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112 <br /> MINOR_LAIELLVISION APPLICATION <br /> P roperty Owner ( s ) Jt)I/f', 4 rn 14- Fi Ati C /E{4 W,0 P..Q <br /> Address 1T /k" t x �/l Phone (q/Y ) 9P9'9467 <br /> Developer/Contact Name i tJ_ /166,./GiA-4 Wo, <br /> Address„ a�_9 NG�u±-� 7RI�� G(4i-J . /� Phone ( 919 ) 3 'SggO (Ni,, <br /> Location of Property eI4AIP,�Z. PILL . 1/2 . ca.,/ <br /> township map block lot <br /> Zoning T -3 _ Pi_U� Fire District. 50(..171 r) .AtUC <br /> Watershed UNIV. LAIL - Impervious Surface 12 °/D <br /> Joint Planning : C. H. Carrboro /' School D istr ict MAPEL P/LL <br /> State Road Number A/C SV _ Name Type_ PAVED <br /> Private Road Class, l- Name POWA at) 11 1LL 120AD - <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- 4 <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 // A C Number of Lots_ <br /> Lot Number: Size of Lots: Structures ( proposed or existing) <br /> A 9 Ac int62 Id-on-,4-- PR0POSt-t, <br /> AC /�dm PROAOS� <br /> y/ l L C r'xI c 7NE� F L)iV ! 1 A'r <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. 1 (We) under- <br /> stand my ( our) application is not complete and cannot be <br /> approved unless all required information and material has <br /> been provided . <br /> Date Signature <br /> Date Signature <br /> Filing Fee is of Lots Fee _ _ Private Road Fee <br /> Other Fee__ Total Fees Date Paid _ <br />