HomeMy WebLinkAboutcommercial landuseInitial Application
Central Permitting
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APPLICANT *:
City:
*Please fill ou applicant
Application #
107.1.3
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CONTACT NAME APPLYING IN OFFICE: Phone #:
PROPERTY LOCATION: Subdivision: (� Lot #: Lot Size:
State Road #:tL t� State Road Name: 0-6k V (� i�� �i'_ ��.(, I Map Bfo�ok &Pa��g(e:
Parcel: PIN:'
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Zoning: Flood Zone: A G Watershed: A Q Deed Book &Page: / Power Company *: f T
*New structures with Progress Energy as service provider need to supply premise number from
A J9/n/ from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: `(,V t ! JV Ail e
PROPOSED USE:
❑ Multi - Family Dwelling No. Units No. Bedrooms /Unit
❑ Business Sq. Ft. Retail Space Type # Employees: Hours of Operation:
❑ Daycare # Preschoolers # Afterschoolers # Employees Hours of Operation
❑ Industry Sq. Ft. Type # Employees: Hours of Operation:
❑ Church Seating Capacity # Bathrooms Kitchen!!
Q--"Accessory/Addition/Other (Size Use L -el
Water Supply: (_) County (_) Well (No. dwellings ) MUST have operable water before final
Sewage Supply: (_) New Septic Tank (Complete Check list) (_) Existing Septic Tank (Complete Check list) (__)County Sewer
Comments: A-C #-c QV4 (th-
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If permits granted I agree t onform to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I here tate that foregoi teme re accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
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1!iggg�.at.ire of Owner or Owner's 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 APPLICATION
Please use Blue or Black Ink ONLY
LAND USE 5/08