Orange County NC Website
\\.,ti' MtW UKAN(it GUUN 1 Y HEAL1H Ut1•AH i Ni NT <br /> , 1 02f <br /> ASR MAP REFERENCE'_ <br /> +75X EXISTING SYSTEM INS 06: 05. 9 S PN9865-88-5784 4. 3. . 25 <br /> '•rEE OWN Eft <br /> JSSELL JEFF MAJOR BUSINESS FORMS <br /> :0 BOX 1299 <br /> '.ILLSSOR000H NC E7E78 R 0 BOX I2SS <br /> 73=-210: .^.IL LSBCROCG:; NC 2727A • <br /> *40NE <br /> ::FICATIONS. ti n f 4 l or$QE/ACREAGE: OESIGNA ED wETW10? <br /> ._PnI R SYS7EM ib relkUet, 'hA,1( A0( Ate!i YES <br /> NO <br /> ATtON/OIRECTIONS: <br /> i,.IY aE `.; <br /> RECEIPT: SIGNATURE OF OWNER OR AUTNORIgp AGENT: <br /> FIRMED BY PLANNER: PLANNER DATE CLERK <br /> :/ ems"1 ' r <br /> rS <br /> ' eSem1 X 4 DISPOSAL /V OTHER / TYPE. SYS _ <br /> 3Z. TANK 04 SZ. CHAMB 2400 W. tr& ITRIFI 130x.3iXl$il OPER. REGI <br /> t_MPRK3. - te_ti►L ui hC_,4 rs1� 3str__ _—..4 ! '__fas< -P-i -- <br /> Ca G�W1 Cori ee.ro hcPc-PnZf` � �hn,nc�• Fr... ,_ pre.- <br /> - Sin zkr l l .. ;n�% ico4 in a.c reaewe. v.A-SIR cte-Sl h peel:0ml \in.j Ortyrr C.r.A.t <br /> conTru`rr , -,4 11 co t'vr ,'TS -Tvr's 4% ( 1 s . <br /> exis31x,"r ,ks 5611 k pie. <br /> a tsi ° es;sn 2001 pik _ cur awl.-c�cl� vra,c l+er/ •a u <br /> 1 r'S VIII. sha116C p .'hl <br /> ( pressv e v ) �' , -a [o'So)gat! n' 1C <br /> ` t:-��,a 1 q �u c s, Aiew ro.nk..l) bt /ect. f&-t;V I, ,,,� S7Ya A,1„r•A 6nGkc AVD7 <br /> � <br /> st l`rt sr so-Cs <br /> 0 z. 4=0 L 4r(.4 4 "sue 4 lo/z n <br /> \ �. z �. c' 6 > <br /> yvv�i �'c �a�-- Bract-- L :4: <br /> .z l A..' S p£C TSB/✓9 <br /> 7S •-7r. T*/a. ZS 7 s7%S. 1 — O <br /> O. <br /> /--c-- <br /> r— /3, i5/- SD <br /> E _v.:Hi <br /> s- - S ,y S k./�-mot l <br /> o . ..„,..I✓.d v,„ v 'f,• <br /> n(,e,1 d�pl.,.rW7 4l, /h !e 07 Pr- <br /> --71----1 ,bpl /!P el�� <br /> --- prtArCkxy 3" Srl,erLift 40 Z K Is <br /> \ 1 iG:r pre-alai <br /> Ol PSG- sett e'ci - r kfialr P..S <br /> u <br /> fit^ <br /> GATE. ISSUED 5-20-9/ SANITARIAN Z lcf. <br /> :ATE. APPROVED e,,0 -4 ! SANITARIAN ` 2,Z71jj4-lrsr-., OS'. <br /> ...T../ A /y <br />