HomeMy WebLinkAbout1000-109.-3-1 "ECEIVED
NOTICE TO ADJACENT PROPERTY OWNER Jit 12 20
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BOARD OF TRUSTEES, TOWN OF SOUTHOLD
In the matter of applicant:
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YOU ARE HEREBY GIVEN NOTICE.-
1.
OTICE:1. That it is the intention of the undersigned to request a Permit from the Board of
Trustees to: v6/a;,0wed /4,.�� /ar�,.,,•� a/r,,,ta /�'1� �nQ/
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---- -2.- That the proparty which is he subject ofnvironmental evie is loca ed
adjacent to your property and is described as follows:
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3. That the project which is subject to Environmental Review under Chapters
96,111 and/or 275 of the Town Code is open to public comment on:
DATE:
You may contact the Trustees Office at 765-1892 or in.writing.
The above-referenced proposal is under review of the Board of Trustees of the Town of
Southold and does not reference any other agency that might have to review.same
proposal.
PROPERTY OWNERS NAME:
MAILING ADDRESS: .23406 /2a-�
PHONE #: G'3/ - 9ri�- 8/ 77 /
AGENT:
MAILING ADDRESS: 10 :20e.> *1 q �r&A Ny
PHONE #: 0 3 /- �03 - 9�s fe-
Enc: Copy of sketch or plan showing proposal for your convenience.
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SENDER: COMPLETE THIS SECTION ' I _I
■ Complete items 1,2,and 3. A. Signature I
I ❑Agent
� ■ Print your name and address on the reverse X ❑Addressee �
161-12 I so that we can return the card to you. B. Received by(Printed Name) C.Date of Delivery
r i ■ Attach this card to the back of the mailpiece,
I or on the front if space permits.
1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes I
if YES,enter delivery address below: [3 No
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I 3. Service Type ❑Priority Mail EcpressO I
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II Adult Signature El Registered MailTM
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strictedIIIIII IIII IIIIIIIIIIIIIIIIIIII IIIIII ill III BLrifed Mail® UVery
I ❑Certified Mail Restricted Delivery ❑Signature Confirmationm
I 9590 9402 6337 0296 3448 10 ❑Collect on Delivery ❑Signature Confirmation
2 n a is ni..n,1-1 fr—nefnr from servirp]ahall 11 Collect on Delivery Restricted Delivery Restricted Delivery
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7020 2452 0001 6 318 6212 1 Restricted Delivery
PS Form 3811,July 2020 PSN 7530-02-000-9053 Domestic Return Receipt i