ETApplication
Harnett County Central Permitting
PO Box 65 Ullington, NC 27546
910-893-7525 Fax 910-893-2793
www.harnett.org/permits
Application for Existing Septic Tank in a Mobile Home Park
Property Owner:
Lot Address:
Name of Park:'
DW TUN (sizeQ
PIN: 2—
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Power Company, (For Progress Energy we need the premise number.)
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There is a $100.00 charge for this service. This certification Is subject to revocation N the
Intended use of the septic system changes, or if false Information Is provided on this
application.
You signature below certifies that all above information is correct.
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Signature of owner or authorized agent: a'- Z'
• • • •
Authorization
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SEPTIC
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