LAND USE Initial Application Dale: / " /1 Application N / r � 017 ✓ 7 79
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION !� CU
Cunha! Permdting��BE. Front Street, Mailing Address: ��/
t, LilMgton, NC 27548 Phone: (�rAnO l11'1 I � Or , www.harnell.otg
LANDOWNER: 5 C1 Q
City:�I QTY !)I) Slate: /Y AA�� t Zip: 2759 l 6 D Nome #: Contact #: I1 `/ 7
APPLICANT: SAIf1e 276.71.-e Mailing Address:
City: Slate: At Home 9: Contact 9:
'memo ell use applicant inhumation II diloent than landowner /� ''
CONTACT NAME APPLYING IN OFFICE: J �Q I ^ l P6 a lµ p Q
Phone ,
PROPERTY LOCATION: Subdwison: /1k t4 I b. Lot 9: i t Lot Size: 1 / J M
State Road 9 : / � State Road Name: Q f q u de in Or 1 js 2 /, n f Map Dook&Page: �d I f) i
Parcel: J)v 5 V pm: 667e_.J.1 51 1 g rcoc
Zoning: A 41 A Flood Zone: Waterahert Deed Book&Page: (0_617 / 09 16
SPECIFIC OIRE_C TONS TO THE PROPERTY FROM ULUNGTON:
PROPOSED USE:
Circle:
O SFD (Size x ) A Bedrooms 9 Baths Basemen (wAvo bath) Garage Deck Crawl Space / Stab
❑ Mod (hex ) 9 Bedrooms 9 Baths Basement (wAw bath) Garage She Bulh Deck ON Frame / OFF
❑ Duplex No Buntings No. SedroomstUrg
O Manufactured Home: _SW _ OW _ TW (Size x 1 9 Bedrooms _ (site built? 1 Deck (site bum? )
❑ Home Occupation 9 Rooms / Use Hours of Operation: I/Employees
AddaiorvAccesscory/Olher (Size Ry x ? L/ 1 Use ('Af A Closets in addeionL)yes Uco
Warer Supply: /County ( ) Well (No. dwehings 1 MUST have operable weber ho f
Selvage Supply: L) New Septic Tank (Complete New Tank Checklist) (__) Existing Septic Tank ( County Sewer
Properly owner of this tract of land own land that contains a manufactured home wfln five hundred feet (500) of tract listed above? (_)YES ( 1NO
Strictures (existing or proposed): Single family dwellings Manufactured Homes Other (specify) _
Comments:
Required Residential "party Line Setbao s .
From Minimum nn Actual J4 { I{ J
Roar 7 ! 5
Closest Side
SldosoeeVcarnor lot
Nearest Building
on same lot
II par / are g mad I agree to conform to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
1 her state at f °going statement are accurate and correct to the best of my knowledge. Permit subject to relaxation 11 false innonnation is provided.
of ner or Owner's Agent jte3�j
"This application expires 6 months from the Initial date If no permits have been issued"
A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LANG USE APPLICATION
Please use Blue cur Black Ink ONLY
9/07
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