LAND USE Initial Application Date i0 4- IR Appacadon# Irl 5001-1—R4 CO
DRB# CU#
COMMERCIAL
COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting 1/08 E.Front Street,�Lillington,NC 27546 Phone:(910)893-7525 p Fax:(910)893-2793 1 cwww hamett.orglpermlts
LANDOWNER: .X. 0 \vF yt f�(✓_#''''��J Mailing AddreseA() . C ( 5 -{f/) s0
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City x I State f - ' Zipo!jJ&Contact# 3V.-ye0'gz11 EmallC:iit,—cC4Plu. �/v 4 �,( yh
APPLICANT`: V C l% l k e,-.6.-,C KS( Mailing Address: C-11-10----e----
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Contact# Email:
'Fleas.EII out appfonl Information if itinerant than landowner
CONTACT NAME APPLYING IN OFFICE: Phone
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PROPERTY LOCATION:r11. Subdivision: )(1"
A c llvl�..c . ✓I() I SOL Lot#: Lot Size J. IS
State Road# Lir)y I cStattee'Road Name:Na �s—� 10 I p O /- / /Map Book&Pag 1 I 5
Parcel:Do/., 1 Dp DSiS bb 15(4 PIN: 0<i< T. / V—I% //• Doo
Zaningb-a.0 fTlood Zone. Pk- Watershe0 / Dead BookBPage: Z (Y 113 9 Power Company' a_gerfis,
'New structures with Progress Energy as service provider need to supply premise
eenumber 1 [ ,�r� (from Progress�yEnergy
SPECIFIC� DIRECTIONS TO THE PROPERTY FROM LILLINGTON:(/s�}moMeg- V.. `f 17 I SON "` Ting a'�#^'ICS
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• USE:
❑ Multi-Family Dwelling No.Units. No.Bedrooms/Unit:
❑ Business Sq.Ft.Retail Space: Type: #Employees: Hours of Opmetion:
❑ Daycare #Preschoolers: #ARsrschooiers: #Employees: Hours of Operation:
❑ Industry Sq.Ft: Type: #Employees: Hours of Operation:
❑ Church Seating Capacity: #Bathrooms: Kitchen: � N!
Accessory/Addition/otter(Size___x_) \r Use: "76 TB'p"d B ati(.6,--Water Supply: C 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
Comments:
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If permits are g `ted I agree to conform to all ordinanc�i a d I: of the State of North Carolina regulating such work and the specilcations of plans submitted.
I hereby state that's ageing statements are accurate and co ,ct to i\best of my knowledge. Permit subject to revocation if false information is provided.
N. CM-.
•
'�F .. x. ... Date
ear-we&
"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
Commercial Land Use Application Page 1 of I 08/10