HomeMy WebLinkAboutLekich OFFICE OF THE TOWN CLERK FO
Town of Southold
Judith T. Terry, Town Clerk %� ,'<FA + �'
Town Hall, 53095 Main Road A '
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P. O. Box 1179 u' z = u yc
Southold, New York 11971 O •
Telephone
(516) 765-1801
TOWN OF SOUTHOLD .
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 91 Residential XX
Fee $ 10.00 Non-Residential
Septic Cesspool XX
NAME OF OWNER: Karlo Lekich
OWNER MAILING ADDRESS: 260 Peck Place
Southold., New York 11971
OWNER PROPERTY ADDRESS: 260 -Peck Place
Southold, New York
OWNER TELEPHONE NUMBER: 516-765-1307
TAX MAP NO. : Section 70 Block 3 Lot 11
CROSS STREET: Wells Avenue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool XX New Existing XX
Residential XX Non-Residential
DATE OF PREVIOUS PUMP-OUT: August 8, 1986
Judith T. Terry
Southold Town Clerk
DATE: October 15, 1986
(TOWN`, SEAL)
OFFICE OF THE TOWN CLERK 'S\FFO(,���"
Town of Southold Application No.
Judith T. Terry, Town Clerk k .11
Town Hall, 53095 Main Road ! Residential
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P. 0. Box 1179 ;;; .' Non-Residential
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Southold, New York 11971 O t
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
OCT 1 5 1986
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
Town Clerk Southold,
APPLICATION
for --
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 9/
Fee $
DATE 'L° ( '-ct#62)
OWNER NAME: kA R j 0 kR c
OWNER MAILING ADDRESS: 02 ® p I ? p ,
S0tiTHeLO1 1t/ y. ii97 /
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OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: 765- /3127
TAX MAP NO. : Section 10 - Block 3 Lot 4/
CROSS STREET: WEL 6-s 4-Pa
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential Ye_C, Non-Residential
DATE OF PREVIOUS PUMP-OUT: f g `
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.)
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Signature of„Applicant
RECEIVED BY: a_c, .
Town C rk's 0 fice
DATE: / ,42-c