LAND USE Initial Applicaflon Date: I Z — Z 5 10 Application # j° 9 729 z ✓ /J a fj
cu #
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting X 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.hamett.org /permits
LANDOWNER: S5i1° cc /-(o' e_ etrif rr Xne. Mailing Address: COI b/ Etna.// d ,ff. 283iy
City: 11.-, State: Zip: 29 Contact # (AO) -9137 Email: 4.1& Str
APPLICANT': .51 -tr./v c N -'. e 2 r Mailing Address: ( 44 ,fti
City: i r� State: r- Zip: Z8$/4 Contact # (9M9 "0'1377 Email: / L cA
'Please fill out applicant information if different than landowner u
CONTACT NAME APPLYING IN OFFICE: L Q° "Shf ' - 7 Phone # (41 9) 5 o- % 337
PROPERTY LOCATION: Subdivision: R r' c Lot #: • Lot Size; . z{Cr
State Road # Ag 2? State Road Name: NC 27 1 Map Book &Page: ?tt6l /O/3 /r
Parcel: 0395 OOt( 20 PIN: 4 /5-C'r2 rF 2 s5-- OC,o
Zoning: (It Z O 4Iood Zone: 7 Watershed: / Deed Book &Page: 21 31 / '9/ Power Company`: (e +6-..l L=(« FT;
*New structures with Progress Energy as service provider need to supply premise number /1./9 from Progress Energy.
SPECIFIC DIRECTIONS k (ri'
TIONS TO THE PROPERTY FROM LILLINGTON: ' y h `-' 7 .2-7 w< S { 4/7.-.. 'Y/ --. —F ' (
�
f ruit 3 s..LSu. Sri. IS ^ - ✓•- , 74
PROPOSED USE:
Monolithic
�/
✓ SFD: (Size 31 x 575 # Bedrooms: # Baths: ... Baasement(w/wo bath): Pc' Garage: /Deck: /Crawl Space:_ Slab:_ Slab:_
(Is the bonus room finished? ( /) y es Lino wl a closet? ( ) yes (J)no Of yes add in with # bedrooms)
❑ Mod: (Size x ) # Bedrooms_ # Baths_ Basement (w/wo bath)_ Garage:_ Site Built Deck:_ On Frame_ Off Frame_
(Is the second floor finished? ( ) yes (_)no Any other site built additions? ( ) 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:
❑ Addition /Accessow /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) 7 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
Structures (existing or proposed): Single family dwellings: 1 Manufactured Homes: Other (specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual y t
Rear 25"
Closest Side /o f
Sidestreet/corner lot
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.
zed-- /2 -23 - / 0
Signature of Owner or Owner's Agent Date
"This application expires 6 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
Residential Land Use Application Page 1 of 1 07/10
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