HomeMy WebLinkAboutHaurus trs
Town Hall, 53095 Main Road
'1 trL a P.O. Box 1179
� / Southold, New York 11971
JUDITH T.TERRY822
TELEPHONE
',...701/1 '�. (516) 765-1801
TOWN CLERK
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 770-R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
New Existing X
Name Of Owner HAURUS, BARBARA M.
Mailing Address 1 P. O. BOX 566
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 24255 MAIN ROAD
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 516-734-6866
Tax Map No. section 109. 00 block 1 lot 4/. 000
Cross Street ALVAHS LANE
Date Of Last Pump Out 0/00/00
Issue Date: 7/22/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
I -
I
OFFICE OF THE TOWN CLERK ` O��'- _ 2 )
Town of Southold �
Application No.
Judith T. Terry, Town Clerk .� ti , ,
I Residential
Town Hall, 53095 Main Road y. 1,
R NlY �R'�Aa
P. 0. Box 1179 Non-Residential
Southold, New York 11971 O ® • O��•
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE July -15 , 1988
OWNER NAME: Barbara M. Haurus
OWNER MAILING ADDRESS: P.O. Box 566
Cutchogue, N.Y. 11935
OWNER PROPERTY ADDRESS: 747cr u. ' . :.. • ••ue N.Y.
OWNER TELEPHONE NUMBER: 734-6866 +'
TAX MAP NO. : Section /(2'7 Block / Lot -2./f y.
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool ✓ New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: June, 1988
LOCATION MAP: Must be attached hereto before permit may be issued.
(Locate building and system; give north arrow and feet
.Ar . � of distance, approximately, to building and closest road.)
d�1 p.,,w YY
Eire- ix:Ltex,_v
QSAor
elif :A°#1Signature of Applicant
RECEIVED BY: '- - •
RECEI®� n Clerk's Office'
DATE: JUL 2 2 1908
•
Town Clerk Southold