LAND USEInitial Application Date: 11 - ?/ ' I I
Application #I I - -I C f` 15 5
DRB CU
COMMERCIAL
COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 693 -7525 Fax: (910) 893 -2793 www.hameti.org/permhs
LANDOWNER: V W t Ve S-(' (icing Address: 10 bOl �ell��il.x(111 A �P,
City: v � ICS. >>Md. l 1.1 rl State: -tZip: ! Zo Home #: 600 — 3 �6- 0 3 contact #:
r
APPLICANT': �` J�CiY1t rc� 0�1� C S Mailing Address: , V ROQf Ail, (I'S )� OrA d
cly: -�Ca�t e }{-� y 4 �e state: 41 1130 —Office #: C(0_323 31 ! ,s Contact #: �flcoYl �j 10 L33t1 S
'Please tip out cant informallon if d�terent than landowner
CONTACT NAME APPLYING IN OFFICE: F n - hone #: O --?o F
PROPERTY LOCATION: Subdivision: l k ot #: _.Lot Size:
State Road ( #': State Road Name: 4 � _ S CS � A Q Map Book&Page:
Parcel: ` q__7 PIN: I� I� ' �-'i2—
Zoning: Flood Zane:_ Watershed: /U t� / Deed Book&Page:7W4 / C�
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
PROPOSED USE:
• Mulli- 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. Fl. Type # Employees: Hours of Operation:
• Church Sealing Capacity # Bathrooms Kitchen
• Accessory/Additlo her ize x,,," 1 Use p 1� - �1� C ciNC4—
Water Supply: (J County (J Well (No. dwellings _� MUST have operable water before final
Sewage Supply: U New Septic Tank (Complete Now Tank Checklists ("__) Existing Septic Tank (J County Sewer
Comments: 4h, S t S n _ _ c�c-2f �- Q a S-- f� �..� q� t� Z I , K �
If permits are granted 1 agree to conform to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitt
I he by state that foregoing statements are accurate and correct to the best of my knowledge. Permit subject to revocation H false information is provided.
Z7,
SI nature 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 4108
z
0
t
I
t
p
v v
\�•\
��
�� ��
}§
�
�
f/ }\ /\
:I7
\
\\
\\\
\� \�
t
I
t
p
v v
\�•\
/
�
�
\
.
�
\
�
(
t
I
t
p
v v
\�•\
/
�
�
\
.
t
I
t
p
v v
\�•\