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DOCUMENTS Initial Application Date: Il t31In Applicationu In S /C DRB Cu COMMERCIAL COUNTY OF HARNETT LAND USE APPLICATION Central Permitting 108 E.Front Street,Lillington,NC 27546 Phone:(910)893-7525 Fax:(910)893-2793 www.harnettorg/peanits LANDOWNER: Herne it ('�vnf7 Mailing Address: 10 £$ /1 9 City: L- I:,.�'I. . State: 4/ L Zip: ;7 RI Home it: Contact 4: APPLICANT': r4l , t lie (c v 1,v.Cv , h w,lvl tMailing Address: /1/1 C(K4.,, np & City: L�.,,• - State: 11/C Zip: A 7firy Office x Contact it: *Please hi'out applicantiintmmatipn if different than landowner CONTACT NAME APPLYING IN OFFICE: I[. T* M.z.lie Phone#: Pf " 177' 79ZZ1/ PROPERTY LOCATION: $ubdiXision: Lot#: Lot Size:n t ":CS State Road#: LI ,1I//S(tateee RoadName: WI' I IIC CMnccc Ctih r� /fit 3 I 0r <Maln rB000k&Page: Qd5I rcGii Parcel: ��..tt��3 VtotO "' S °3 PIN: V (J'I t)0 / `Y -2Jc% /0 Zoning: VY ' �-)Flood Zone: 13 Watershed: 1v Deed BookBPage:33C I1 33 Power Company': *New structures with Progress Energy as service provider need to supply premise number from Progress Energy. SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: NsitH n , H.,� '1).1 Tvr4 lef-t c , w./lie (nem m . 1 ) .t. cn Ie 4+' PROPOSED USE: ❑ Multi-Family Dwelling No.Units No.Bedrooms/Unit ❑ Business Sq.Ft. Retail Space Type #Employees: Hours of Operation: ❑ Daycare #Preschoolers #Afterschoolers it Employees Hours of Operation U Industry Sq.Ft. Type it Employees: Hours of Operation: ❑ Church I_W^ SoCapacity Kyit Bathrooms Kitchen Accessory/Addition/Other(Siznv ' Use Play GdCn oC'•['vserY Water Supply: (L) County (_) Well (No.dwellings ) MUST have operable water before final Sewage Supply: (_)New Septic Tank(Complete Checklist) 1 )Existing Septic Tank(Complete Checklist) 1 )County Sewer Comments: Ili /i'eta, -'t1L., S,..r. I .. .tJ4 C.A+e 4L/ 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. .1 fit A � aloin Signature of Owner or Owner's Agent Date "This application expires S 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 LAND USE 5/08 'Each x'salon below must be filled out by Application# whoever is performing the wort. Must 6e Harnett County Central Permitting owner or licensed phonedor. Address,rnPF Box 65 Lillington,3-2793NC 27546 company name 8 phone must match 910-893-7525 Fax 910-893-2793 www.hamett.orglpermits information on state license. COMMERCIAL Application for Bulldino and Trades Permit Owners Name: Harnett County Public Utilities Date: 12/13/17 Site Address: 25 Willie Cameron Rd., Lillington,NC 27546 Phone: 910-893-7575 Directions to job site from Lillington: North on Hwy 421,Turn loft onto Willie Cameron Rd., Site on left Subdivision: None Lot: Description of Proposed Work: Water Booster Pumping Station Heated SF 1225 Unheated SF 0 General Contractor Information: Building Cost$ 170,000 Mizelle Construction Services Inc. 919-279-7933 Building Contractor's Company Name Telephone 1311 Elkhorn Rd., Garner, NC 27529 scoff@mizelleconstruction.com Address Email Address Jar d60575 Signature of Owner onlC tractor/Officer(s)of Corporation License# Electrical Contractor Information: Electrical Cost$ 175,000 Description of Work Water Booster Pumping Station Service Size: 1600 Amps #T-Poles 1 Mizelle Construction Services Inc. 919-279-7933 Electrical Contractor's Company Name Telephone 1311 Elkhorn Rd., Garner, NC 27529 scott@mizelleconstruction.com Address Email Address ,04>47— / 1938W Signature of Owner on/� tractor/Officer(s)of Corporation License# Mechanical Contractor Information: Mechanical Cost$ Description of Work #Units Mechanical Contractors Company Name Telephone Address Email Address Signature of Owner/Contractor/Officer(s)of Corporation License# Plumbing Contractor Information: Plumbing Cost$ Description of Work # Baths Plumbing Contractor's Company Name Telephone Address Email Address Signature of Owner/Contractor/Officer(s)of Corporation License# Insulation Contractor Information Insulation Contractor's Company Name 8 Address Telephone *NOTE: General Contractor must fill out and sign the second page of this application