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• Orange County Health Department <br /> Environmental Health Division <br /> r P.O. Box 8181,306-C Revere Road <br /> Hillsborough,NC 27279 <br /> Phone 919-245-2360 Fax 919-644-3006 <br /> www.co.orang-e.nc.us <br /> IMPROVEMENT PERMIT �OA <br /> Parcel Pin: 9843137930 TMBL: 3.55..4 <br /> Application Date: 03/29/2005 Permit#: IPO"6220 <br /> Applicant: NC UNITED METHODIST CAMP Owner: NC UNITED METHODIST CAMP <br /> Address: P O BOX 10955 Address P O BOX 10955 <br /> RALEIGH NC RALEIGH NC <br /> 27605 27605 <br /> Phone: 919-304-3900 / Phone: / <br /> Property Desc.: S/O SR 1120 <br /> Prop Address: 4300 CAMP CHESTNUT RIDGE RD DIRECTORS HOUSE-CAMP CHESTNUT RIDGE <br /> Permit Type: RESIDENTIAL REPAIR Lot Size(Acres): 201.05 <br /> Facility Type: RES SFD Square Footage: 0 0 <br /> Water Supply: COMMUNITY WELL <br /> Initial System Replacement System <br /> Wasteflow: 480 GPD System Type: Conventional(Shallow) System Type: _ <br /> No.of Bedrooms: 4 System Class: He System Class: - <br /> Site Classification Useable Soil Depth. 40" Useable Soil Depth: 0 " <br /> PROVISIONALLY SUITABLE LTAR. 0_3 gpolft2 LTAR: 0 gpolft2 <br /> Conditions: <br /> Refer to the attached site plan for specific information regarding location of the designated area Sail and site descriptions are located on file at <br /> Environmental Health. <br /> There may be other types of systems which are applicable to this site. <br /> The applicant for the Construction Authorization must specdfy the system types to be considered <br /> The permit and evaluation are valid only for the site as designated on the attached site plan. <br /> A Construction Authorization must be issued prior to the issuance of the Budding Permit and before any construction or system installation can <br /> commence. <br /> This permit is subject to revocation if the stile plan,plat,or intended use changes or if the site is altered, <br /> Subsequent changes to the siteplan or information in the application requires a new application and additional fees. <br /> ISSUED: 03/29/2005 4 EXPIRES: 03/29/2010 <br /> nvironmental Health Specialist <br /> EHIP 4130102 Pick up _ Mail_ File Reviewed <br /> 171 <br />