HomeMy WebLinkAboutLeonard d-$
OFFICE OF THE TOWN CLERKFO
Town of Southold �SVF • 14
Judith T. Terry, Town Clerk � Z . "1 'rc
Town Hall, 53095 Main Road ?. 1j
P. O. Box 1179 - �
Southold, New York 11971 p r �- •
Telephone -_�.( [
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 201 Residential x
Fee $ 10.00 Non-Residential
Septic Cesspool x
NAME OF OWNER: Jean Leonard
OWNER MAILING ADDRESS: 1980 Leeton Drive
Southold, New York 11971
OWNER PROPERTY ADDRESS: 1980 Leeton Drive
Southold, New York
OWNER TELEPHONE NUMBER: 516-765-1274
TAX MAP NO. : Section 58 Block 2 Lot 13
CROSS STREET: Kenny's Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New - Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
Judith T. Ter
Southold Town Clerk
DATE: January 13-. 1987
(TOWN SEAL) )
OFFICE OF THE TOWN CLERK OFOC,(-
Town of Southold �� CQG' , Application No. (-JO/
Judith T. Terry, Town Clerk of," Wit) Residential
Town Hall, 53095 Main Road r.
cn �z , .
P. O. Box 1179 W - Non-Residential
_
Southold, New York 11971
OSP
Telephone 4°/41%-,
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
MEM for
JAN 051987 OPERATION PERMIT
'down Orli Southold SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE I) 1 137
OWNER NAME: Ju& � e..61/1.a. rc ,
OWNER MAILING ADDRESS: ?qv) Lr
v` e,,,p)-ems ; 1 t9,—) 1
OWNER PROPERTY ADDRESS: tqw)
OWNER TELEPHONE NUMBER: 71 S 1,).--21/411
TAX MAP NO. : Section 6 Block (D- Lot 1 3
CROSS STREET: eAn *If 13 Qc/(_
J
TYPE OF SYSTEM: Septic Tank /, New Existing
Cesspool New Existing
Residential 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.)
Signature o Applicant
RECEIVED BY:
RECEBVETown Clerk's Office
DATE: 1987
s a
Town Clerk Southold
•
s, y-i. ?""7"'s _�. 't � _i t lY'u;