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HomeMy WebLinkAboutMckinney o 4fr:44 JUDITH T. TERRY Town Hall, 53095 Main Road TOWN CLERK CM Fri P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER �Q O� , Fax (516) 765-1823 'W Telephone (516) 765-1801 — rr ►r OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 2042-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner MCKINNEY, JULIE L. Mailing Address 1 BOX 1632 - Mailing Address 2 City St Zip SOUTHOLD NY 11971-0000 Property Address 1 7373 SOUNDVIEW AVENUE Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 516-765-9235 Tax Map No. section 59.00 block 9 lot 26.013 Cross Street KENNY'S ROAD Date Of Last Pump Out 0/00/00 Issue Date: 2/22/93 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK c.0FD(,i- Town of Southold % ,-- C2'.. Application No.c2f� Judith T. Terrry, Town Clerk . �► _� ; -4 IP .0 1 $10.00 - Residential Town Hall,' 53095 Main Road r P.O. Box 1179 v' ,V,:: Khp.' Z $25.00 - Non-Residential Southold, New York 11971 O0 �0�,•�` Telephone 1 r • (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for ' OPERAT ION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ j0 , 2. _ DATE Z S G.J OWNER NAME: J U''8.. 1 F L, fAc`tf lu P Er OWNER MAILING ADDRESS: .C)x. I 6 0 2 .&-'0 0700L6 toy WO l OWNER PROPERTY ADDRESS: 1. .. eio t//�[jJ liV OWNER TELEPHONE NUMBER: %S _ 2 3S TAX MAP NO. : Section Block Lot ., ./ ,�I i i3 CROSS STREET: TYPE OF SYSTEM: Septic Tank New Existing Cesspool 7 New Existing 10 Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: / 21/1 7 2/. 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.) 7 i& (3 / 1 C-44.."---(62 ' Signature of Applicant RECEIVED BY: .(A.A /,���� Tow Clerk's Office DATE: /7.2 V �/ , • q9.,I - ' ' ' , ,-, . • • , . _ ..-...0 : .--ki '' , . ,, ' t ok,' „ c...,-F---- 0, _ - , _ ,_, ,1 , s.,,.... _, ._ - . _ ,, t „ '�' is ; ' " - - 'ii H- -.. , „,1 . c's= . . . ,'' -tz..4'7„2:-.z , _ _ _ - -: