Orange County NC Website
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APPLICANT'S NAME TMBL <br /> Orange County Health Department <br /> Environmental Health Division <br /> r <br /> P, ik <br /> r{t C0 <br /> APPLICATION FOR PERMITS <br /> Improvement Permits <br /> Construction Authorizations <br /> Existing WeWSeptic System Inspections <br /> Well Permits <br /> This application is used to apply for any or all of the above permits or authorizations. <br /> The form must be filled out completely and accompanied with payment before services <br /> can be inifiated <br /> Completion of this form does not imply or guarantee any permit will be issued or an <br /> authorization granted. Please be sure all the information is connect as the information <br /> you provide will guide the staff in the evaluation and permitting of your property.Any <br /> permit may be suspended or revoked if the information is falsified, incorrect or if the <br /> site is altered after the permit/authorization is issued. <br /> Orange County Health Department, Environmental Heath Division <br /> P.O.Box 9191,306-C Revere Road <br /> Hillsborough,NC 27278 <br /> PHONE: 919 24S-2360 FAX: 919-644 M <br /> www.co.orangemc.us <br /> APPLICATION M PIN P <br /> DATE RECEIVED: OCPD CONFIRMED: <br /> REVIEWED BY: ASSIGNED TO: <br /> NOTES: <br /> 227 <br />