LAND USE RR / / /////// -/// CAP L t . ' /{ new (g.n d c, �p ci caruoq I . //�� f % (/�� I //
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A pplication # ^� ' 1 /�• \^ I I `
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IU COMMERCIAL
-I} TY OF HARNETT LAND USE APPLICATION
Central Permitting 108 E. Front StrL+'et, Lil I ton, 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.harnett.org /permits
LANDOWNER: SC ditto ., .0 kick F1
vi h nk Mailing Address: T 1I) • ZnY (i 5C t-..r II tin v1 MC, 7S tt
City: Lit lthtt state: t•--IC Zip:/09f b contact# 410 P.S7 Email: CCSCFre anl.Crawt
APPLICANT': S CbWne • V 0.H( -( br, Mailing Address: V, C \- NV . S C ( 1 1 1 1InAi-ay+ Al C. Das
fi J
City: 4-I( l ), State:LIS',_ Zip: 2-')S tIbContact# RI0 Email: sr rot r 04 ti a n1. rpt. -,
'Please NI out a nt information if different than landowner 1 /!
CONTACT NAME APPLYING IN OFFICE: ` )C6* \
, 0 I Gv1Nnn IA . Phone # 1 10 - X S7 — 11 rid., � )
PROPERTY LOCATION: Subdivision: �-1 �� / ' Lot #: Lot Size: 3 • Z.7 f I `J
State Road # 1I-2 III State Road Name: 1 �- 1 VV� 42 1 Rid- ) Ma l p Book&Page: /
Parcel: J 0 (40 / . l / 1 O / V / PIN: �' I VY / ` 1 r .. L2 . �-1 r�1 4
Zoning: ill E! Zone: \ Watershed: . V Deed Book &Page: -I 1 I Power Company':
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTION TO THE PROPERTY FROM LILLINGTON:
PROPOSED USE:
❑ ulti- Family Dwelling No. Units: ,y No. Bed ooms/Unit: 11 _(—�,PM
0
Sq. Ft. Retail Space: J 1 l A A y� /Type: (Pi il tM # Employees: 2Q) Hours of Operation: I 1-4 —1
❑ Daycare # Preschoolers: # Afterschoolers: # Employees: Hours of Operation:
O Industry Sq. Ft: Type: # Employees: Hours of Operation:
O Church Seating Capacity: # Bathrooms: Kitchen:
❑ Accessory /Additi n /Other (Size _x_) Use:
Water Supply: 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:
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Sliair A a1 QT/T fi JW .I
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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 submitted.
I hereby state that foregoi g statements are accura e and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
"WI
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