LAND USE / — / IG Application # /( Fa 23 90/
Initial Application Date: � PP
DRB # CU #
COMMERCIAL
COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting 108 E. Front Street. Lillinglon, NC 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.harnett.orglpermits
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LANDOWNER: /1/19 L.JI Y/rf� ,(��" #_ Mailing G Address: �A /�i?' 4/7 city:S 4/ Sttate: ZipWild2'Contact# z9-4.f �`.S /j/ Email:
APPLICANT *:j4i //" -" / //Un Ciztd 1 /e4 -rtnr Mailing Address: PV, X/JY 72 - Z
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City'C p - /✓�'q+� La Pr statewz- zip79.350 Contact # y/d- 4 3L' -31 / Email: //z fl CM r t- --- • ingi La
'Pleas fill out aV$eant information if different than landown !
CONTACT NAME APPLYING IN OFFICE :Ai1//7i / /7)/ Eli7n if'. Phone # 971
PROPERTY LOCATION: Subdivision: a.{ /A 4 /7 s -r ,..4 / Lin r 5 Pr de Lot #: 2 Lot Size: 7, a r Ale_
State Road # _f/ ,1) State Road Name: _ 247.-i r / // n c t'e7r Map Book&Page2 DOW / 7 7 Z
Parcel: / fit l 3 , r/ PIN: C/; 5 f ✓ 4f, -^• ..ore)
ZoningQv,l tit Flood Zone: - Watershed: `V/ Deed Book &Pager ‘t f / 3 i Power Company` X77/- /7/
New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
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SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: /G it/r /, 'I-4.x a 6/7 gr 2 ! n 6 61 ` /S 7¢''./
PROPOSED USE:
❑ Multi - Family Dwelling No. Units: No. Bedrooms /Unit:
❑ Business Sq. Ft. Retail Space: Type: # Employees: Hours of Operation:
❑ Daycare # Preschoolers: # Aflerschoolers: # Employees: Hours of Operation:
❑ Industry Sq. Ft: Type: # Employees: Hours of Operation:
I:! Church Seating Capacity: # Bathrooms: Kitchen:
Of Accessory /Add" Other (Size 219_,x Aft) Use: j7.48 74 Q Fr
Water Supply: x 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
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Comments: �� - a 1 e c^
11 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.
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1- / ��f'" SL c 3
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
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