HomeMy WebLinkAboutDanzer TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 129 Residential g
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Meinrad Danzer
OWNER MAILING ADDRESS: Smith Drive North
Southold, New York 11971
OWNER PROPERTY ADDRESS: Smith Drive North
Southold, New York
OWNER TELEPHONE NUMBER: 516-765-1530
TAX MAP NO. : Section 76 Block 2 Lot 13
CROSS STREET: Terry Place
TYPE OF SYS1EM: Septic Tank New Existing
Cesspool g New Existing x
Residential g Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
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Judith T. Terry
Southold Town Clerk
DATE: November 6, 1986
(TOWN SEAL) •
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
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®�m MR SWIM = OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. /c2f ;,
Fee $ )0 '
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DATE //////76
OWNERNAME:- - ' MeI4/ f7 k h 197v2-e
OWNER MAILING ADDRESS: S�./ 71A P/C/P Ire- /1J9
e® tr.a/d 4J-y, l(9. 7/
OWNER PROPERTY ADDRESS:
54-141
OWNER TELEPHONE NUMBER: 76 $ /$ 3
TAX MAP NO. : Section 76. Block oZ Lot 73
CROSS STREET: ��k. 0 �'�
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool x New Existing
Residential )( Non-Residential
DATE OF PREVIOUS PUMP-OUT:
LOCATION MAP: Must be attached hereto before permit may be issued.
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
i id
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Signature of iidicant
RECEIVED BY: c-CC_,_
Town Clrk's Of ice
DATE: 1/- 6, —
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