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F.r I tJ.op APCI ! -4,710N 106 <br /> Property Owner ( s ) `4- ,; " rl r-N <br /> Address 11 \$ Se01 -4 ,Tx Phone X07) 7�s— y,7 <br /> hone <br /> Developer/Contact Name a/2A/3E77-1 C/ZA 1 4 4, A,1 IC/-iALI_ Wi 4cra7a <br /> Address iturz 4- boxy. net 141acthoko -H r12-�550 [i'1) <br /> Phone (�� ) <br /> EL7AP3bf 1 Lw;a K) Ali.- ioi <br /> Location of Property . 'c ("1i 22 1 .4 z 2-6 <br /> Township map block lot <br /> Zoning, Fire District D k")64-- <br /> Watershed NA Impervious Surface AA <br /> Joint Planning : C. H. NA Carrboro School District p;ZA#JGi..(O. <br /> State Road Number 1 s1i�tcil r� 153V <br /> Name Type ruL7 c <br /> Private Road Class C' Name \~ <br /> _ LA uE l 1-1-ornG gip. <br /> Do you plan to build the road before final approval ? <br /> or secure construction with a security document? <br /> Utilities : Public Sewer Community System Septic Tank ✓ <br /> Public Water Community Water Well ✓ <br /> If on a septic system, the Health Department must <br /> examine all existing and potential building sites on <br /> lots shown on the plat. <br /> Total Lot Area 7 t . '1. AGcr 5 Number of Lots <br /> Lot Number: Size of (Lots : Structures ( proposed or existing ) <br /> 1, .44 ac. ' i-i f�1 G H-o c <br /> I (We) hereby certify that I (we ) have read the above infor- <br /> mation and that the information I (we) have supplied is <br /> accurate to the best of my ( our) knowledge. I (We ) under- <br /> stand my (our ) application is not complete end cannot be <br /> approved unless all required information and material has <br /> been provided. <br /> Dale � <br /> Signature <br /> / 2/��g ; A , 1 . <br /> Date . ,. <br /> Signature 4 <br /> F i I i ng Fee` f of Lots Fee Private Road Fee <br /> Other FFee�, Total Fees Date Paid <br />