HomeMy WebLinkAboutSchroeder Marilyn O}'~C~' O? ~ TOWN CLERK
TOS;~ OF SODWHOLD
~ 5TH ^. N ¢_ W~Z.E, TOWN CL~RK
Telephone
516) 765-1801
Constructt6n_ '~'/'
Alteration
$1o.00 -Residential.
$25.00 -Non-Residential
TOWN OF SOUTHQLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONST'RUCTION or ALTE~,AT ON PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
APPLICANT NAME:
APPLICANT ADDRESS:
:,'..
SEPT' ~..,,~CE~SPOO~.y' .
DE~CR'~T,ON o~ ~'RoPoSED CONSTrUCT,ON OR ^LTERAT,O'"
, //
.4.
LOCATION MAP: Must be attached hereto before permit' may be Issued,
LOCATION OF PROPOSEO CONSTRUCTION OR ALTERATION:' . .
O\'tNER OF PROPERTY: ~_~¢-I~A.~ ~¢_.¢~¢/.4~i0 ~~
OV/NER MAIlING ADDRESs: ~'0~0 ~.~ ~ g. ~
TELEPHONE NU?/I[3ER OF CONTACT PERSON:
BUILDING PERMIT NUMBER CROSS REFERENCE:
R,.-CztVED BY:
DATE:
I Tcnvn Clerk's Office
LOT AREA 21L39~ SO.FT.
~ BEV 38.0
F FL ELEV 38.0
VAO. mJ~IT
HOW O~ ~¥ CA~E]~ON COOK
fd
1
0.81 E
S 10'48'30""E
S 10'50'53"E
(33.e) ·
120.g1' MAP
120.91' ACT.
(33.3
(~.~)
HOLE BY McDONALD GEOSCII~NCE 4--21-200
· q~Z¢ F'H~E YEA:iS FROM DATE OF APPROVAL
?:~-- DARK BROWN LOAM OL
aROWN S~w SAND S~
PALE BROWN FINE TO
COARSE S/elD SW
17' g-I
CERTIFIED ONLY TO:
N.Y. LIC. 'Ne. 04e992
HAROLD F, TRANCHON JR. PENN. LIC. No. 21'~-E
FILED ~ No. 5315 DATE 6-~9-1969
TAX MAP No. (1~ ONLY)I000-22--4---26~ DISK 20(
HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR l
P.O. BOX 616
1866 WADING RIVER-MANOR RD. WADING RIVER,
NEW YORK, 1/792
8.31---929-4695