LAND USE R Initial Application Date: l/I ✓_`F' 1 Application# l 500q ' ? 7c
CUP
• COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 109 E.Front Street,Llllington,NC 27546 Phone:(910)893-7525 exl:2 Fax:(910)893-2793 www harnettOrg/pemilts
'•A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)/SITE PLAN ARE REQUIRED MIEN SUBMITRNO A LAND USE APPUCATION^
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LANDOWNER: •JQLII&- Iaf Tay/0er Mailing Address: Pa (3Ox (tic5-v2
City: L.illiVtq}otn state:)JC zip a'2 NS Contac No: Email:
APPucANr: SQNiA�vc'^i //o✓re• &t /oSitirAddress: /Y?09 N. tita.'n Sl--
Ciry: Lret )r4,63
✓✓'1-o-t state:NC Zip:3'j3`a2Conmm No: 9/0 — 9d Wad: /, co,
•PIaam M cut wgl&M information If different tionla landowner
CONTACT NAME APPLYING IN OFFICE: 01":14 ISI S kee rro ci Phone# 9 to" 9 As—(/31°
PROPERTY LOCATION:Subdivision: JOA a A40.1
I dtt /c/ [.^� Lot#: 8 Lot Size:i(J(O CI State Road# I OI4 ` State Road Name: O l Cj W x'1 W I Map Book 8 Page:a 017/ l CI
Parcel: J1".<65 -1 `/Dos")- I23a3
- PIN: 00 tiro -3a .GOO
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Zoning: r r /k
Zone: Watershed:— Deed Book S Page: 34-8,/£23b8 Power Company': LA tie T:E'y y
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE: 5/e",t UAI�
11 / Monolithic
❑ SFD:(Size 4W x100)#Bedrooms: #Baths: Basement(wlwo bath): Garage: Deck:_Crawl Space:_SlabV_Slab:_
(Is the bonus room finished?( )yes ( )no w/a closet?(_)yes ( )no(If yes add In with#bedrooms)
❑ Mod:(Size x )#Bedrooms_N Baths_Basement(wMo bath)_Garage:_Site Built Deck:_ On Frame_OS Frame_
(Is the second floor finished?( )yes ( )no Any other site built additions?(—)Yes ( )no
❑ Manufactured Home:_SW DW_TW(Size x 1#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/Accessory/Other.(Size_x_)Use: Closets in addition?(_)yes ( )no
Water Supply: ✓County _Existing Wel New Well(#of dwellings using well )*Must have operable water before final
Sewage Supply: ttNew 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 with _in five hundred feet(500')of tract listed above?( )yes ( no
Does the property contain any easements whether underground or overhead(V I hiyes ( )no
Structures(existing or proposed):Single family dwellings: I _Z Manufactured)Homes:( / Other(specify):
as.
-
Required Residential Property Line Setbacks: Comments: - S` —• —U / 1
Front Minimum 3 5 Actual
S
Rear
Closest Side t.. 2S—
SidesireeUcarner lot
Nearest Building
on Bare lot 03111
Residential Land Use Application Page 1 of 2
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINOTON:
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 nate that foregoing statynents are accurate • correct to the best of my knowledge. Permit subject to revocation If false information is provided.
/ a-d2 - /t
Signature of• ner or Owner's Agent ate
"9t 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 bean Issued"
Residential Land Use Applicalmn I'ase 2 or 2
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