ETHTE #: 13 -5 -32173
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Melvin Ray Allen Phone #: 920 -6548
Address: 71 Season Dr. Cameron NC 28326
Name of Mobile Home Park or S /D: Carolina Seasons lot 112
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): 71 Seasons Drive
Purpose of Inspection: Storage Building (12'x26')
The aforementioned site has been evaluated by the Harnett County Health Department
Environmental Health Section. At the time of inspection, there appeared to be a septic
system serving this site. If the system should malfunction, the owner is responsible for any
necessary repairs.
THIS INSPECTION IS VOID IF:
1. the intended use of the septic system should change, and /or
2. the system should fail or malfunction, and /or
3. the owner or tenant of the property change, and /or
4. after six months
t 1 ' . ' i
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental
ialist
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