ET2
2-
Application #
Harnett County Central Permitting
pO'Box 65 Lillington, NC 27546
910-693-7525 Fax 910-893-2793
www.harneft.org/permfts
Application for Existing Septic Tank In a Mobile Home Park
property Own
Lot Address.
Name of Park. L.VL I."„'u"..
Parcel;~ PIN:
Year~~
r' SW DW TW (Size _Z_~ x~.~ # Bedrooms___
Power Compa any: (For Progress E=nergy we need the premise number.)
~W
S ecific D"recd ns to Job fr m Lillin ton;
You signature below certifies that all "emotion is
Signature of owner or authorized
DO NOT SIGN BELOW - FOR OFFICE USE ONLY
Authorization of Existing System
.
a .6 s
Signature of Environ ntal ealth Specialist sate
ease
sEnric