ET RHTE #: 16-5-40059R
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Matt Worley Phone #: 237-5428
Address: 1478 Arrowhead Rd Dunn NC 28334
Name of Mobile Home Park or S/D: Lees Place lot 8
Name of Owner (if different): William & Rose Taylor
Address of Owner (if different): 108 Lees Place Dr. Lillington NC 27546
Property Location (State Road name and #): 108 Lees Place Dr
Purpose of Inspection: Det Garage (24'x32') All parts of the building must be 5' from drain lines.
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
BUILDING MUST BE 5' FROM ANY PART OF SEPTIC SYSTEM
DO NOT DRIVE OR PARK ON SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
Signature
uo