HomeMy WebLinkAboutUtz OFFICE OF THE TOWN CLERK ic_IFOC(�,"-
Town of Southold � y 0,
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road rk;
P. 0. Box 1179 Fri
Southold, New York 11971 \\Q ® V; •
Telephone �l
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
• SEPTIC TANK or CESSPOOL
Operation Permit No. 484 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
NAME OF OWNER: Susan Park Utz and Mary Anna Muir
OWNER MAILING ADDRESS: P.O. Box 166, Orient, New York 11957 (Utz)
P.O. Box 276, East Marion, New York 11939 (Muir)
OWNER PROPERTY ADDRESS: Youngs Road
Orient, New York
OWNER TELEPHONE NUMBER: 516-323-2799 (Utz) 516-477-1079 (Muir)
TAX MAP NO. : Section 18 Block 1 Lot 9
CROSS STREET: Main Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
drateehaudJudith 1- rry
Southold Town Clerk
DATE: November 17, 1987
_
(TOWN, SEAL) `
. ,
OFFICE OF THE TOWN CLERK 'c0Feure,-
Town of Southold �oN CQ '` Application No.
Judith T. Terry, Town Clerk �
Town Hall, 53095 Main Road �[ Residential
P. O. Box 1179 —r3 v Non-Residential
Southold, New York 11971 O6�
Telephone _ .( ��•
(516) . 765-1801
TOWN OF SOUTHOLD
Q FC:EIVED
NOV ® 9 1987 SOUTHOLD WASTEWATER DISPOSAL DISTRICT
Town Clerk Southold APPLICATION
tor
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 'wy
Fee $
/51
DATE 3
A
OWNER NAME: t k'e -r ' .4 -
n
OWNER MAILING ADD ' ESS: a, , G6 Ori ii
_
f�
• 1� .. 'J iIr O m
OWNER PROPERTY ADDR SS: Yerz..eS ilVe72t0, -
OR/r , ) y /ifs-7
OWNER TELEPHONE NUMBER: 329-2791 q77 ) 07f
TAX MAP NO. : Section 60/7; Block 0/. Lot Q(jj,
•
CROSS STREET: fr) /9/,J RA
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential X Non-Resi ential
DATE OF PREVIOUS PUMP-OUT: 9/,;?3
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.)
• tR.
Signature of Applicant
RECEIVED BY: .0' ' I.,
Town Ci-rk's Off'Ce
RECEIVED
DATE:
OV 171997
Town Clerk Southold -
v l
ti
'- . /\\
---- R- --- - ,-jr,E - _ ..,.,
.._ _ .. _ _ _ _____.. _ . __ .._
___(.17,0) .__,......„,.. 1))4 _. _ _ .
, .
--------------- --- ------------------ --- -- --- -- -
-------P4- <C)
- c,-- --:- -- - -- --- - - - -- - -- --
, 4 _ . _ _ _ _ _
. .
, _ _ _ _
i
0 _,
co)
_ c„. 0 _ .........F _th,,... _„,...„...._
____ _
_, _______ _ ,....._ __
,,
,.. ,,
\ z,/5- Fee/r
- -- - - — �
Ars
- - — - � >
_- _ — --- - = - - S - - 1 _ .-. - --P
•11
P=3
i
1 c __---77----._ 6,-- \ '
L
i
---------- --—--- --- -- ---
Ill
II
6e,
n
-- ---------- - - - -- - - -- -- - -
iiI
_ _ _ _____ � _ _ _ _ _ - _ _ _ ___ _ - _ _
- -- - ri.
Ou-- -- -- - , , _ - - _4- --_ - klfie