ETHTE #: 18-5-43613
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Barbara Hall Worden Phone #: 919.275.9362
Address: 54 Moonlight Dr. Fuguay Varina, NC 27526
Name of Mobile Home Park or S/D: Stetson S/D Lot 52
Name of Owner (if different): Marc Sipes & Barbara Hall Worden
Address of Owner (if different): Same
Property Location (State Road name and #): Atkins Road (SR 1448)
Purpose of Inspection: Addition -Family Room w/ Powder Room (18'x24')• Deck (12'x24',). No
additional bedrooms. Proposed building not within septic field or septic setbacks Permittable
repair area available.
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
U05 -'s
Signature of Environmental Health Specialist