ETApplication # ~ 3-S
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910-893-7525 Fax 910-893-2793
www.harnett.org/permits
Application for Existing Sentic Tank In a Mobile Home Park
Applicant Name:
Sa Date: ~r ` t U
Address: Z J
Telephone: ` %19 r (:::tr~<-Irn _geoe
Property Owner: 7061
Lot Address: / p Phone:
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Name of Park: 014
Lot Number:
Parcel: lx 8b' 60cic CAS PIN: US
TW (Size -11-x-2 } # Bedrooms Year_~_
Power Company:
(For Progress Energy we need the premise number.)
S ecifi Directi ns to Job from Lilfin ton:
"2_ / c-" I a / r► c CU A, r AL-
1
K/
You
There Is a $100.00 charge for this service. This certification Is subject to revocation if the
intended use of the septic system changes, or if false information is provided on this
application.
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