HomeMy WebLinkAboutWillman ilf et A\
_7 4' '�. r Town Hall, 53095 Main Road
�` P.O. Box 1179
40`,/ Southold, New York 11971
JUDITH T.TERRY �" TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 882-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner WILLMAN, KATHLEEN & OTHERS
Mailing Address 1 19 KIM AVENUE
Mailing Address 2
City St Zip HAUPPAUGE NY 11788-0000
Property Address 1 8300 HORTON LANE
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-265-1274
Tax Map No. section 54.00 block 4 lot 29.001
Cross Street NORTH SEA DRIVE
Date Of Last Pump Out 0/00/82
Issue Date: 10/12/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF t?"F'�T ,�►OWN CLERK ��+F•
Town of Southold �� „ CQ ' , Application No.
Judith T. Terry, Town Clerk
Y
Town Hall, 53095 Main Road fix = Residential
P. O. Box 1179 *`4 ' z. Non-Residential
Southold, New York 11971 O ; " �0/�`
Telephone .�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ Jp• D O
DATE Oa:-
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