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Orange County Health Department <br /> *te'.,,+. .r <br /> 41 <br /> CONSTRUCTION AUTHORIZATION APPLICATION FIELD NOTES <br /> THIS IS NOT A PERMIT <br /> Parcel Pin: 9843137930 TMB1,: 3 <br /> Application Date: 03/19/2018 <br /> Permit#: CA18-00084 <br /> Applicant: CAMP CHESTNUT RIDGE Owner: NC UNITED METHODIST CAMP& RETREAT <br /> MINISTRIES IN <br /> Phone: 919-304-2178 / Phone: / <br /> Property Desc.: S/O SR 1120 3� A r }c��' Y- Cot Size: 201.05 <br /> Prop Address: L Nt-w &TrAGC <br /> Permit Type: RESIDENTIAL EXPANSION <br /> Facility Type: 1029 RES SFD Improv.#: NA Expires <br /> #GPD Requested:240 Water Supply: Private Well <br /> ---ACTIVITY LOG AND NOTES <br /> Wasteflow: OWIP GPD Primary System Type: Sys Class <br /> No.of Bedrooms: Nitrification: Ft. X Ft. Wide <br /> STB Tank: gal Max. Trench Depth: In. <br /> Pump Tank: gal Horz. Trench Sep: Ft. <br /> Repair System Type: Sys Class: <br /> Comments: <br /> Date EHS Notes <br /> �/Y/$ ew � �o <br /> CA-4130102 Pick up_ Mail_ File_ Reviewed <br /> 279 <br />