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Application # B
HARNETT COUNTY CENTRAL PERMITTING
PO BOX 65 LILLINGTON NC 27546
(910) 893-7525 FAX: (910) 893-2793 www.harnett.org/permits
APPLICATION FOR EXISTING SEPTIC SYSTEM INSPECTION
FOR MORTGAGE COMPANIES COMMERCIAL CHANGE OF
OWNERSHIP, FIRE DAMAGE, ETC.
NOTE: A DEED OR OFFER TO PURCHASE IS REQUIRED AT TIME OF APPLICATION.
Date:
Buyer or Business Name:
Mailing dress
C v:
TQ.kphone: ( )
Other (
Zip:
Current Land Owner: 9141,nVe ' 1 _______Phone:
Propez rty Address: s° 5 0-v z 334
PIN: n., 1wcel: °
State Road State Road Name:
Name of Subdivision: ' Lot #tf Applicable)
if employees # of'children - 4z Hours:
# of emjrloy , # ots w How
There is a $100.00 charge for this service. This approval is subject to revocation if the
intended use of the septic system changes or if false information is provided on this
application.
rrnation is correct.
Your signature below certifies that all above in
00
Signature of Owner, Authorized Agent or Applicant:
SEPTIC / 4/08
Directions: (please give concise, complete directions from Lillington, NC to the property)