LAN USE R ei CINN p
Initial Apptimtion Det . # ► 1 sl�0`"FaW� �R
3 II -- ) ^' L�� CU#
W ' 4W of ETT RESIDENTIAL LAND USE APPLICA7WN
Central Permitting 1 E.Front Sbset,LRi 27518 Phew:(910)895-7525 ext2 Far(910)8912793 www.hwMLo9/penYas
"A RECORDED SURYEII MAP.RECORDEDDEED OR( FER TO PURCHASE)L SITE RAN ARE REQUIRED WHEN SUBMFTING A LAND USE APPLICATION"
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LANDOWNER:Gledbel Gof eZ '. I MaAag Address;178 Lee county line b
275D5
Cly: brOBdway State,':nc
2irf Contact No: 325282-7689
Email:
ucµr:Clyde Patfo ng x:4271 Leaflet ch rd
CityBroadway :NC y 427505 Contact No:919-258-5538 Email:
*Passenu out applrant a afferent den laiden w
CONTACT NAME APPLYI"w'IAITI IN OFFICE Glarbel❑onZ4ler ' #325-262-7889
phone
LOCATION:PROPERTLOCATION:Suk�Meion: !I Lot#: Lot Slee: IJ.a a
State Road# "-- i I Stale Road None: ipso 344 — ei-7 Map Book&Page: 1/T"fiS
Parcel: b-L(� CisuCo b14o TT1 I PIN: Gs-►lo .- "
)3 —StoEric •du
Zonin� l Tore, ' E... Water}twd: J Deed Book S Page: tP Power Company':
'New sboAres with Progress Energy as sender/provider riled to supply Premise number from Progress Energy.
PROPOSED USE: '
Monolithic
❑ SFD:(Size_x Y#Bed : !#Be Basement(wMo bath):_Garage:_Deck:_Cmwl Space:_Slab:_Slab:_
(Is the bon room finis yes (i no w/a decal?LJ yes LJ no(if yes add In wan#bedrooms)
I
U Mod:(Size x I y#Bed _g�d1.# a Basement(wMo bath)_Garage:_Site Built Deck:_ On Frame_OB Frame_
(Is the l ' 1 ?L)yes U no My other site built additions?(_ )yes (A no
O Manufactured Home:_OW_D _TW(Size 14 x70 )#Bedrooms:2 Garage: (site built? )Dodo (she built? )
❑ Duplex:(Size x I I )No.Buildings: 'I �'' No.Bedrooms Per Unit:
U Hone Occupation:#
Hulas
Usk Hours of Operation: #Employees:_
I i
o AdditioSAaessory/Other;(Sae x_)LIW: 1 Closets N addition?(J yes U no
Water Supply: ✓ Count)I � Ex. .rg Well New Well(#of dwenngs using well )*Nust have operable water before Mal
Sewage Supply ✓ New R6ptic Tank( Existing Septic Tank(Compote ChecMaf) County Sewer
Does owner of this tract of FII own and tat tui dlx
ntain a rr$nufaed home within five hundred feet(500')of tract listed above?LA yes ( )no
r
Does the properly contain 04 Msemena whetter underground or overhead U yes (J no I
ify):
Structures(existing or propoey):Singo family dwelli+s: Manufactured Homes: I 9fl? r(spec
I SL. -rk
Required Residential Property Line Se(becl®: Comments: M Y•?Q,,... 1^\C\,^
Front Minimum_ '. Actual II ,C-- Q_AJ1�1 I.• I Wko r LA A
Rear
Closest Side � l� .. h ¢
Sidesteetconer lot '
Nearest Building isi
on same lot j
RanocAtial paid Use Appllc mon F Page 1 of? 03/11
PLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO FRE PROPS 1r FROM 11LL ROTOR:
from lillington take 27 hwy go approx 15 miles turn right on 2427 hwy
appmx 6 miles pass water tank pmpe is Ito the tight
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If permits are granted I agree I< conform b al ordinances�a_}nxd�._lad_ws of the State of North Carcina regulating such work and the specifications of plans submitted.
I healthy stab that f. :. r. . are -As- nd+red to i,best of my knowledge. Permit subject b revocation If false Information b provided.
•fr.r i, , . • S d aoi�
Signata4 . •.,., ao4rar'a Marry Date
I Q
gb the ownM IWMy to peovEsou county with sayapplicablelnfonueon abona She subpar properly, but not bitted
to:boundary I house ionti ..ummdaryround or overhead easamorb,etc.The courtly or M employees cos not responsible for my
Inamct or missing Informalbn that Is contained within these applications•••
"'This application a�M B months from IM MEM data g permits haveIssuer
been a
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GRAPHIC SCALE 1"-200'
0 200 400 600