ETCj r 5 ~ ' D Application I 05-on ~?L42
HARNETT COUNTY CENTRAL PERMITTING
PO BOX 65 LILLINGTON NC 27546
(910) 893-7525 FAX: (910) 893-2793 www.hamett.org/permits
APPLICATION FOR EXISTING SEPTIC SYSTEM INSPECTION
FOR MORTGAGE COMPANIES COMMERCIAL CHANGE OF
OWNERSHIP FIRE DAMAGE, ETC
NOTE. A DE FD OfR OFFER TO PURCHASE IS REQUIRED AT TIME OFAPPL~ C pNr~
Date:
Proposed Buyer or Business ame:
Applicant/Mortgage Co:
Mailing Address: p Y
City: Y~ State: Zip:
k[14 --W Telephone: Other VA
Current Land Owner:
Property Address:
C4 -
PIN:' j
State Road 1 C d
Name of Subdivision:
D c e: of empl s # fii
R . urant. of ploy s # of
Directionsi ~please~give,conci% complete
Hours:
Tours:
s from Lillington, NC to
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.
Ell-a(
Lot - If Applicable)