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Home My WebLink AboutLaurel Links Country Club l r .' -- ,,i°'S�FFotAr = ELIZABETH A. NEVILLE �i Town Hall, 53095 Main Road TOWN CLERK y � ‘ P.O. Box 1179 REGISTRAR OF VITAL STATISTICS • t Southold, New York 11971 MARRIAGE OFFICER `: �i ��, Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER __�Ql ill �a0�1/ Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER ��,�� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL operation Permit No. 4206-N Residential Non-Residential x Fee $ 25.00 New x Existing Name Of Owner LAUREL LINKS COUNTRY CLUB Mailing Address 1 6700 MAIN ROAD Mailing Address 2 City St Zip LAUREL NY 11948-0000 Property Address 1 6700 MAIN ROAD Property Address 2 City St Zip LAUREL NY 11948-0000 Owner Telephone No. 631-744-1039 Tax Map NO. section 125.00 block 4 lot 24.023 Cross Street Issue Date: 6/16/03 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) ,,,,,,,,,,,,, ELIZABETH A.NEVILLE /07 \; Town Hall, 53095 Main Road TOWN CLERK i p • P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER O � Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER -= �fo a0�i'° Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER = '' * 1 010. southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION OPERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10 or Non-Residential @ $25 Application No.CfsG(‘;' Permit No. a(f- Owner Name ZA NSC( Z /,v,�S Cat' d 4/ C1 `12 Owner Mailing Address 7 U ® ,%4"-' /Pi) L �,!•(��- Owner Property Address C v /Vo'iv Ire!j Owner Telephone No. 7`l'V- Tax Map No: Section /o?S Block 7 Lot 2 9' .-3 Cross Street Please check each that applies: New Construction t� Alteration to Existing System Residential Non-Residential NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate building and system; give north arrow and approximate distance in feet from system to building and closest road. New construction may submit copy of survey with SCHD approval.) 4A, 6/2A1 Signature of Applicant Date Received by: