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Home My WebLink About(5) SCDHS Receipt of Application for Variance 012121.pdf RECEIPT SUFFOLK COUNTY GOVERNMENT SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES, DIVISION OF ENVIRONMENTAL QUALITY OFFICE OF WASTEWATER MANAGEMENT, 360 YAPHANK AVENUE, SUITE 2C, YAPHANK, NY 11980 (631)852-5700 Today Date: 01/21/2021 Application: C10180810-ZEC Application Type: Other Than Single Family Residence Application Address: Fee Allocation: Fee Item Description Fee Amount Amount Paid Amount Paid Total Balance Due Board ofReview variance/waiver $000.00 $090.00 $900.00 $0.00 ---'-----'-----'-----'-----'-----'------'-----'-----''------'-----'-----'-------'-----'-----'-----'-----'--------' Tota|: $000.00 $090.00 $000.00 $0.00 - - - — ReoeiptNo. 418447 Payment Method Chaok# Amount Paid Payment Date Payor Comments Check 35265 $900.00 01/21/2021 pVVGROSSER CONSULTING, INC Contact Info: STRONG'GYACHT CENTER STRDNG'SYACHT CENTER 5780WEST MILL KD K8ATT|TUCK. NY11052