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ORAN"-%E COUNTY HEALTH DEPARTMENT 13 <br /> REFERENCE NUMBER DATE PIN MAP REFEF�NCE <br /> -7 0 r <br /> APPLICANT: OWNER. <br /> HILL R-D <br /> R L <br /> R5 I E- <br /> -1 --44 22 riTTS '-!r- <br /> TELEPHONE: <br /> SPECIFICATIONS: LOT SIZE/ACREAGE. DESIGNATED WETLAND? <br /> YES <br /> NO <br /> LOCATION DIRECTIONS: <br /> FEE: RECEIPT. SIGNATURE OF OWNER OR AUTHORIZED AGENT. <br /> 1,5, <br /> CONFIRMED BY PLANNER: PLANNER DATE CLERK <br /> 4 <br /> DRAWING Nq--�. <br /> ,T -q <br /> PICALE <br /> - --- ------ ------ - ------ <br /> -------------- ----------------- <br /> V)6ul <br /> 0 10- <br /> SEE IMPORTANT INFORMATION ON THE REVERSE SIDE <br />