LAND USE R Initial Application Date: .E. 1 4 Application# 1(4 SOO. >LFW
DRB# CU#
COMMERCIAL
COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting 108 E. Front Street,Lillington,NC 27546 Phone:(910)893-7525 Fax:(910)893-
( ) ( ) `�:w^ww.harnett.org/permits
LANDOWNER: L//;L A. �GL t l e Mailing Address: 97 ff Jv-f J�j^SpN�` d
City: L'11/4.97110#1 State: _l: ,
C Zip�?f�y� Contact# Email: �� _
APPLICANT*:_ Faye. G(,}f l GOA. Mailing Address: /1/ 5 ei pI c am, 2rf'Y c..
City: a)LA.n n State:ALZip:A Contact#(9 10)5/sV-- FM 73,/Email: r(,u/iSi .Z(g c oI.c04Y1
*Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE: FQ ye, I I C c X Phone# (91O) 5/9- 2775/
PROPERTY LOCATION:Subdivision: /`'�— /_
Lot#: Lot Size:
State Road s# s2 j 31/ State Road Name: Jpt,./ J4G�r,� Rppel Map Book&Page:
Parcel: C o SI PIN:_C — 9-7 - OL-1U 3-c5(K
Zoning's ,FOR Flood Zone: )( Watershed: IV Deed Book&Page: DSJ/ / Q//D Power Company*: Sai f ✓e,'
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: Sc z 4.74/22e3hedi
PROPOSED USE:
❑ Multi-Family Dwelling No.Units: No.Bedrooms/Unit:
❑ Business Sq.Ft. Retail Space: Type: #Employees: Hours of Operation:
yl Daycare #Preschoolers: a 6 #Afterschoolers: /1) #Employees: Hours of Operation:A dr. —' t°�
❑ Industry Sq.Ft: Type: #Employees: Hours of Operation:
❑ Church Seating Capacity: #Bathrooms: Kitchen:
❑ Accessory/Addition/Other(Size x )Use:
Water Supply: SV.County Existing Well New Well(#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: 21 t^% 1 LI) I1 CI -aC'I y
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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 submi -.4
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. 111/
A2 & SCUIleAt 5..
Signature of Owner or Owner's Agent D to
**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
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