LAND USE Initial Application Date /1 - / /Q / / f ,/d App /oadon r /P ' 9;2.; ' Zia &4A4
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COUNTY OF HARNErT RESIDENTIAL LAND USE APPLICATION
Central Permlltlng 108 E. Front Street, Ltllington, NC 27548 Phone: (910) 893.7525 Fax: (910) 893 -2793 www.hamed.org/permde
LANDOWNER: I. ^. - s :111nM C �rk I'4-1/) ''�p� MallingAddrese:n BIN '7 ti
City: Q, 1 V 1 (1 Y t. Stats:iX'. Zip 3 Sontad A Ernst 1 f-fy .
APPLICANT': t 5 A Mailing Address: t tr 1\00-- ci) - 3 50 %Ca' --
City: State: Zip: Contact # Email: C c�Y ra r L 4
'Please M out applicant Information If different than landowner
CONTACT NAME APPLYING IN OFFICE: ... k�
31/V Phone # q /
- 77 4 'I 0 I ' �t ' - CAaL 0112,
PROPERTY LOCATION: Subdivision: Lot #: /L Lot Size; ` *h 350
Slate Road 0 9 2 bG State Road Name:: P #Y7i&t„• 5j 7 q �7 Map Book &Page: v�/
Parcel: 9 / s,,I 9472 t2 2/J ,1/ PIN: 14� / 74 7 .p, 1 (� G /�c� e I r y
Zoning:A 1 7/i/ Flood Zone: �� Watershed: `+' � Deed 800k8Page: f 4 1 A . �/ Power Company*:
'New structures with Progreso Energy as service provider need to supply premise number . r • m % • • let erg).
SPECIFIC DIR TIONS TO THE PROPERTY FROM LILUNGTON: 7- / , ' � / .. . t
A � �s� �.. I � Q ac7 I Z 9D /i, � y. *Al
Snt�is N
PROPOSED USE:
Monolithic
O SFD: (Giza _ x ) # Bedrooms: Baths: Basement(w/wo bath). Garage: Dedc Crawl Space: Slab: Slab:
(Is the bonus room finished? Li yes Lino w/ a closet? U yes Lino (If yes add In with 0 bedrooms)
O Mod: (Size s ) # Bedrooms 5 Baths Basement (w/wo bath) Garage: Site Built Desk: On Frame Off Frame
(Is the second floor finished? L_) yes (_ Any other site built additions? (__) yes Lino
Cl Manufactured Home: _ SW _ DW _ TW (Size x ) 5 Bedrooms: _ Garage: (site bulltt_i Dedc built?_)
O Duplex: (Size x ) No. Buildings: No. Bedrooms Per Unit:
O Occupation: 0 Rooms: Use: p Hours of Operation: //Employees: '/
AddBbNAcceas ory�ther: (Size 47 )< ) Use: ( .10.k..... nil /. Closets in addition? (__) yea ( o
r Supply: / County — Existing Well _Now Well (# a using well )'MUST have operable water before final
Sewage Supply: _ New Septic Tank (Complete Checkllet) Existing Septic Tank (Complete Checklist) County Sewer
Does owner of this trail of land, own land that contains a manufactured home within live hundred feet (500') of trail listed above? Li yes Lino
Structures (existing or proposed) Singb family dwellings: Manufadured Homes: `_ r (specify):
Required Residential Property Line Setbacks: Comments: G//4/4/' � iv 5 T /4/4
=rout Minimum Actual / 4 " 2 4 1/ n» / � &'
tear / 9✓4 DG 2 S G1 /,',,,,, Ai C r
n((--k / t `6
aoseet Side C- � I I I J
ildesfreetrcomer lot L
dearest Building
in same lot
' permits are granted 1 agree to conform to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
hereby state that foregoing statements are accurate and correct to the beat of my knowledge. Pemhit subjed to revocation if false Information is provided.
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Signature of Owner or Owners Agent Date
"ibis application expires 5 months from the Initial date if permits have not been Issued"
A RECORDED SURVEY MAP. RECORDED DEED (OR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION