Orange County NC Website
W <br />sAPPLICATXON FOR ENVIRONMENTAL ASSESSMENT <br />Project Name lca" &nm rri-en c &L061 malt-ft Ptah <br />l cha&n I�IG 2770 <br />Phone qtq - 383- 0;60Z <br />Owner Same. ®S abgm!g• <br />Address above <br />Phone S'Qwte- QS 264 <br />Location of Property _ Gkst spd� of 12ft S �Odl &q 4m <br />FOR DEPARTMENT USE ONLY <br />Date received <br />Date accepted /rejected <br />Summary Comments: <br />Reviewed by <br />