ET~ Application #
HARNETT COUNTY CENTRAL PERMITTING
PO BOX 65 LILLINGTON NC 27546
(910) 893-7525 FAX: (910) 893-2793 www.hamett.org/perntits
APPLICATION FOR EXISTING SEPTIC SYSTEM INSPECTION
FOR MORTGAGE COMPANIES, COMMERCIAL CHANGE OF
OWNERSHIP, FTRE DAMAGE, ETC.
NOTE, A DEED OR OFFER TO PURCHASE IS REQUIRED AT TIME OF APPLICATION.
Date: 3129/2012
Proposed Buyer or Business Name: Benham Real Estate Group
Applicant/Mortgage Co:
Mailing Address: P.Q. Box 844
City: Harrisburg State: NQ Zip: 2807-5
Telephone: 01~345'4759 ext. 2101 Other ( )
Current Landowner: _ Bank of New York Mellon Phone: N/A
Property Address: 91 Vail Ct. Sanford, NC 27332
PIN: 9586-29.21o1, o Parcel: I Cam,)
S
State Road State Road Name:
Name of Subdivision: The Summit t k 5 (rt Applicable)
Daycare: # of employees n/a # of children Hcrzrs
Restaurant: # of employees n/a # o set .,,-"ours:
Directions: (please give concise, complete directions from Lillington, NC to the property)
Head south on S. Main St. toward E. Front St, Turn right unto N Carolina 27 W/W Old Rd continue to follow N
Carolina 27 W for 14.4 miles, Turn left onto Buffalo Lake Rd go 1.6 miles to Alpine Dr and take a left. Take 1st
left onto Vail Ct. Destination will be on the left.
There is a $100.00 charge for this service. This approval is subject to revocation if the
intended use of the septic system changes or if false information is provided on this
application.
Your signature below certifies that all above information is correct,
Signature of Owner, Authorized Agent or Applicant:
FOR OFFICE USE ONLY
AUTHORIZATION FOR USE OF EXISTING SEPTIC SYSTEM
Signature of nvironmental Health Specialist Date
SEPTIC 4/08
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