LAND USE R y /— /1 P I-
SCANNED Initial Application Date i DATE - Application # J 9 ✓ ° " 2 2 9 Si
cu #
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E Front Street Lillington NC 27546 Phone (910) 893 7525 Fax (910) 893 2793 www hamett org /penults
LANDOWNER CTfl/ -rl n 6 CA`l /rL/Cr Mailing Address .23 1 r r...€1 1.._ I di
City / /11,0 I ✓t State / . Zip 244?-37 y (91(2) (o 90 — ?6 5
-r— �� L , Home # Contact #
APPLICANT* ?4-7 CAC - 1 . 6.-Cr'1-) , Mailing Address / 0t53 i%' , c k n-,, 1 / RD
city th9-T5 State MZIp c2753.I Home # ( 9,) w9? ( Isar) Contact # ( /o) `I P y-c0 p8
Pleas III t eppl cant 1 m tia I d fl re t th I downer {
CONTACT NAME APPLYING IN OFFICE I ern-ACC ICJ Phone # ( g I of / Q (7 JI L/ -co 3? 2
PROPERTY LOCATION Subdivision w /phase or section /)1I'/ r ! � W(9OT) Lot # / / Lot Acreage (o `r
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State Roadd �1 p � State Ro ad d / / Na m e 1 ,% L! N )4 p ��
. Page 7 7 / / 75
Parcel J as of 1 4 oc ! // PIN ✓r e�� -- / �� — q`
Zoning o 7A_ P Flood Zone a/ Watershed 4///4. Deed Book &Page /66'9 1 6G Power Company
New homes with Progress Energy as service provider need to supply premise number from Progress Energy
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON
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PROPOSED USE Circle
❑ SFD (Size x ) # Bedrooms_ # Baths_ Basement (w /wo bath) Garage Deck Crawl Space / Slab
(Is the bonus room finished/ w/ a closet if so add in with # bedrooms)
❑ Mod (Size x ) # Bedrooms_ # Baths_ Basement (w /wo bath) Garage Site Built Deck ON Frame / OFF
(Is the second floor finished/ Any other site built additions? )
❑ Manufactured Home SW OW TW (Sizex ) # Bedrooms Garage (site built/ ) Deck (site built? )
❑ Duplex (Sizex ) No Buildings No Bedrooms/Unit
t ❑ / Home Occupation # Rooms / its° / / Hours of Operation #Employees
Addition/Accessory/Other (Size I x Use f _ /7/'J coal Closets In addition( Wes tAno
Water Supply ( County (_) Well (No dwellings ) MU T p ave operable water before final
Sewage Supply ( ) New Septic Tank (Complete Checklist) litl Existing Septic Tank (Complete Checklist) ( )County Sewer
Property owner of this tract of land own land that contains a manufactured home Win five hundred feet (500) of tract listed a ve (DYES (
Structures (existing & proposed) Stick Built/Modular r Manufactured Homes Other (speafy) i /Vj' ,is/ T ( (/t
Required Residential Properly Line Setbacks Comments
[ � 1
Front Minimum ' ✓ Actual / "! _ I 0 �1 � s% • ' / , • - s oc J r / a t /
7
Rear 2 tr _ •• . . '
/ a r .. wrn
Closest Side /I 19 1 1 -, 1/ r ,- ;i ( /� r 7 9 V
Sidestreet/comer lot _
Nearest Building
on same lot
If permits are granted I agree to conform to all ordlnances and laws of the State of North Carolina regulating such work and the specifications of plans submitted
I hereby s e that foregoing statements are accurate and correct to the best of my knowledge Permit subject to revocation if false information is provided
Ignature of Owner or Owner s Agent Date
This application expires 8 months from the initial date It 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
Initial Appl cat on Date 13 0111 Appl t o #
Cuff
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E Front Street Lillington NC 27546 Phone (910) 893 7525 ext 2 Fax (910) 893 2793 www harnett org/permits
A RECORDED SURVEY MAP RECORDED DEED (OR OFFER TO PURCHASE) 8 SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION
LANDOWNER Tarr �1�
n ne 1,0e,� Ma l ng Add s �3 (Jr ee� qvrf �.n e - e.
\
C J !Lkn n // C Slat IV� Zp tact No Email
1-h.' r� [Email
APPLICANT & pl /D) Pools «S Wei- Malting Address 129 US tovy " £
City (Oa{r�ff State it 2-7
Zip. gContact No g(9 77q qa o Erna l & V 0,4-0 f'1/!('vo/ CU's
PI fil t ppl t f mt f d ff i th 1 d w /9 LJ h 1
CONTACT NAME APPLYING IN OFFICE \�ell((j Yh Phone # 9!9 7 // 79 99Y3b
PROPERTY LOCATION Subd son Thy d" PNTD7)/,� L t # A Lot S ze
Slat Road # State Ro d Nam M p 6 k 8 P ge !
Parcel PIN
Zoning Flood Zone Watershed Deed Book & Page ! Powe Company
New st ct es wth Progress Energy se p o der need to supply premise number from Progress Ene gy
PROPOSED USE
M I th
❑ SFD (S e x ) # Bedrooms it Baths _ Basement(w /wo bath) G age Deck _ Crawl Space _ Slab Slab
(Is the bo us om fn shed? (_) yes (_) no w/ a 1 s t? ( ) yes ( ) no (if yes add n w th it bedrooms)
❑ Mod (Si e x ) # Bedrooms Baths Basement (w/wo b th) Garage Site Built Deck On Frame_ Off Frame_
(Is the second floo f n shed? ( ) yes ( ) no Any oche s te built additions? (_) yes (_J o
❑ Manufactu ed Home SW DW TW (S e ) # Bedrooms Garage (site built ?_) Deck _(s te b 11? )
❑ Duplex (Size ) No Build ngs No Bedrooms Pe Un t
❑ Horne 0 c pat on # Rooms Use ,t Ho rs of Ope at o #Employees
Adddio /Accessory/Other (S )(p 34) Use 1 h (7Y0 /A nil (pool Closet add tion? ( ) yes(X) no
Water Supply X C ty Existing W 11 New Well (# of dw !1 g s ng well ) Must h operable water before final
Sewage Supply New Septic Tank (Comp( te Checklist) /` E sti g Sept c Tank (Complete Check! st) Co my Sewer
Does wner of this tract of I d wn land that contai s man factured home w thin f h dred feet (500) of tract I sted b e ( ) yes ( no
Does the p party conta n any easeme is whether unde g ou d h d ( yes (
St u t es (existing o p op d) S ngle family dwell g Ma of t d Homes Oth (spec fy)
Req d R de t al 1 I t L S tb I Comments
Front MI m m A t 1 6
Rear
Closest S de �l
S destreeticor lot
Nearest B Id ng
same lot
of A o �s
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON
if permits are granted I agree to confo o all o d n es and laws of the State of North Carol na regulating such work and the specifications of pla s subm tted
I he eby state that forego tatement re accur ie and correct t the best f my kn wl dge Permit su ect revocation if false information is provided
3 ( 1
n ture of caner or Ow er's Ag t ggate
It is the owner /applicants responsibility to pro d th county w th any applicable information about the s bl ct property including but not limited
to boundary f mation house location uncle g nd or o erhead easements etc The cou ty o is employees are not responsible for any
r ct or missing information that s onta ned w thin these applications
Th s appl cation expires 6 months from the t I date f permits have not been issued
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