LAND USE R Initial Application Date: Application # `f 5779 2:: I
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.harnett.org /permits
LANDOWNER: 4.114 e 'Q4',s9 // Mailing Address: ',7//1 itteriv/ ciensce
City: J^/"TL,¢ -CD Statel Zip: 7 # 3 /y re 7 /O sEmaiil:
APPLICANT': it //// 1 4-A'Depevn r Mailing A dress Y 4- 3 3 0 to " e eyoy ,) i
- v,^�Lnns
Cit 5 .`i o0 State/AC. Zip: ?»3z Conta'ct # f60 -53%-ZYYB Email: N (' H'fcDt uft6QJ, not-
'Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE: Lem C4 ).. - r Phone# ) ?'.2 i ,C
R y
PROPERTY LOCATION: Subdivision: GO UGC #2 Lot / !/ Lot Size: a r A
State Road # State Road Name: Map Boo &Pa
e: ,[// /� I ^ p ge: 200/ '/ 0
Parcel: 0tI 7 06 ✓! 2 ' 6 PIN: (/ 5-O / /
�ycA� jiff f � yn d/ J A ��, cc,
Zoning:M / O Flood Zone: / Watershed: _L-L'— Deed Book &Page: 2 777/ t /O Power Company ":
New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
27& ere \ // o+iTS /9i 2 onro /3,'iC / •// .erg/ /F'1F C. r
i9T tom. rite Z.- E iJ7(. �o7'T/t t HKe- Pc. e'cl la�s lJr P. 77 sZ
PROPOSED USE:
Monolithic
❑ SFD: (Size x ) # Bedrooms:_ # Baths:_ Basement(w /wo bath):_ Garage:_ Deck:_ Crawl Space:_ Slab:_ Slab:_
.Os the bonus room finished? (_) yes (_)no w/ a closet? (_) yes (_)no (if yes add in with # bedrooms)
Mod: (Size 22 q4 7 t ) # Bedrooms .g # Baths Basement (w/wo bath) ,t9 Garage:,Q f Site Built Deck:NA On Frame_ Off Frame
(Is the second floor finished? (_) yes ( ✓)no Any other site built additions? (_) yes (Vino
❑ Manufactured Horne: _SW _DW TW (Size x_) # Bedrooms: _ Garage: (site built ?_) Deck: (site built ?_)
❑ Duplex: (Size x ) No. Buildings: No. Bedrooms Per Unit:
❑ Home Occupation: # Rooms: Use: Hours of Operation: #Employees:
❑ Addition /Accessory/ ther: (Size x_) Use: Closets in addition? (_) yes (_)no
Water Supply: C my 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
Does owner of this tract of land, own land that contains a manufactured home within five hundred feet (500') of tract listed above? (_) yes ( )no
Structures (existing or proposed): Single family dwellings: Manufactured Homes: Other (specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum � Actual i� 34
L
Rear r
Closest Side CI 5
Sidestreet/corner lot
Nearest Building
on same lot
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 statem is are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
5 . . Gam. -.PdJ 1/2//1/
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
Residential Land Use Application Page 1 of 1 07110
THIS SITE PLAN IS FOR INFORMATIONAL
PURPOSES ONLY. NOT INTENDED AS A
SURVEY OR FOR RECORDATION
'jr JUR SDICTION E L AUTHORITY
APPROVAL OF THE LOCAL
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DWG. TITLE: SITE PLAN
CUSTOMER NAME: E. BOUDREAU
DATE: 2 -21 -11 (COUNTY: HARNETT
s o s o DRAWN BY: BRB FILE NAME: TuROTRAISW111.ES10 ELOTag
MI a HONES BY VANDERBU /L T •
zs 1 25 3300 JEFFERSON DAVIS HWY.
grgl F= 1 "= 5n' -D" SANFORD, NC 27332
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1 / CPP 26 /10