Land Use R12 1 fl
Initial Application Date: 2=f U Application #
t Lam/' I I (F-7 COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting �� 108 E. Front Street, Lilliinngton, NC 27546 Phone: (910) 893-7525 Fax: (910) 893-2793 www.harnett.org
LANDOWNER: TFC � i h 1l?/ • ��f �i 1 [ Mailing Address: 7- �' S Le S 11,2 /
City: /( M, State:/t Z Zip:,Z 7, E Home #: Contact #:4
APPLICANT*: /A-<,1,,7 f �� c eA,, c ��� S� .t< ! Mailing Address:
r
City: State:.// e_Zip:Z Home #: 5710 �' %� S F, Contact #: %/e % z% e -r 76S'
*Please fill out applicant information if different than landowner
PROPERTY LOCATION: Subdivision: -/ ;7 S e -t- je2e t • 7' Lot #: _Lot Size: —
Parcel:
Zoning
Deed Book&Page: �i� Map Book&Page:
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: lZ Cw�fT^�t fs cv�'S�p^
h h ` /r7� / <l �C_ lc j� l G( .PL i
0n n /;1 e7 de-, /- G 7 c' It --'e- 1-�
PROPOSED USE:/O�
2 Circle:
LJ SFD(SizeSy xO ) # Bedrooms s # Baths 2- Basement (w/wo bath)
Garage,1k Deck ravel Spac Slab
❑ Modular: _On frame _Off frame (Size_x_) # Bedrooms # Baths
Garage (site built?_) Deck (site built?_)
❑ Multi -Family Dwelling No. Units No. Bedrooms/Unit
❑ Manufactured Home: _SW _DW _TW (Size x_) # Bedrooms
Garage (site built?_) Deck (site built?_)
❑ Business Sq. Ft. Retail Space Type
# Employees: Hours of Operation:
❑ Industry Sq. Ft. Type
# Employees: Hours of Operation:
❑ Church Seating Capacity # Bathrooms Kitchen
❑ Home Occupation (Size—x—) # Rooms Use
Hours of Operation:
❑ Accessory/Other (Size—x—) Use
❑ Addition to Existing Building (Size x ) Use
Closets in addition(_)yes (_)no
Water Supply: (_�ounty (_) Well (No. dwellings _) MUST have operable
water before final
Sewage Supply: (_L+11—ew Septic Tank (Complete New Tank Checklist) (__) Existing Septic Tank (-) County Sewer Other
Property owner of this tract of land own land that contains a manufactured home Win five hundred
feet (500') of tract listed above? (_)YES ( NO
Structures on this tract of land: Single family dwellings ✓ Manufactured Homes
Other (specify)
Required Residential Property Line Setbacks: Comments:
r
Front Minimum 35 Actual
1
Rear 25
Side 10 /2 7' S`
Sidestreet/corner lot 20
Nearest Building 6
on same lot
If permits are granted I agree to conform to all ordinances and the laws of the State of North Carolina regulating such work and the specifications of plans
submitted. I hereby state that the foregoing statements are accurate and correct to the best of my knowledge. This permit is subject to revocation if false
information is provided on this form.
- < 1-- f
Signature of Owner or Owner's Agent Date
**This application expires 6 months from the initial date if no permits have been issued**
A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION
Please use Blue or Black Ink ONLY
3/07
N ONIAAY80 SAV :A9 NMV80 '01P - .1 :31VOS LOOVOI 8380100 :31VO VNIlO8V0 H180N :31VIS
008 0131
:A8 03A3A8f1S Ot of LL3NHVH 'kiNno 3AO369VG dIHSNM01
108 01�3
2426-s69 (016 VT V V'� S3VHd'0/S 31NIOd 1430NI1
949L: '3'N'N019NIllll"08 HHV13 2991 M — 101 — NVId 101d a3SOdCMd
ONS "MWS 113NN30 :WA A3A!lY1Q
V9YfL0 'ON W
CE LH813H P(m Ixm
102— OSVA 3018 10.1 tlaWo
Al—(IWA 3018
.01 ---- OWA W30
,8£ GWA L/DVA
EM In mlinim MWMM
_r'
'ON dYW :30N3M A M dYPI
W