TOWIN INFO r r
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a m l, 1- �i &Town of Erwin
a e ' $ - -" P 1 't i s a Pemut #
� , 1 tii4:,rw Z oning App & Permit oar o(o
; P 1 a mnng & Insp Department
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it Each application should be subnutted with an attached plot/site plan with the proposed use /structure showing lot
shape, existing and proposed buildmgs parking and loading areas access dives and front, rear and side yard
dnnensions
Name of Applicant pyre{ r. AA (,inn . tWnffdnn Owner 1Pr✓i4 .4 l gn ns. 7
Home Address ..7 1,7 yq Ai C s e Home Address ll 44 a C S 2
Qty State Zip £ruj h tJ C 2 -Cr 3119 Qty State Zip £v 60 n t3 t 2 - $r3a`1
Telephone c l Ito 2.39 i l (4 l b) T e l e p h o n e q f 0- q 1(0 - 2-399
Email Email
Address of Proposed Property n t" NC 5g... la n N c 2 Y3ay_
Parcel Identification Number(s) (&s4 01 oo/ y Q - 7 0 S {nS — 00 / : - AP us< po 34
What is the applicant requesting to build / what is the / l4 9 fr Mm r1K r tiutrhpio n
proposed use of the subject property? Be specific To L t de. i n
Description of any proposed improvements to the building /'1 4 f sxod aJ« r Chwn' ' c rt
or property
Estimated Project Cost 90,000 10
What was the Previous Use of the subject property? Cr . (c?
Does the Property Access DOT road? yK S
Number of dwelling / structures on the property already 1
Property / Parcel Size a S keizes
Will the Proposed Use / Buildmg connect to a septic system? e s
Owner/Applicant Must Read and Sign
The undersigned property owner or duly authorized agent/representatwe thereof certifies that this application and the forgoing
answers statements and other information herewith subnutted are m all respects true and correct to the best of their knowledge
and belief The undersigning party understands that any incorrect information subnutted may result m the revocation of this
application Upon issuance of this permit the undersigning party agrees to conform to all applicable town ordinances zoning
regulations and the laws of the State of North Carolina regulating such work and to the specifications of plans herein subnutted
The undersigning party authonzes the Town of Erwin to review this request and conduct a site inspection to ensure compliance
to this application as approved
- re "V Morr.S141 rgAntr 217e vz4' 3 -4
Pint Nam S gnat a of Owner o Repr s nt tiv D to
For Office Use
Zoning District {{�� Existing Nonconforming
i'\ Uses or Features
Front Yard Setback t(Q ' Other Permits Required _Conditional Use _Building _Fire Marshal _Other
Side Yard Setback l a Zoning Permit Status Approved _Denied
Rear Yard Setback L(o Fee Paid t • - Date Paid Ra Staff Initials
Comments 9 Li se $ ,^q 0,i, e��l"H
Signature of Town Representati l�� p� • •roved/Demed 3/
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