ETHTE #: 18-5-43304
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Cumberland Homes Inc. Phone #: 910.892.4345
Address: P.O. Box 727 Dunn, NC 28335
Name of Mobile Home Park or S/D: The Reserve Lot 19
Name of Owner (if different): Same
Address of Owner (if different): Same
Property Location (State Road name and #): 69 Trophy Ridge Fuouay-Varina, NC 27526
Purpose of Inspection: Accessory Detached Storage Building (28'x24'). No bathroom. No
bedrooms. Proposed building, not within septic field, repair area, or septic setbacks.
Partial Septic Relocated - reference 18-5-43304 operational permit
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 of
G�laall�
Date