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HomeMy WebLinkAboutOltmanns �-- € ,'oto\ss,, O(�co JUDITH T.TERRY ���_� y� Town Hall, 53095 Main Road TOWN CLERK t o ; P.O. Box 1179 ten Southold,New York 11971 REGISTRAR OF VITAL STATISTICS \./0 �,I� Fax(516)765-1823 MARRIAGE OFFICER -4% 0 .0 Fax (516) 765-1800 RECORDS MANAGEMENT OFFICER •I FREEDOM OF INFORMATION OFFICER Os OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3456-R Residential X Non-Residential Fee $ 10.00 - New Existing X Name Of Owner OLTMANNS, WARREN J. & BEVERLY Mailing Address 1 45 OAKWOOD DRIVE Mailing Address 2 City St Zip SOUTHOLD NY 11971-0000 Property Address 1 45 OAKWOOD DRIVE Property Address 2 City St Zip SOUTHOLD - NY 11971-0000 Owner Telephone No. 516-765-3249 Tax Map No. section 70.00 block 13 lot 1 .000 Cross Street PINE NECK ROAD Issue Date: 4/16/96 Judith T. Terry Southold Town Clerk (TOWN SEAL) 4OFFI OF THE TOWN CLERK :,s,\_-Town of Southold -C'QG.� Application No..34C5 7i Judith T. Terry, Town Clerk �� y Town Hall, 53095 Main Road $10.00 - Residential P. O. Box 1179 cn `' $25.00 - Non-Residential Southold, New York 11971 OO �0*-$ Telephone j • (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ • DATE OWNER NAME: Wibt-k_Rt_g T. 'E- ISEVE IX 1 1 OL-TMA /�`/F l, , � ) OWNER MAILING ADDRESS: aO W 00 0 �� j Va OWNER PROPERTY ADDRESS: /VV Pi F j cIA Ro O A 4J " w -C�.� BLA�. 41- 0 -Kut DA V. OWNER TELEPHONE NUMBER: 176 — 3-2- illT TAX MAP NO. : Section 7 (9 Block l3 Lot I CROSS STREET: E-�Jc ©Aj� TYPE OF SYSTEM: Septic Tank New Existing Cesspool )( New Existing Residential( Non-Residential LOCATION MAP: Must be attached hereto before permit may be issued. LLocate buildina and system:. give north arrow and feet of distance, approximately, to building and closest road.) • Ji/ / , _ %/ P. '* LI re of .p icant RECEIVED BY: ) Town I,erk's Office DATE: /j`/6. - y6 SE.c- 10 - 13 1-49e-f - 13 -- Lo-r- I 3 Nill, - - O"1, ( "f iirom woob Dkoi — 4LlAttiviS .., filvE ivF_.p.....l< 1?0,/4 b Raoul till. l q't 1 - 14 005 1 BACK -I 4 1 t I goDR mss ‘R i i ''IIt 4 I AI r Q a r; 9 1 1 RonD Z,I'Q6i. -_____401 — — ------ ` S6L1 a \k SQ v-r--14