LAND USE R Initial Application Dat 6 SCAN E Application# I X11 :1)
E ` CU#
�l I ' I I�NTY n, 46T RESIDENTIAL 9NO USE APPLICATION
e���Ce�ntr�al�P'ery�mitting�L `�101LB1EtF rontStrepetgLi�llingtoLn,NC 27546 Phone:(910)893-7525 ext:2 Fax: (910)893-2793 www.hametLorglpermits
".11114OEE614k/YMP0,RE PrirthD(OIiO FER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
& Wynn Construction, Inc. Mailing Address:2550 Capitol Dr. Ste 105
City: Creedmoor State:NC Zip:27522 Contact No: 919 603-7965 Email: edward@wynnconstruct.com
APPLICANT':Edward Averett Mailing Address.2550 Capitol Dr. Ste 105
City: Creedmoor State:NC Zip:27522 Contact No: 919 603-7965 Email. edward@wynnconslruct.com
*Please fill out applicant information if different than landowner
JCONTACT NAME APPLYING IN OFFICE: Edward Averett Phone#919 603-79655 rJo
PROPERTY LOCATION:IOjSubdivision: Avery Pond (� 1 7--� Lot#: O(s / Lot tSS Size: 'tt f1 E
State Road# �L['1 D �y ,� State Road Name:, RpO et G\'O{A+ 1!r• Map Book&Page:alb, /Ll g
Parcel. Q L7 CU 53 Lata. 11 00 ppm OAnS3- Lin - UacLtff rttl
Zoning. food Zone. Watershed: n 7 1 Deed Book&Page: D I{'� Power Company': Duke Energy
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:ygr' ?4 3ll
, Monolithic
SFD'.(Sized,/• #Bedrooms'#BathsZ'Basement(w/wo bath): Garage'. ✓ Deck:•Crawl Space:_Slab:_Slab:_
(Is the bonus room finished?(_)yes (_)no w/a closet?( )yes (_)no(if yes add in with#bedrooms)
LI Mod (Size x )#Bedrooms_#Baths Basement(w/wo bath) Garage. Site Built Deck: On Frame Off Frame_
(Is the second floor finished?( )yes ( 1 no Any other site built additions?( 1 yes ( )no
❑ Manufactured Home._SW_DW TW(Size x )#Bedrooms: Garage: (site built? ) Deck: (site built?_)
❑
Duplex: (Size x )No. Buildings: No.Bedrooms Per Unit:
❑ Home Occupation#Rooms: Use: Hours of Operation: #Employees'._
U Addition/Accessory/Other(Size x_)Use. Closets in addition?( )yes ( )no
Water Supply: ✓ County Existing Well New Well(#of dwellings using well )`Must have operable water before final
Sewage Supply: ✓ New Septic Tank(Complete Checklist) Existing Septic Tank(Complete Checklist) County Sewer
Does owner of this tract of land,own land that contains a manufactured home within five hundred feet(500')of tract listed above?( )yes ( )no
Does the property contain any easements whether underground or overhead(_J yes ( )no
Structures(existing or • 0.0s-• :Single family dwellings: 1 Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks:/ Comments:
Front Minimum 35 Actual 3G
Rear 25 /01.3
Closest Side 10 ,20
Sidestreet/corner lot 20
Nearest Building
on same lot
Residential Land Use Application Page 1 of 2 03/11
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: From HCCP right onto 210 Hwy. 3 miles, Left on 401 Hwy.for 15 miles
Left on Chalybeate Rd.for 1/8 mile,Avery Pond on the left
If permits are granted I agree to onform o all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing eme re ccurate corre t to the bas o y knowledge. Permit subject to revocation if false information is provided.
6 -/6
Signature of Owner or Owner's Agent Date
**St is the owner/applicants responsibility to provide the county with any applicable information about the subject property,including but not limited
to:boundary information,house location,underground or overhead easements,etc.The county or its employees are not responsible for any
incorrect or missing Information that is contained within these applications.***
""This application expires 6 months from the initial date if permits have not been issued**
Residential Land Use Application Page 2 of 2 03111
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