HomeMy WebLinkAboutcomm land useInitial Application Date:
Application #
COMMERCIAL
COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.harnett.org /permits
LANDOWNER: &il jG 4 /rIJ eA /",a��%� sMailing Addr(eess: 17d ��} /4�6r <` ®4a Q /� !J (�
City: Cameron '� St /ate :��Zip: 28324 Home #: / 9916f7i1 � Contttaact #: 7I7�� ?b( /O�
APPLICANT/:' !�t°�1ne /CYYCrl �j Mailing Address: /ry70 /��C P/ Q�Ja�
City: m'iDi State:/VC Zip: ZO.3Z6 Office #: Contact #: �la /D -Ill/
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*Please fill out applicant information if different than landowner (y) 9 Q �p
CONTACT NAME APPLYING IN OFFICE: Cl Y r 1 P i(k Phone #: 1 / r �/� ® Z U 34
PROPERTY LOCATION: Subdivision: / JJ n Lot #: h 14 Lot Size: ( �
State Road #: 1154 State Road Name: Ma. l ('Y' r � 6/ (� 11-9 p Map Book &Pag2:� /
Parcel:A(k // PIN: 7 %�° //70 , 000
Zoning: R�, °ZIOM Flood Zone:_ Watershed: N/ a Deed Book &Page: / U f (/ 60 2 Power Company *:
*New structures with Progress Energy as service provider need to supply premise number n 16- from Progress Energ &tl!414 l Giv(C�
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PROPOSED USE:
❑ Mul ' Family Dwelling No. Units No. Bedrooms /Unit
Business Sq. Ft. Retail Space ✓' Uf Type it�k�'titE /Q�j,?'tP�'Slrap # Employees: Hours of Operation:? °F$g - ��t,�: Sam -%Z
❑ Daycare # Preschoolers # Afterschoolers # Employees Hours of Operation
❑ Industry Sq. Ft.
❑ Church Seating Capacity
# Bathrooms Kitchen
❑ Accessory /Addition /Other (Size x____J Use
Employees: Hours of Operation:
Water Supply: U County Well (No. dwellings ) MUST have operable water before final
Sewage Supply: ew Septic Tank (Complete Checklist) U Existing Septic Tank (Complete Checklist) (County Sewer
Comments:
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 are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
Sign ture 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