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Attachment A <br /> DocuSign Envelope ID:28DA00F8-4193-4A09-B5AF-6D4761 A9B655 <br /> Orange County <br /> tots;, �' Fire Protection Permit Emergency Services <br /> 1 K enc <br /> g Y) <br /> Fire Marshal Division <br /> 41:0 '°.0, e aE <br /> 510 Meadowlands Drive <br /> ! NO Hillsborough,NC 27278 <br /> 919.245.6100 <br /> Permit No.: FPP-2016-002 <br /> Project Title: Combustible Fuel Tank Installation <br /> Project Type: Relocation from one parcel to another <br /> Address: 1514 Eubanks Road, Chapel Hill NC 27516 <br /> Description: Install AboveGround <br /> Applicant: Four Star Petroleum <br /> Address: 1119 Beaumont Road, Hollins VA 24019 <br /> Phone: 540-691-5847 Cecil Morgan <br /> Four Star Petroleum <br /> I hereby certify that the above information is true and correct. I recognize that the approval of plans <br /> and specifications by Orange County does not permit the violation of applicable building codes, county <br /> or city ordinances, or state laws. I acknowledge my obligation to allow inspections during normal <br /> working hours,to request inspections as needed, and to pay all applicable plan review and permit fees <br /> imposed by Orange County. <br /> ,----DocuSigned by: <br /> Applicant Signature: Vigor 'bh! iv Print Name: <br /> `'* 3021AA36281241C... <br /> Iiii 0 \;:\"7::P c,77— t <br /> ddd <br /> Fire Marshal: <br /> Jason B. Shepherd <br /> Issue Date: August 22, 2016 <br /> Inspection Notice <br /> Contractor is responsible for contacting the fire marshal's office for an inspection of each installation <br /> component,witness testing of tanks,piping and their appurtenances of the system prior to installation,post <br /> installation and prior to any covering of any component of the system including but not limited to <br /> foundation bed depth and depth of trench,pre tank installation,tank installation and anchoring,tank cover <br /> up with earth depth check,piping hydro test or pneumatic test, concrete depth prior to pour and/or asphalt <br /> prior to pour. Bollard inspection prior to pour and all gas island installation inspections <br /> Contact the Fire Marshal's Office for Inspections 24 Hours Before <br /> Requested Date at 919-245-6100. <br /> A Prepared, Coordinated, and Integrated Emergency Services System <br />