HomeMy WebLinkAboutSolinger, Laura ELIZABETH A. NEVILLEt‘
Town Hall, 53095 Main Road
TOWN CLERK o P.O. Box 1179
WSouthold, New York 11971
REGISTRAR OF VITAL STATISTICS 4 $
MARRIAGE OFFICER Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER `�y0! �a��0�,' Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �� southoldtown.northfork.net
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OFFICETOF THETFTOWN CLERK
SOUTHOLD WAVW�4 r �Ubil AL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4158-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner SOLINGER, LAURA
Mailing Address 1 13459 OREGON ROAD
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 13459 OREGON ROAD
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 631-734-7039
Tax Map No. section 83.00 block 2 lot 10.012
Cross Street COX LANE
Issue Date: 8/22/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK COFOL4 CC
TOWN OFSOUfHOLD 0� CSG Application No. LILA
ELIZABETH A.NEVIII.F,TOWN CLERK ' 4 $10.00 - Residential V
P.O.BOX 1179
SOUTHOLD,NEW YORK 11971 �'���� $25.00 - Non-Residential
Telephone _Oj IF
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 2 H 0'R
Fee $ 10,Oo
DATE C6/02
OWNER NAME: /U)°-",9S40LA✓6r/2-
OWNER MAILING ADDRESS: I3L1-S / Oi2F 6o/1.1 140
11 9 35-
OWNER PROPERTY ADDRESS: 13 4 Y OVZEGG/v 21)
cLiTGHa&t/ iris/ 1 19 3c
OWNER TELEPHONE NUMBER: 6 31- 7 3 `t -7039
TAX MAP NO. : Section aq 3 Block 040 Z. Lot O 10.01 -2-
CROSS STREET: ' O> LN
TYPE OF SYSTEM: Septic Tank / New 1Z Existing
Cesspool New Existing
Residential I/ 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.)
07,rf
Signature of Appfl -"
RECEIVED BY:
Town Clerk's Office
DATE:
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