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Q• <br />(PLEASE TYPE OIL PRINT - INK ONLY) 8/88 <br />APPLICATION FOR CLASS, A SPECIAL USE PERMIT <br />ORANGE COUNTY 130A.RD OF COMMISSIONERS <br />DATE:/ /- <br />&PPLICATION NUMBER: PD- _ - <br />I (We) request a Class A Special Use Permit as provided for in. Article of the <br />Orange County Zoning Ordinance for <br />The following information is provided in support of this request: <br />A. PROPERTY INFORMATION: <br />Street Address or Location: . <br />'lo'ck <br />Orange County Tax Map _ -- Lot(s) Township <br />Zoning District(s): <br />Lot /Parcel Size: acres or square feet <br />Number of Existing Buildings: Gross Floor Area; square feet <br />feet <br />Number of Proposed Buildings: _ Gross Floor Area: <br />s. care <br />Water Supply: public (Specify) . Community individual <br />Wastewater Disposal: Public (Specify) Community — Individual <br />School District: Fire District: <br />General Land Uses in Area: <br />Critical Areas: Stream /Drainageway Flood Prone Area <br />Watershed (Specify) Historic Site <br />Other (Explain) <br />B. SITE PLAN INFORMATION: <br />Twenty -six (26) copies of a Site Plan, prepared by a registered North Carolina <br />surveyor or engineer, are provided as required by Article 8.8. and which, contain the <br />following information: <br />North point, scale, and date. <br />Extent of area to.be developed, <br />Locations and widths of all easements and rights -of -way within or adjacent to <br />the site. <br />Location of all existing and proposed structures on the site. <br />Location of all areas on. the.site subject to flood hazard or inundation as shown <br />on flood maps or soils maps. <br />Location of all Water courses on the site, including direction of flow. <br />Existing topography at a contour interval of five (5) feet based oa mean sea <br />level datum. <br />Existing and proposed fencing, screening, gates, parking, service, and storage <br />areas. <br />Access to site, including sight distances on all roads used for access. <br />(PLEASE COMPLETE REVERSE SIDE) <br />