ETHTE #: 14-5-35116
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Keith Muse Phone #: 709-7900
Address: 264 Carl McLean Rd Bunnlevel NC 28323
Name of Mobile Home Park or S/D:
Name of Owner (if different): Erica Muse & Antonio Harris
Address of Owner (if different):
Property Location (State Road name and #): 1136 Fire Lane Rd
Purpose of Inspection: Man Home (80'x14')
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
04 W DKIJ I'A Ally IN N1116,W] N 0 1
AUTHORIZATION OF EXISTING SYSTEM
Signature of Erhvironiilentd%l' a(th Specialist 1 /Date