LAND USE Initial Application Date 7 --, Zi — /1 Appl cat on # 11 5 33z
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E Front Street L II ngt n C 27546 Pho e (910) 893 7525 Fa (910) 893 2793 www harnett org /permits
LANDOWNER 1 "I/ S/ •' tS Mailing Address 7 r ' N ,L- S S 'P//4 ),5. 1 1 , 1 4 +tr s tY/ 0
City 5/) IG k-' State /VCZp ?b19OContact 1/ Yi / Email
APPLICANT ( / /� 7 / tf' t / Mailing Address
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City State Zip Contact # Email
PI fill t ppl a t f m ti f d ff 1 th I dow
CONTACT NAME APPLYING IN OFFICE ert i-S- / 7/ 7 / 7 / Phone # (C - 2 / '7
3 9 e
PROPERTY LOCATION S bdivision 7, 4 S �/1 D Lott( Lot Size Q J
State Road # State Road Name �J ace,
Book &Page Z &n / 7S
Parcel °✓ O 9 2 /7 0/ //�/7_� PIN 0 /5 9I ° 0/77 Oo
Zoning 1 /^ 0,j 4 2' Flood Zone .(/ Watershed / / ? /L'Deed Book &Page 2&69 1 72 Power Company
New str ctures w th Progress Energy as service pro der need to supply premise number f om Progress Energy
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON C 1f- / 1 Re- Y , G ,
r (r/e //c (/a Lk+ ni ) t-tr5/ itOus Cn dCr 7k
Jc y/A V % k 5
PROPOSED USE
M Ith
❑ SFD (S e x) # Bedrooms _ # Baths _ Basement(w/wo bath) _ Garage _ Deck Crawl Space _ Slab _ Slab
(Is the bon s room fnished (_) yes (_)no w/ a closet? (_) yes (_)no Of yes add in with # bedrooms)
❑ Mod (Size _x_) # Bedrooms_ # Baths_ Basement (w /wo bath)_ Ga age _ S to Built Deck _ On Frame_ Off Frame_
(Is the second floor finished? (_) yes (_)no Any other site built add bons? (_) yes (_)no
❑ Manufactured Home SW DW TW (S e_ _) # Bedrooms _ Garage _(site b ilt? ) Deck _(site bu It ?_)
❑ Duplex (S ze ) No Build ngs No Bedrooms Per Un t
p FJO me Occupation # Rooms Use urs of /operation #Employees
/ � /K \ /A ddit on /Accessor er (S e _ _ ) Use n / "1(,q Closets n addihonv (_) yes (_)no
Water Supply County Exist ng Well New Well (# wettings us ng well ) MUST ha e ope able water before final
Sewage Supply New Septic Tank (Complete Checklist) E sang Septic Tank (Complete Checklist) County Sewer
Does owner of this tract of land own land that conta ns a man factu ed home w th n five hundred feet (500) of tract listed above? (_) yes ( )no
Structures (e sting or proposed) Single family dwellings Manufactured Homes Other (spec fy)
Required Residential Property L ne Setbacks Comments S w in ).y p cr 1 / t> "'/
Front Minimum 3Z' 5 Actual I 1 ) - /r y 0.1/4"& /- ye F1 'J 5
Rea L 4 ! 'in k , 1l�� Q/L
Closest Side k l/
Sidestreet/corne lot
Nearest B ilding
on same lot
If permits are granted I agree to confo m to all ord nances and laws of the State of North Carol na regulating such work and the specif cations of plans subm tted
I hereby state that forego ng statements are accu ate and correct to the best of my knowledge Permit subject to revocation if false information is pro ded
7 -- V 7 L
S ignat u re 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
Resident al Land Use Applicat on Page 1 of 1 07/10
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