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MINOR SUBDIVISION APPLICATION <br /> 010 . <br /> Property. Owner(s) _±__ t : �i. 4'I� . <br /> Address . 2 - . 'Si0/ ..� i Phone ( ) �.2• - _7 a-/ <br /> Devekvger/Contact Name I 2_ �__ X4.4. -!- - -.r °r 52 S" 174i/.2-0 <br /> Address Phone ( ) 7, .2 _ j'S <br /> Location of Property 6 S . /ii e. /V hi <br /> township map. block lot <br /> A <br /> /„,, _ <br /> Zoning . - �. Fire District <br /> Watershed Impervia7.Ls. Surface ' <br /> Joint Planning: C.H. -- Carrboro °-" School District Q _ <br /> State Road Number /[7 0 4. Name Type __ _4Wgg <br /> Private Road Class t_, Name <br /> Do you plan to build the road before final approval? <br /> or secure construction with a security document?. a---- <br /> Utilities: Public Sewer Community System . Septic Tank <br /> Public Water Community Water Well ' t...--° <br /> If on a septic system, the Health Department must examine all existing and poterrt5_ai <br /> building sites on lots shown on the plat. <br /> Total Lot Area 4p . 6 ,4 (!„ Number of Lots et ' <br /> .. <br /> Lot Number: Size of Lots: Structures (proposed or existing): . . <br /> / 11/ <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 /> ale <br /> C - Q m it e- /L_!� <br /> Date Signature •.s - - <br /> Date Signature <br /> Filing Fee # of Lots Fee Private Road Fee Other Fee <br /> Total Fees Date Paid • <br />