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.4INOR SUBDIVISION. APPLICATION <br /> 02[ <br /> Property Owner(s) �,� � 40..Aziex iQ.' n Ass- 3-6774) <br /> Address 7C L 5- egry j Cl7 -- Phone ( ) .5 ` /d y <br /> Developer/Contact Name /`' 7h <br /> Address Phone ( ) 7302- 777 <br /> Location of Property r _ 7 . SZ15. <br /> !� township map block lot <br /> Zoning !l ` / Fire District <br /> Watershed /".1IA9— Impervious Surface v1,4— <br /> Joint Planning: C.H. /)A-- Carrboro g4 School District r✓ A7 1 <br /> State Road Number //a Name Doi 44 WS Type rzt l e2 ,LZ_ <br /> Private Road Class 4 70 K__ Name <br /> Do you plan to build the road before final approval? _....1 ..t. 40/ — <br /> or secure construction with a security document? ,,J/�, <br /> Utilities: Public Sewer Community System ` Septic Tank / <br /> Public Water Community Water Well <br /> If on a septic system, the Health Department must examine all existing and potential <br /> building sites on lots shown on the plat. <br /> Total Lot Area - 11' 66 214 Number of Lots I + 4. ki <br /> Lot Number: Size of Lots: Structures (proposed or existing) : <br /> • <br /> I (We) hereby certify that I (we) have read the above information and that the information <br /> I (we) have supplied is accurate to the best of my (our) knowledge. I (we) understand <br /> my (our) application is not complete and cannot be approved unless all required information <br /> and material has been provided. <br /> \ 141 <br /> Date Signature <br /> Date Signature <br /> Tiling Fee # of Lots Fee Private Road Fee Other Fee <br /> ,oral Fees Date Paid <br /> • <br />