LAND USE RR Initial AppliWfioo Date: 2yI
cuNTY. .FFt ARi ETT RESIDENTIAL LAND USE APPLICATION 11 5-(014 titer?
Permitting 108 E.Front Lillington,NC 27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.hamettorg/permits
ffigt "A RECORDED SURVEY MAP,RECORD�Ey DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USI A ,
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v{OW : /n/// x // MailingAddress: 4 i4 73 '`��_
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city—LA/iv sstttaate,/i/C zip:,2g{56-contact No: 9/0 163-65/6Emaie r�oAeveee/(4AvL r•`v ff rC""
APPLICANT': `U/fir`i (SSI /!1/ -L/�� Mailing Address: ���r 1<it i &
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Ciry:�NN/✓ 1We:fe- Zip}kij 'Contact No: 9/0 " /3-/.5/ ) Email: T/S144emso.vlc1AJegi s?rn/ ,rc+..,
'Please fill out applicant information if different than landowner !!�� J J
CONTACT NAME APPLYING IN OFFICE:\ b NN/✓C 6 /P /lfi+v"�LN Phone# 7jC/ --,T Wj 63/U
Ci� 71 Ai >SS-311C Pa Lot 3 V
PROPERTY LOCATION:Subdivision: 0 Lot Size: -6 r /3Zns
7�
State Road/� # State Roos me:(,'/tA4N LL✓- �`,,ny Q� p (J Map Book&Pagee00 `r 1 a
Parcel: 1000o i D. ON-) ( T� PINI7(Uoh2O - U 1- (1 O ( 0 (JY v
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Zoning: k iO Flood Zone. /� Watershed: Nl) Deed Book&Page: 26( > OS I Power Company'.
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
2 Monolithic
❑ SFD:(Size Ltx ` -4 )#Bedrooms'.,) #BathsfJ—Basement(w,Iwo bath): Garage: Deck: /Crawl Space:V Slab: Slab:
(Is the bonus room finished?( )yes (JI no w/a closet?( )yes (_)no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms #Baths_Basement(w/wo 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 Operation: #Employees:
❑ Addition/Accessory/Other:(Size x )Use: Closets in addition?( )yes (_)no
Water Supply: Countyou 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
Does owner of this tract of land,own land that contains a manufactured home within five hundred feet(500)of tract listed above?( )yes ( t PIET--
Does the property contain any easements whether underground or overhead(_)yes ( no
Structures(existing or proposed):Single family dwellings: ManufacturedlHomes':� C �, �,Other(specify). �t� I
Required Residential Property Line Setbacks: �( Comments:
_1 nCN \CY `q_ l d S_tt Ca-C LS O �I/d�p/�
Front Minimum 2e Actual 166 CA`I`( � r/c''V 1pV�t uJ ct 9 TV 3I� rV t r I •
Rear .2� -231? -70,L1 ;/ J3/ 1 '1 - LU L 1
Closest Side /C - -4 .Y . I O .5 (in ..4-int L -P- SLti-,.
Sidestreeticorner lot 4�113118 - Itof.c- p r GH fi �� l
e
'/,/
Nearest Building _,AjN4 t 3 IAI — Uw� 'l r,. 0 1 t 'a1
on same lot 1 ����y�_
Residential Land Use Application Page 1 of 2 SC
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APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:�� P4✓t , - N -C, f'd5/" !N
Y1/ Jen/ / 7/ Gi✓/d/' O/J e Y G t I3, k7i / /p SS ddY✓
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If permits are granted I agree conform ttII d dinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing laments .:- .,/urate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
F /271)
Signatur •f Owner or Owner's Agent Date
•"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 ere 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"
•
Residential Land Use Application Page 2 of 2 03/11
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