HomeMy WebLinkAboutHohnhorst OFFICE OF THE TOWN CLERK ' •cOFO(/rL'
Town of Southold �� �
•
Judith T. Terry, Town Clerk �G
Town Hall, 53095 Main Road a
P. O. Box 1179 v' ,14 '
Southold, New York 11971 0 *1,
Telephone
(516) 765-1801 -
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT d
SEPTIC TANK or CESSPOOL
Operation Permit No. 40 Residential XX
Non-Residential
Fee $ 10.00
Septic Cesspool xx
NAME OF OWNER: Carl Hohnhorst
OWNER MAILING ADDRESS: 5700 Vanston Road
Cutchogue, New York 11935
OWNER PROPERTY ADDRESS: 5700 Vanston Road
Cutchogue, New York 11935
OWNER TELEPHONE NUMBER: 516-734-5102
TAX MAP NO. : Section 111 Block 10 Lot 13.1
CROSS STREET: Little Peconic Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool xx New Existing xx
Residential XX Non-Residential
- _ DATE OF PREVIOUS PUMP-OUT: Unknown
Judith T. Terry
Southold Town Clerk
DATE: September 11, 1986
(TOWN SEAL)
1
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OFFICE OF THE TOWN CLERK c.�FFO(,r� -
Town of Southold �� CQ� Application No. /7/ 0
Judith T. Terry, Town Clerk ► � ,L;` te ' Residential
Town Hall, 53095 Main Road
P. O. Box 1179 cn4 n, �• Non-Residential
Southold, New York 11971
Telephone
®144 }t
(516) 765-1801
TOWN OF SOUTHOLD
,vv: miVED SOUTHOLD WASTEWATER DISPOSAL DISTRICT
SEP 0 81986
APPLICATION
Tnwn Cleric Southold
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1-70
Fee $ /0,. b
DATE A" ,016) jqn
OWNER NAME: C0- 417(1 h1.37'4
OWNER MAILING ADDRESS: 57i IA 4't l'
Ao 1
OWNER PROPERTY ADDRESS: S
OWNER TELEPHONE NUMBER: 7,31-i— ,57
TAX MAP NO. : Section / / / Block / 6 Lot I3 1
CROSS STREET: Ciif'"t-e— ree-an'dG ; Otne1l
TYPE OF SYSTEM: Septic Tank New Existing
/
Cesspool V/ New Existing
Residential V 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.)
-.4„,i/L.,
Signature o Applicant
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RECEIVED BY: , 'i , `1/
down Cler s Office
DATE: //>/ ,
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