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HomeMy WebLinkAboutRyan, Michael ��o�N4 0 (,-c O� ,. *P G ELIZABETH A. NEVILLE ��_ �: Town Hall, 53095 Main Road TOWN CLERK ; y P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER y �/ Fax (631) 765-6145 � RECORDS MANAGEMENT OFFICER __�Ol *Doe. Fax (631) 765-1800 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 4061-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner RYAN, MICHAEL Mailing Address 1 PO BOX 1686 Mailing Address 2 City St Zip MATTITUCK NY 11952-0000 Property Address 1 1077 CRESENT WAY Property Address 2 City St Zip MATTITUCK NY 11952-0000 Owner Telephone No. 631-298-4910 Tax Map No. section 121 .00 block 4 lot 25.000 Cross Street LAUREL LAKE ROAD Issue Date: 11/30/00 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) • OFFICEOWNOFSOUI'HOLgERK C��FFO(/�'`,O Application No. y0(,t 8LIZABETHA.NEVILLE,TOWNCLERK $10.00 - Residential ✓ P.O.BOX 1179 g SOUTHOLD,NEW YORK 11971 $25.00 - Non-Residential Telephone 01 , 0' (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT RECEIVED APPLICAT ION for -- NOV 3 0 2000 OPERATION PERMIT Southold Town Clerk SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ DATE //— /7 -- c0 OWNER NAME: Ur CI-M- L ) Rye/ OWNER MAILING ADDRESS: Po 80 x 1 67 / 'ar, ' l / 9 z OWNER PROPERTY ADDRESS: / © 77 Cl2 Sen/7 (A)f 7 i1'g-/T 772l� OWNER TELEPHONE NUMBER: (, 3 / 2 Q — 9 10 TAX MAP NO. : Section 4'73 8 9 Block I Z / _ Lot '— 4 — CROSS STREET: L,9Ui L Lig,�� R 5 TYPE OF SYSTEM: Septic Tank New Existing Cesspool New Existing Residential Non-Residential 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.) g =I1* Picant RECEIVED BY: Town Clerk's Office DATE: 1 ©-ZS-OO \ EW PooL E Q'X �' a Soo GL cp p — �,� 4- / \<( \ 'a' 1\ 22` EXiSi-W(.r it) , oto L. TREE-' i 70 I oJ5E TRx MAP I .413 889_2� 1zl . 4 077 C265&jT WAy rYPet1111Znic, nly Ot„)1.1tQ.. M►c till-tL b. Rv44