LAND USE R 0 — (I C /1 SCANNED
Initld Application Date: - / 0- 5 c - , z51 83 if
Application If �!
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION CU#
Central Permitting 108 E. Front Street, Ullington, NC 27548 Phone: (910) 893 -7525 Fax: (910) 893-2793 www.hamelt.orypemrila
LANDOWNER: ‘- `)O1/),5 ;Cna err- Mailing Address: (0 Aix 33,z
!city: /PVe NT' 1�l ,7: M j Slate: / NP zip:28323 Home#: 9 /C 7934393 contact a:
(APPLICA: E 7 7 ' M / j Leo n Mailing Address: �‘p3of33G 1 / 7 5 / Ale II -J-/a s ,
Clly� n n / P. _e State:N zip:c'�Home a:7/6 O ZT,� Contact #: 9/6- 65E 4927
'Please m out applicant information if different than landowner �- -� �� 9/0 CONTACT NAME APPLYING IN OFFICE: de . C' /7/5 ,, / i/ J rain Phone #: 93 - 07 8 97
PROPERTY LOCATION: Subdivision w /phase or section: "& - Lot 0: Lot Acreage: -3 ,1 Z
Stg to Road a: 202 to State Road Name: !-,ree r 2l1 55 4?0 Map Book&Page: I S /
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Oq5$ 21 0747 - GOO goSSb oloto
Zoning: 1`m-C/ Flood Zone: V watershed; /f DeedSook&Page: 21 5 - 8 / `17L Power Company: 5w'rrF rZu'f
'New homes v4th Progress Energy as service provider SPECIRC DIRECTIONS TO THE PROPERTY FROM ULUNOTON premise 4o / 5 IXAH
?Ass pile ✓e / � n S7d 2415 "I r
1 Mel 1n Lean 4# , /011 1 4 ! L Men m /945 ,Lc/ Af - mss Read- On 7
Alin, 05 eri- , d Mt- cs /tot 44t n 1t4K� Road / 6X /mot
On w-& f m - f4smE Caned i # ‘94
PROPOSED USE: arctic
O SFD (Size _ x ) 0 Bedrooms # Baths Basement (w/wo bath) Garage Deck Crawl Space / Slab
(Is the bonus room finished ? w/ a closet_ if so add In with f bedrooms)
O Mod (Size x I # Bedrooms # Baths Basement (w/wo bath) _ Garage Site Built Deck ON Frame / OFF
(Is the second Iloernlshed ? Any other Ste bulb additions ?_ )
IZr Manufactured Home: SW OW TW (Size I — x 7 0) a Bedrooms', Garage _ (site bulk? ) Deck (site built? )
O Duplex (Size _ x ) No. Buildings No. Bedoorne/Unit
y O me Occupation # Rooms Use _ Hours of Operation: #Employees �
Addhlon'Accessory/Olher (Size /y x 70) Use kit P /7A 7h Ft iJ - 4/ Al ai Closets In addiuol7l� yes Uno
•
• Water Supply: (County i J We4 (No. dwellings _1 Mug / have operable water before final
Sewage Supply: U New Septic Tank (Complete ChsmtN$ ( Existing Septic Tank (Complete Chen d/p) (_)County Sewer
Properly owner of this had of land own land that Domains a manufactured home wAn five hundred feel (5001 of tract listed above? (DYES ( ✓Jn 1
Structures (existing 8 proposed): Stbk Built/Modular 1£4 C Manufactured Homes Ie w' 54 Other (spedfy)
Required Residential Properly Lino 8slbsoks: L Comments: / /
Front Mlnlmum T3S Actual Sr 7 "/ / 141 0e 3 IL OA ,f`/tl� 'roil (/i e 113121
Rear zs 109 S 47/
Closest Side / 0 4 5 •
�
Weaned/comer lot Z° ! •
Nearest Building iG J
on same lot
If permits are granted I agree to conform to all ordinances and laws of the Slate of North Carolina regulating such work and the specifications of plans submitted.
I hereby slate that foregoing statements accurate accurate and correct lo the best of my knowledge. Permit subject to revocation if false information is provided.
/ j / � 1 � " C r� n P9 ••• /l ‘ 0/D
Signature of OwAh or Owner's Agent Date
"This °pollution expires 8 months from the initld dale It no permits have Iran Issued••
A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPUCATION
Please use Blue or Black Ink ONLY
LAND USE 5/08
SchLE : I = 5D
SITE PLAN APPROVAL
DISTRICT "RA 20 12 USE 5vl if
#BEDROOM$ 5 rah/
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ZONING ADMINISTRATOR
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