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LAND USE Initial Application Date: / — i 2 — I/ Application # ! 5 25 D 74 COUNTY OF HARNETT DEMOLITION APPLICATION 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893 -7525 Fax:(910) 893 -2793 www.harnettorg/permits Land Owner: ( yet/ 0 44e— Sao-'/ / 76 Mailing Address: / S ? 7 inf17o 2.n- City: y G £c2 Stater/ N - CZip:R3 : Home #:-S #:-S 9)/ 7 Contact #: APPLICANT *: TL>A(4 /tlt' /j/e r E- Mailing Address: / X"/ Svr2/ J C 2 � 1 A City: 3v rYr/ ltO ' [ State/v`Zip: r2K,3' #Y2 / 23/9 Contact #: *Please fill out applicant information if different than landowner CONTACT NAME APPLYING IN OFFICE; Phone #: PROPERTY LOCATION: Subdivision: Lot Acreage: / 7 � 5 State Road #: State Road Name: �f Parcel: / 2 0 57, 0 t— 1 23 PIN: �! ^ 2 i8 �d Zo ing: /fHZ loos Zone: SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: AWL / Structure(s) to be demolished & removed: Single family dwelling Manufactured Home ✓ Other (specify) Structures (existing and /or proposed): Single family dwellings f Manufactured Homes v Other (specify) Water Supply: (_) County ( Misting Well Sewage Supply: (r) Septic Tank (_) County Sewer * If a new structure is to be replaced on this lot, please ensure that existing septic system is not damaged. * If an existing well is on site and is to be discontinued, please contact Harnett County Environmental Health for assistance. *upon the issuance of the Certificate of Compliance, the Harnett County Tax Department shall be notified of the removal to ensure proper listing. *The demolition contractor is responsible for submitting verification of proper disposal prior to the Final inspection. * *PLEASE NOTE* *Failure to completely demolish, remove, and clear the premises will result in the withholding of the Certificate of Compliance. Thus, future permits for the property will be denied, and fines may be imposed for failure to complete demolition/ removal. 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 s to that foregoing statements are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided. Sig ture of Owner or Owner's Agent Date * *This application expires 6 months from the initial date if no perrnits have been issued ** S:1Planning and Inspections Files\FORMSICP Forms Print - Maps Page 1 of 2 Bing Maps My Notes rtr 108 E Front St, Lillington, NC 27546 -6683 (Directions to approximate location.) 784 Surles McLean Rd, Bunnlevel, NC 28323 Route: 10.6 mi, 22 min FREE! Use Bing 411 to find movies, Irfj businesses & more: 800 - 411 108E Front St, Lillington, NC 27546 -6683 A —B: 10M mi 22 min - - 1. Depart E Front St toward 2nd St / S 2nd St < 0.1 mi r 2. Turn right onto 2nd St I S 2nd St <0.1 mi 4 3. Turn right onto E Ivey St 0.2 mi 4. Turn left onto US -401 - / SR-27 / SR -210 / S Main St mm 6.3 mi 1E Pass KANGAROO in 0.4 mi 5. Turn right onto McNeill Hobbs Rd 0.2 mi 6. Turn left onto Wire Rd 2.3 mi 7. Bear right onto Nutgrass Rd 0.9 mi 0 8. Bear right onto Wh McLean Ln 0.1 mi 4 9. Turn right onto Surles McLean Rd 0.5 mi • Arrive at 784 Surles McLean Rd, Bunnlevel, NC 28323 on the right The last intersection is Wh McLean Ln <0.1 mi These directions are subject to the Microsoft®: Service Agreement and for informational purposes only. No guarantee is made regarding their completeness or accuracy. Construction projects, traffic, or other events may cause actual conditions to differ from these results. Map and traffic data © 2010 NAVTEQTM. http : / /www.bing.com/maps /print.aspx? mkt= en- us &z= 12 &s =r &cp= 35.344170,- 78.803405... 1/12/2011