HomeMy WebLinkAboutKlinge JUDITH T. TERRY : Town Hall, 53095 Main Road
�� P.O Box 1179
TOWN CLERK rva rp
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER V'�® Fax (516) 765-1823
`Tv' �! Telephone (516) 70-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1935-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner KLINGE, RORY AND KATHY
Mailing Address 1 P. O. BOX 203
Mailing Address 2
City St Zip GREENPORT NY 11944-0000
Property Address 1 1045 WASHINGTON AVENUE
Property Address 2
City St Zip GREENPORT NY 11944-0000
Owner Telephone No. 516-477-9710
Tax Map No. section 41 .00 block 2 lot 11 .000
Cross Street MIDDLETON ROAD
Date Of Last Pump Out 0/00/00
r
Issue Date: 6/24/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK .cwFFD it - /0 2 cr—i
Town of Southold � CQ ' Application N .
Judith T. Terry, Town Clerk 44'0 y
Town Half, 53095 Main Road a _4'' $10.00 - Residential
p.. 0. Box 1179 u' � � $25.00 - Non-Residential
Southold, New York 11971 O '4,pj n. -
Telephone y
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE June 15, 1992
OWNER NAME: Rory C. Klinqe & Kathy M. Klinqe
OWNER MAILING ADDRESS: PO Box 203
Greenport, NY 11944
OWNER PROPERTY ADDRESS: 1045 Washington Avenue
Greenport, NY 11944
• OWNER TELEPHONE NUMBER: 477-9710
TAX MAP NO. : Section 041 Block 02 Lot 011
CROSS STREET: Middleton Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing X ,
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: I `� � 1\y \Seta
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.)
o hL ti�
Sig ature of A plican
RECEIVED BY:
Town Clerk's Office
DATE: REcevED
JUN 22199?
lawn Clerk foofd
t'
E
.
t -
.
- EXT .
. . ,
r .
_.
TON W MAP OF
M.I abi- _ w .W r - DESCR/BED PROPER T Y
i . k • • 1 NEAR G/ EENPOR T TOWN OF •
m• I .(RES.) � • 7I
` - -SOV THOD SUFFOLK CO, N. YLIx ;GRADE EL.=/0 4
ND
----tiI ql �I ' N/F REEVES P,P ..n.--- 3.0' .
H�TmPSOL - 1 \
HEAVY4 `S 1
4./ ci N--l3° 53 I s' i o - t. C i'
WATER r \9 •I�254' V4/ 1 ti t3 �t .1 COVERED 1 12 ._..TEST HOLE = TEES : ^► �P��ME _-_ 3' m• �� r. ���SF�0 492�3�,��0
Nor TO SCALE) N,I ill`J \ ' - I _ O LAND SJ
[' ” CO sr `U V ? CERTIFIED TO:
-)2 4 5,' a/t'•— o 1,THE TITLE GUARANTEE COMPANY
tc�rn� m a.' cP ►� - .. [ N- T-/285-3277
CO Of r o el 54 r,� SOUTHOLD SAVINGS BANK
5`f K �0 7 o H ,wR£s `�, I FOR RY KL/NGE • -
i3.e' u9 �/a w iT.HY KL/NGE
/38.6/' 1 . • ? f }
PIPE FNP_2PO d0I1�ICk associates
QS
V/L'L AGE, OF land surveyors & consulting engs.
GREENPORT W i 4 P west main street
AREA: /O, /8Osgft(O.2337ocres) (VAC) - ti ri •derhead , new york 11901
(516) 369- 17I7
i - JUNE 19;1984 Job no. 84-533
t F/NAL-6-2-86
Ty 8ELEr,-3-7-86 1000-041-02-11 Scale: 111=30'
NOTE: ELEVATIONS IN ASSUMED DATUM - FOUNO. L.::. - 7-/ -b� `
1•
f