HomeMy WebLinkAboutMattituck Park Dist ELIZABETH A, NEVILLE
TOWN' CLERK
REGISTRAR OF VITAL STATISTICS
' MAItP, IAi~E OFFICE~
P,,EOOP~D8 NIANAGEIV~ENT OFFIOER
I:'R~EDONI OF IlqFORMAT;ON OFFICE1%
P.£ -..o. ~
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
....... .. l~ax (681) ~.6/5-6145
Telephon~ ~631) 7~5-2S00 '
southoldtown.n or t~ork.net
OFFICE OF THE TOWN CLE1%K '
TOWN OF SOUTHOLD
$OUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Rcddent/al~$10, or Non-Rcsidcntial(~$2f / Application No, 27J P ~nuit No.
Sep~c T~or C~sspoo~
Bric~c~c~9on o~opos~ Cgn~n]ction
Nme ~d phone number of mnt~t p~son
CONSTRUCTION ~QU~S SURVEY W~H~ALTH
8~uffolk County Department of Hea~th Serv/ces
Approval for Construct/on - Other Than 8ingle
Project
~hese plans have been reviewed for general co~form,.ee with
County Department of Health Servkes standards, relating to water
supply and sewage disposal. Regardless of any omissions,
inconsistencies or lack of detail, construction is requir~ to ~e in
accordance with the attached perm/t cond/tions and appl/cable
standards, unless specifically waived by the Department, This approval
~pprovsl Date
.......... ~w"~'- ['~'"=*~' O~' g~ ~.L';'H SER¥1~F.$. I
I 0 ,~CHE. DULF- I
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