HomeMy WebLinkAboutRauchOFFICE OF THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. 0. Box 1179
Southold, New York 11971
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
I
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 445 Residential X
Fee $ -10.00 Non -Residential
Septic Cesspool X
NAME OF OWNER: Marvin Rauch
OWNER MAILING ADDRESS: 480 Inlet Lane
Greenport, New York 11944
OWNER PROPERTY ADDRESS: 480 Inlet Lane
Greenport, New York 11944
OWNER TELEPHONE NUMBER: 516-477-1765
TAX MAP NO.: Section 43 Block
CROSS STREET: Manhasset Avenue
TYPE OF SYSTEM: Septic Tank
New
Cesspool X New
Lot
Existing
Existing X
Residential X Non -Residential
DATE OF PREVIOUS PUMP -OUT: Approx. 5 years ago - 1982±
DATE: September 28, 1987
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Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. 0. Box 1179
Southold, New York 11971
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
"6F
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ /0
Application No. !V / 4
Residential
Non --Residential
DATE 9117/&2
OWNER NAME: M _Aj&;d
OWNER MAILING ADDRESS:" ��® �l►i-If" CAT
CR W Aly V j**
OWNER PROPERTY ADDRESS:_ �A�l'�$ 0.5 cdolic
OWNER TELEPHONE NUMBER: x}77 - 17GS
TAX MAP NO.: Section /do b Block 4- Lot 1
CROSS STREET: Aj
TYPE OF SYSTEM: Septic Tank New Existing V
Cesspool ✓ New Existing V/ -
Residential Non -Residential
-- DATE, OF PREVIOUS PUMP -OUT: 646AP 9' WAM &aD
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:
��C wnlerk's /Office
DATE:— SEP 9
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