LAND USE Initial Application Date: I — - /Q � — -: J 1, Application # / P 5-0, 25
ORB CU
COMMERCIAL
COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893 -7525 Fax: (910) 893-2793 /` "L'-"
2793 www.hamett.org /permits
LANDOWNE - : 1 / 4/i / M • / �, f �0 Mailing Address: _ / 9 � t44 , 114
City: / ,/. ' ' / __ / ..� State. f/ *: 7132 // 3 - some #: 7/ Contact #:
APPLICANT': P3 (Crm # I/
1- r r o)? % di /r - ' / a 5 Mailing Address: 6 < 2 , s 6 4ac /J qs -cc
t city: tit hl nsii1 /j' State: NC Zip:" sal? Office #: vet 7..9! /S % Contact #: . - Le . , /
* Please fill out applicant information it different than landowner
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CONTACT NAME APPLYING IN OFFICE: tali) r sot 9 --r> Phone #: 2 4'2 "3 q / 7 " E7 e.? ,
PROPERTY LOCATION: Subdivision: tic t) / kid 1,A") / Lot #: Lol Size: // /7 2, 7 9
State Road #- // State Road Name: //1 / r.� ft yJ /,•` Map Book&Page: ( /
Parcel: l � / Iv7 ,9011 / PIN: ((( ,} ,7 / � 1 ( C� 2 cz <-, ��b
Zoning: 212 Flood Zone: y�`L Watershed: !r'/ `l Deed BookBPage: F Z Z y h wer Compan
New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
PROPOSED USE:
❑ Multi- Family Dwelling No. Units No. Bedrooms/Unit
❑ Business Sq. Ft. Retail Space Type # Employees: Hours of Operation:
❑ Daycare # Preschoolers # Afterschoolers # Employees Hours of Operation
O Industry Sq. FI. Type # Employees: Hours of Operation:
O Church Seating Capacity # Bathrooms Kitchen
❑ Accessory /Addition/Other (Size x ) Use —Chi rrr✓ ` t h y e vl a i-cr1 rer Ce/ / 5,/r
Water Supply: ( ) County ( ) Well (No. dwellings ) MUST h ave operable water before final
Sewage Supplly :: :,h (J New Septic Tank (Complete Checklist) (� Existing Septic Tank (Complete Checklist) ( )County Sewer
Comments: U /? (AA pl� A 0t 1 /t. S� Ae5, g / 1 7 n i t /'/29 i
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.
/� i2 / z 3 .7o/ O
Signet frp'of d w FOwne Agent - _. Date / /
/ "This application expires 6 months from the Initial date It 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 5109