ETHTE #: 13 -5 -32288
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Stephen Milton Phone #: 303 -1967
Address: 3205 421N Lillington NC 27546
Name of Mobile Home Park or S /D: Ted Brown S/D lot 2
Name of Owner (if different): Rose Crowder
Address of Owner (if different): 532 Joe Collins Rd Lillington NC 26546
Property Location (State Road name and #): 1258 Joe Collins Rd
Purpose of Inspection: SFD (59'x55')
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
'
11 1 1 A LTJ WORM WA i
UTHORIZATION OF EXISTING SYSTEM
Signature Z)f Environmental HealtlilSpali