comm. land useInitial �, ,cation Date: �J I �—+ it' C � � n 0 Application# `r C_�✓
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COMMERCI L
COUNTY OF HARNETT LAND USE APKICATION
Central Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.harnett.org /permits
LANDOWNER: Jl JJ�� Mailing Address:)) � C L –z
City: � U ! State: ocontact # ' 4LZ Zq I Email:
C1 P -75-3 DEC 4Z W
APPLICANT*: J '� C� Mailing Address: �7 /p /
City: L" ��(. State: /V�xZip:2EIClontact #c'iQ F-2Z Iro Email:
*Please fill out a lic nt i formation if ifferent than landowner ,f
CONTACT NAME APPLYING IN OFFICE: �# l U Q ��'( �.0 Phone #010472-70q/
PROPERTY LOCATION: Subdivision: t C ` -`�`' `J Lot # I nt -gi7P'
State Road # State Road Name: / 1 V % Map Book &Page:
Parcel: _ CIL& C C �0I PIN: C �j IF 2
Zoning �lood Zone:_ Watershed: Deed Book &Page`i- 2 / / 612-5 Power Company *.
*New structures with Progress Energy as service provider need to supply premise number
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
PROPOSED USE:
• Multi - Family Dwelling No. Units:
• Business Sq. Ft. Retail Space:
• Daycare # Preschoolers:
_ No. Bedrooms /Unit:
Type:_
# Afterschoolers:
❑ Industry Sq. Ft: Type:
❑ Church Seating Capacity: # Ba
M Accessory /Addition /Other (Size JLx3 Use:
from Progress Energy.
# Employees: Hours of Operation:
# Employees: Hours of Operation:
# Employees: Hours of Operation:
Water Supply: County Existing Well New Well/t# of dwellings using well ) *MUST have operable water before final
Sewage Supply: New Septic Tank (Complete Checklist) � 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.
Signature of Owner or Owner's Agent
Date
* *This application expires 6 months from the initial date if permits have not been issued **
A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION
Commercial Land Use Application Page 1 of 1 08/10