DOCUMENTS Initial Application Dale: Si a2-sI I. O Application# (J SON' `L✓:.50
DRB CU
COMMERCIAL
COUNTY OF HARNETT LAND USE APPUCATION
Central Permitting 108 E. Front Street,Ullington,NC 27546 Phone:(910)893-7525 Fax:(910)893-2793 www.harnetlorg/permits
LANDOWNER: EauttatiOn
/ / 1VC✓✓1 IV/W/tib 0•k'e"ryrt�-oF Mailing Address: PD box' IOa�
City: GIl/,-rP7H,v✓) State:NC Zip:27 Yb Home#: /V/ s Contact it:
APPLICAA.NyT::�/i�IDbi ttte/ Mailing Address:O3 Z113�y-Efht mofl* Jc Alt /to?)
City: A 1 as F1 Ok State:10/7 Zip:3D305 come; 1 i 14v Contact#:
'Please fill out applicant information if different than landowner
I� II '' (� p / AZA �l�J
CONTACT NAME APPLYING IN OFFICE: 44I l Ae/ /7l r-b Phone It: /w11-AM/-0 7.3t
PROPERTY LOCATION: Subdivision: N/A- -}� Lot#: /V/T Lot Size: /VA--
State
v�A .y
State Road#: x1/)9 . StateuRoadoaName: /P fa Ic(1 5T-
p L� Maaapp/,B000kkn&&Pple: /�5/01 /6 37 p
Parcel: pI,1) STV & -7001/ -/005 PIN: 0610— D ! � x "'� 1, W Old Il
Zoning:Rk-ao l Flood Zone:VIVA a erahhed: car 1----Treed Book&Page: 3/D / O. tS Power Company': ✓iA✓\Q'
'New structures with Progress Energy as service provider need to supply i-��premise number - from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM ULUNGTON: DIT F F I t O A 5 / noel,- C mpheJ ) I]
i Fro rrt o f f3tnies Crn k EJesnenMc/ schoo/ ,f/rl
NL-Do-rROIn! Goca.9-ed prn est side o Matti Sr RVW ,
PROPOSED USE:
❑ Multi-Family Dwelling No.Units No.Bedrooms/Unit
❑ Business Sq.Ft.Retail Space Type it Employees: Hours of Operation:
❑ Daycare it Preschoolers #Afterschoolers #Employees Hours of Operation
❑ Industry Sq.Ft. Type #Employees: Hours of Operation:
❑/ Church Seating Capacity #Bathrooms Kitchen 11�� hit
p Accessory/Addition/Other(Size x_)Use 5tMA ) I cel) 1A/Ic2 5 Pok_ oVe#`0.)) #t�1/t 3s
Water Supply: Li County L_) Well (No.dwellings ) MUST have operable water before final
Sewage Supply: ( )New Septic Tank(Complete Checklist) ( )Existing Septic Tank(Complete Checklist) ( )Co
unty Sewer
Comments: smai I C�a)) 1N1 /PLess pole �� I `ICP � ROW,�
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 ars accurate and correct to the best of my knowledge. Permit subject to revocation if fal e information Is provided.
Signature of Owner or Owners Agent Date
"This application expires 6 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 APPLICATOR
Please use Blue or Black Ink ONLY
LAND USE 5/08