LAND USE R Initial Application Dateri-21-12be- Application# I Cr;\)L-I'--S 4 [v
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CR
-S c)-3 I v COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Peon tting 108 E.Front
Street,Lillington,NC 27568 Phone:(910)893-7525 ext:2 Fax:(910)(8�9 P3 ■y;- - its
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)B SITE PLAN ARE REQUIRED WHEN SUBRI1nX?A �!I
LANDOWNERLEW IS \A mi.IJAt t4L�S\A WI\ll43ns Mailing Address: 35 CALL LA,J�;gat �#4,-,s+s_+s-Jc 111111
City: State.NC Zipf +-40 Contactct/N'o:/ EmaiIdeCO14nOV 4Ww.l ij„1
APPLI NT': I - -- I Mailing Address 36 Glu- p�/��s�Kti Viiczt k Fl���1❑///���vista,
City: l._a,a NRs : , State:NIC Zips-11 Contact No: LIR * 119 153- Emmail:L.l2L(JTQULN'kjIRn00,(_ONn
'Please Oil out appli a nt information if different than laa_rdox1ner ,,I c (] (�J
CONTACT NAME APPLYING IN OFFICE: l-EAJI c. VYII II J Phone# „91 I 39- I5;3
GALL UNE uA9 Vibizio ,1 INC- Lot CL c
PROPERTY LOCATION:Subdivision:35 Lot p: Lot Sae'
State Road# State Road Name' ) ILOLi I I . Map Book 8 Page: .I
Parcelyn/n� �¢h '0V, "\t/J • 1 )v/� \-� PIN: / • _
Zoning:A T h✓nA Flood Zone: X Watershed: I V/1Deed Book 8 Peg:: - -ICt V I "ower Company': _
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
Monolithic
❑ SFD:(Size x )#Bedrooms:_it Bats:_Basement(w/wo bath): Garage._Deck:_Crawl Space:_Slab:_Slab:_
(Is the bonus room finished?(_)yes (_)no w/a closet?( )yes (_)no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms_#Baths_Basement(wtwo bath)_Garage:_Site Built Deck: On Frame Off Frame_
(Is the second floor finished?(_)yes ( )no Any other site built additions?(___)yes (_)no
❑ Manufactured Home:_SW_DW TW(Size x )#Bedrooms:_Garage: (site built?_)Deck: (site built? )
❑ Duplex:(Size x )No.Buildings: No.Bedrooms Per Unit.
❑ Home Occupation:#Rooms: Use: / Hours of pen: #Employees: `I
VAddition/AccessorylOthel:(Size 1 Use: 2-C'K `"( I JC tt t/` Closets in addition?( )vas (yyJ no
Water Supply: V County _Existing Well New Well(It of dwellings using well )'Must have operable water before final
Sewage Supplyll
New Septic Tank(Complete Checklist) V Existing Septic Tank(Complete Checklist) County Sewer ,/
Does owner of this tract of land,own land that contains a manufactured home within five hundred feet(500')of tract listed above?(_)yes (sno
Does the property contain any easements whether underground or overhead(_)yes ( )no pH�y�
Structures(existing or proposed):Single family dwellings: I Manufactured Homes: Other(specify): 4Zifb6i
Required Residential Property Line Setbacks: Comments:
Front Minimum v.' J Actual C •
•t SL�, \-{�—
Rear 2`-) a Q-S
Closest Side �I/ 1 A I 0
Sidestreeticorner lot /. .
Nearest Building ' 20+
on same lot
Residential Land Use Application Page 1 of 2 03/11
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 1"Iw 4o1 SE14To Ci4Q.15TjA1 "4E441 Kd.J
IAA4a kms.-'P-AJc- Appao,. Lo t 'les . Mek aGth- 1DTL& otJ 10 P(LL. UtJE
If permits are gran 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 tha regoing statements are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
I�—�.» WINJ wr�ww
Signature of Owner orOwner's Agent Dato
"'It 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 been issued"
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Residential Land Use Application Page 2 of 2 03/11
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