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Initial Application Dace: �
Centt Permittin
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Application9L6,
COUN'T'Y OF HARNETT LAND USE APPLICATION &9 91 �.
E. Fr nt Street, Lillington, NC 27546 Phone: (9I0) 893-4759': (910) 893-2793
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City: (� (1 �t (� C f U/� / State Zip
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APPLICANT: Mailin
City: _ State: tp:
PROPERTY LOCATION: SR #: L.- SR Name: ~
Parcel: � r � / S�1 � — s ' PIN:
Zoning: YJ I
Subdivision:
C'
Flood Plain: ^� Panel: 0 Watershed; Deed Book/Page:
If located with a Watershedindicate the %of Imperious Surface:
SPCII:IC DIRECTIONS TO THE PROPERTY FROM L LLINGTON:
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�(( PlatBook/Page: LQ—Ci:5�f_
If permits are granted I agree to conform to all ordinances and the laws of the State of North Carolina regulating such work and
the specifications or plans submitted. I hereby swear that the foregoing statements are accurate and
orrect to the best of my
knowledge. P, : is/-� ,Li j.rr1l
isg%C�� t & (-)I
Signature of O. neror Owner's Agent Date1/L,
"This application expires 6 months from the initial date, if no permits have been issued-'
A RECORDED SURVEY PLAT AND RECORDED DEED ARE REQUIRED WHEN APPLYING FOR A LAND USE PERMIT
PR POSED USE: L11
Dwelling # Bedrooms #
Sg. Family (Size x of Baths .9, Basement (w/wo bath)
—
Garage �/Deck L--
_�—
❑ Multi -Family Dwelling No. Units No. Bedrooms/Unit
0
�---2
O Manufactured Home (Size,x_ j # of Bedrooms Garage Deck
/; f did '.n-J'`d
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Comments:
`C3_Number of persons per household
G 3usincss Sq. Ft. Retail Space Type
O Industry Sq. Ft. Type
Cft
❑ Home Occupation (Size x__ _) # Rooms Use
O Accessory Building (Size x-----) Use
O Addition to Existing Building (Size x_---) Use
0 Other
Water Supply: C-Lf-&-unty (__.) Well (No. dwellings } (_) Other
Sewage Supply: ( 'New Septic Tank U Existing Septic Tank County Sewer U Other
Erosion & Sedimentation Control Plan Required? YES NO
Structures on this tract of land: Single family dwellings 1 1 )Y w Manufactured homes Other (specify)
Property owner of this tract of land own land that contains a manufactured home w/in five hundred feet (500') of tract listed above? YES NO
Required Property Line Setbacks: Minimum Actual Minimum
Actual
/
Front Rear 7C D
3
Side l l(J� Corner
''—
Nearest Building v
If permits are granted I agree to conform to all ordinances and the laws of the State of North Carolina regulating such work and
the specifications or plans submitted. I hereby swear that the foregoing statements are accurate and
orrect to the best of my
knowledge. P, : is/-� ,Li j.rr1l
isg%C�� t & (-)I
Signature of O. neror Owner's Agent Date1/L,
"This application expires 6 months from the initial date, if no permits have been issued-'
A RECORDED SURVEY PLAT AND RECORDED DEED ARE REQUIRED WHEN APPLYING FOR A LAND USE PERMIT