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SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4330-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner ALEC ELAK
Mailing Address 1 P. 0. BOX 296
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 1170 FOUNDERS PATH
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 631-765-2084
Tax Map No. section 64.00 block 4 lot 500
Cross Street LANDON LANE
Issue Date: 12/14/06 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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