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HomeMy WebLinkAboutPrince R ,11eeCOFO1.Iir44 JUDITH T. TERRY - Town Hall, 53095 Main Road TOWN CLERK T Z, P.O. Box 1179 • REGISTRAR OF VITAL STATISTICS tr2 Southold, New York 11971 yr Fax (516) 765-1823 MARRIAGE OFFICER O r • �,�/®d ,�1� �� Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3184-R Residential X Non-Residential Fee $ 10.00 New Existing X Name Of Owner PRINCE, JOANN Mailing Address 1 1335 HOBART ROAD Mailing Address 2 City St Zip SOUTHOLD NY 11971-0000 Property Address 1 1335 HOBART ROAD Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 516-765-3943 Tax Map No. section 611.00 block 2 lot 10.000 Cross Street L'HOMMEDIEU Issue Date: 3/03/94 Judith T. Terry Southold Town Clerk (TOWN SEAL) p • III OFFICE OF THE TOWN CLERK FDU( I'= Town of Southold � CQ Application No.3J Judith T. Terry, Town Clerk Town Hall, 53095 Main Road ' .. $10.00 - Residential P. O. Box 1179 cr3 > ; $25.00 - Non-Residential Southold, New York 11971 Telephone (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation al ermit No. Fee $ IO U DATE . /`s// 7 OWNER NAME: /U A/Nce-- OWNER MAILING ADDRESS: �3' 5 /17664 i( cd/A-7-7(cL 4 I OWNER PROPERTY ADDRESS: /ids OWNER TELEPHONE NUMBER: 76.51-394/3 TAX MAP NO. : Section 64" Block Lot /D CROSS STREET: `-rC/" ( 4/E TYPE OF SYSTEM: Septic Tank New Existing Cesspool New Existing Residential Non-Residential 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 of Applicant • RECEIVED BY: Town Clark's Office ,DATE: /1r1C/IV:7V'J JrJV i 'r 7. © U 1. . v. r_ . . , Np1:�' `.1 / ci\------'-----------, / 14 04 T.J dr^`e P Y a' 01 T iv....:.,...--- zs a irage c& N _ v / -gr 96 O — o rs A �' 0- Tri � ..--------- 7.11got p.,...... 6.2011' W / s\ch.01 N 0 O o- 11.64 1)901 7°° p 10"--- 4---' �Ofr f 15 J ~ 51.:4'- ''7- / z o LO �, /2g . \-------- moo- / a° /F/� �- / 0 N to i(7 9. C>4 ✓i o_ 56 tree \ .,rel