LAND USE R G -G�!
Initial Application Data: / Application #11 5 2 �.
COUNTY OF HARNETTRESIDENTIAL LAND USE APPLICATION CU*
Central Permitting !' 108 E. Front Street, Lillington, NC 27548 Phone: (910) 893.7525 Fax; (910) 893.2793 www.hamett.org/perrnits
LANDOWNER: LJ; n Y1 I R n vn Mailing Address: A? Q Reify' Om Y. pr.
City: . c/ fl rr l State:_,(YCzip:.2 737(kontad # (cf /CI 2 ) — 4Q4 A Email: a n�I trrA n-1 o 73 ac (24 0 Ct
APPLICANT': V fr.fty Mailing Address:
City: State: Zip: Contact* Email:
'Please fill out applicant information if different than , V \ landowner -
CONTACT NAME APPLYING IN OFFICE: 01 ✓l - Th e &A. Yl Phone (41 q 72 1-66 - 4 ,
PROPERTY LOCATION: Subdivision: N/) r f 2 () (au >� 1 - c) A t t n t #: 3 7 _ Lot Size; 2 2 cj A C
State Road # ,.Z I () State Road Name: /VT) Y 4i 2/0 �: t /0 ✓ tI k Any .z ,) Map Book &Page: AVOW 3 is C) 36q
Parcel: q 2 O 'n 6 _0O -f 4 — 6q PIN: ✓hi(, 3 ) - / gD - g07? &Dv
Zoning: fllf /o Flood Zone: / Watershed: /U /'+Deed Book &Page: 2 2z 2 / , /G Power Company;
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM ULLINGTON:
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- the 1 r Y' + ilr Yf A T `"`x PYr; pP - r'1 - j fin 1 -?0
PROPOSED USE:
Monolithic
❑ SFD: (Size 61 - x `3 # Bedrooms: , # Baths: BasemeM(wlwo bath) Garage: Dedc 4 Crawl Space: Slab:_ Slab:_
(Is the bonus room finished? (__) yes (Zno w/ a closet? ( yes ( )no (it yes add in with # bedrooms)
❑ Mod: (Size x 1* Bedrooms *Baths Basement (whvo bath) Garage: Site Built Dedc On Frame Off Frame
(Is the second floor finished? (i yes (jno Any other site built additions? (_._) yes (__)no
❑ Manufactured Home: SW DW 7W (Size x ) # Bedrooms: Garage: (site built?___) Deck: (site buiit?_J
❑ Duplex: (Size x ) No. Buildings: No. Bedrooms Per Unit:
❑ Home Occupation: # Rooms: Use: Hours of Operation: *Employees:
❑ Addition/Accessory/Other. (Size x ) Use: Closets in addition? ( ) yes Lino
Water Supply: Y County A/Fxisting Well _ New Well (# of dwellings using wail ) 'MUST have operable water before final
Sewage Supply: V New Septic Tank (Complete Cheddlst _ Existing Septic Tank (Complete Checklist _ County Sewer
Does owner of this tract of land, own land that contains a manufactured home within five hundred feet (500') of tract listed above? (J yes (__)no
SWdurea (existing or proposed): Single family dwellings: Manufactured Homes: Other (specify):
Required Residential P' _ Actual Property Line Setbacks: Comments: f �j ,+ Vie
1
Front Minimum Y G 9 0 2- 2.- It /)! A 4 4U,J lira 2.4
Rear 2y 3/o k .x.y /.q 4i II t 19 /
Closest Side /o 2.r
Sldestreeticamer lot
Nearest Bullding
on same lot
If permits are granted 1 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 foregoin• - ements are accurate and correct to the best of my knowledge. Pemmit subject to revocation if false information is provided.
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Signature of Owner or Owner's Agent Date
"This application expires 8 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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