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION