HomeMy WebLinkAboutTR-4226 GF James F. King, President
Bob Ghosio, Jr., Vice-President
Dave Bergen
John Bredemeyer
Michael J. Domino
Town Hall, 53095 Main Rd.
P.O. Box 1179
Southold, NY 11971
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN
APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO
SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE
PERMIT.
INSPECTION SCHEDULE
Pre-construction, hay bale line
__ Ist day of construction
~ constructed
Project complete, compliance inspection
James F. King, President
Bob Ghosio, Jr., Vice-President
Dave Bergen
John Bredemeyer
Michael J. Domino
Town Hail Annex
54375 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
November 14, 2012
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Mr. Matthew Ivans
Suffolk Environmental Consulting, Inc.
PO Box 2003
Bridgehampton, NY 11932
RE:
LEON MUNIER
4030 GREAT PECONIC BAY BLVD., LAUREL
SCTM# 128-6-1
Dear Mr. Ivans:
The following action was taken by the Southold Town Board of Trustees at their Regular
Meeting held on Wednesday, November 14, 2012:
RESOLVED, that the Southold Town Board of Trustees APPROVE the Administrative
Amendment to Wetland Permit ~4226 to use steel sheathing versus vinyl sheet
sheathing on the bulkhead; and as depicted on the revised project plan praparad by
Suffolk Environmental Consulting, Inc., received on November 14, 2012 and stamped
approved on November 14, 2012.
Any other activity within 100' of the wetland boundary requires a permit from this office.
This is not a determination from any other agency.
If you have any questions, please call our office at (631) 765-1892.
Sincerely,
,lames F. King
President, Board of lrustees
JFK:amn
James F. King, President
Bob Ohnsio, Jr., Vioo-President
Dave Bergen
John Bredemeyer
Michael J. Domino
Town Hall Annex
54375 Route 25, P.O. Box 1179
Southold, NY 11971
Telephone (631 ) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Please be advised that your application dated II !2~/! ~ , has been
reviewed by this Board at the regular meeting of " !/Il ! ~/J ?_.__ and
your application has been approved pending the completion bf thd following items
checked off below.
__ Revised Plans for proposed project
__ Pre-Construction Hay Bale Line Inspection Fee ($50.00)
__ 1st Day of Construction ($50.00)
½ Constructed ($50.00)
V/7- Final Inspection Fee ($50.00)
__ Dock Fees ($3.00 per sq. fl.)
Permit fees are now due. Please make check or money order payable to Town of
Southold. The fee is computed below according to the schedule of rates as set forth in
Chapter 275 of the Southold Town Code.
The following fee must be paid within 90 days or re-application fees will be necessary.
You will receive your permit upon completion of the above,
COMPUTATION OF PERMIT FEES:
TOTAL FEES DUE:
BY: James F. King, President
Board of Trustees
James [: King, President
Bob Ghosio, ,Ir., Vice-Presidenl
Michael J. Domino
P.O Box 1179
Southold, NY 11971
Telephone (631 765-1892
Fax(631)765-6641
Southold Town Board of Trustees
Field Inspection/Worksession Report
Date/Time:
Suffolk Environmental Consulting, Inc. on behalf of LEON MUNIER
requests an Administrative Amendment to Wetland Permit #4226 to use
steel sheet sheathing versus vinyl sheet sheathing on the bulkhead.
Located: 4030 Great Peconic Bay Boulevard, Laurel. SCTM# 128-6-1
Type of area to be impacted:
__Saltwater Wetland Freshwater Wetland
Sound Bay
Distance of proposed work to edge of wetland
Part of Town Code proposed work falls under:
__Chapt.275 Chapt. 111 other
Type of Application: __ Wetland __Coastal Erosion ~Amendment
~Administrative__Emergency __Pre-Submission Violation
Info needed:
Modifications:
Conditions:
Present Were: J. King B. Ghosio
J. Bredemeyer Michael Domino
Form filled out in the field by
__ D. Bergen,
D. Dzenkowski other
Mailed/Faxed to:
Date:
BOard Of SouthOld' Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO. 4226
DATE:. ~gust .Bi.~. 199!
ISSUED TO Leg~ . ~T~!~
Authorizatio
Pursuant to the provisions of Chapter 6t5 of the Laws of
+he State of New York, 1893: and Chapter 404 of the Laws of the
State of New York 1952; and +he 'S°u+hold Town Ordinance an-
if+led "REGULATING AND THE ~PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIAL5 FROM
LANDS UNDER TOWN WATERS~" and in accordance with +he
Resolution of The Board adopted a+ a meeting held on A~g.ust 26
19 ~6, and in consideration of the sum of $. Z?~O~ paid by
]~on Munier
of N.Y. and subject to the
Terms and Conditions listed on +he reverse side hereof,
of Southold Town Trustees authorizes and permits the following:
Grandfather permit for bulkheads, bathouse ~nd stairs
as per drawing of Leon Munier and survey by Peconic
Surveyors. Located ?econic Bay Blvd.
all in accordance with the detailed specifications as presented in
+he originating application.
IN WITNESS WHEREOF, The said Board of Trustees ~re-
by causes its Corporate Seal fo be affixed, and these presents to
be subscribed by a majority of +he sald Board as of this date.
Trustees
Moved by John Holzapfel. second by Bruce Loucka. it was
RESOLVED recommend to the Southold Town Trustees APPROVAL of
the Wetland Application of the NORTH FORK COUNTRY CLUB
109-[[-7,1 to create new 16th teeing ground and fairway in wooded
area to the east of existing 15th green .and 16th fairway according to
submitted plans. The Council recommends approval with the
understanding that the runoff be contained and native vegetative
buffer areas be maintained.
Main Road, Cutchogue
Vote of Council: Ayes: All
Motion carried.
Moved by Patricia Isaksen, seconded by John Hagerty, it was , .
RESOLVED to recommend to the Soutl~old Town TFuste~- APPROVAL
of the Wetland Application of JEEON L~:,M[J,NIEl~,~]~28~6-1..which_ is a
Crandfather Permit for stairs ~n~t deck's for bblkheads; deck and
bathhouse approximately 12' x [[0' located in between bulkheads.
403§ Peconic Bay Blvd., Laurel
Vote of Council: Ayes: All
Motion carried.
Moved by Patricia Isaksen. seconded by John Holzapfel. it was
RESOLVED to recommend to the Southold Town Trustees APPROVAL
of the Wetland Application of VICTOR CATALANO 128-6-13o3 to
replace (within 18"J 103 .f. of timber bulkhead. Wall to be
backfilled with 350 c.y, of clean backfill to be trucked in from
upland source and delivered over owner's property. Remove an
existing concrete stairway and replace with a 5' x 7' wood stairway.
Property damaged by winter storms. The Council recommends
approval and suggests the applicant may wish to tie in the adjacent
bulkheads to create a solid line.
Peconic Bay Boulevard. Laurel.
Vote of Council: Ayes: All
Motion carried.
Moved by John Holpzalfel. seconded by Patricia Isaksen. it was
RESOLVED to recommend to the Southold Town Trustees
DISAPPROVAL of the Wetland Application of ROBERT TAYLOR
126-6-9.1 to construct 58' of timber retaining wall no more that 2'
in front of existing retaining wall. with a 30' return on the east
property line. Approximately ~0 c.y. of clean backfill to be trucked
~n in from upland source.
The Council recommends disapproval as submitted because there is
plenty of room behind the existing seaward bulkhead (not retaining
wall); the proposed plan would be 2' in front of adjacent western
bulkhead which would create an angle, which can create erosion
problems. The Council also questions the MHW. it does not appear to
be correct on the submitted plans.
Sigsbee Road. Mattituck
Vote of Council: Ayes: All
Motion: carried.
2
TRUSTEES
John M. Bredemeyer, IlL President
Albert J. Kmpski. Jr.. Vice President
Henr,,' P. Smith
John B. Tuthill
Wilham G. Albertson
Telephone (516) 765-1892
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
SUPERVISOR
SCOT!r L. HARRIS
Towe Hall
53095 Main Road
EO. Box 1179
Southold. New York 11971
Office Use Only: DATE REC.:
Coastal Erosion Permit Application m~l l
--Coastal Erosion Variance Application
--Wetland Permit Application
--Waiver from Chapter 97(Application/per
--Trustee Lands Permit Application
~Grandfather Permit Application~/~3~/93
Rec.
__Comple%ed Apps. Date:
Inspection date:
CAC comments-Date: Sent
~Variance Required: (Y/N)
~Neighbors notified-Date:
SEQRA Type
Coord.: Date sent
SEQRA Determin./date:
~_Public ~earing/date:
Findings: Approved (Y/N~
Special Conditions: (Y/N)
[see file)
Permit(s) issued-date:
Application Fee:
Application Number;SCTMgl000- ~'~l
Da~e: ?//~3
Interest: (owner, consultant, lessee,etc.
Owner of Property:
Address jr
Phone (
Subject Property Location:
(Provide LILCO Pole ~, Distance to cross Streets if. not on
location maP)
THIS IS NOT A PERfqlT
Page 1
Yds. to be excavated: ~
Manner in which material will be
Yds. no be filled:
removed or deposited:
Width of canal, creek or bay fronting property: t OO
Depth at low tide: Aver. rise in tide:
Distance to nearest channel: Distance Pro3ect
~extends beyond similar projects in area:
Area zoning: ~O Land area in acres: .~,~q~
Is pro3ect for pri~ate or b~siness use: ~lJ~_
Intended use of property: ~k~/_~
Describe known prior operations conducted on premises:
Has any prior license or permit been issued ~o erect structures,
dredge, or deposit fill on said premises:
Has any license or permit ever been revoked or suspended by a
Governmental Agency:
Project Description
The proDect description must also include plans for reclamation
of land disturbed during construction of the principle and
accessory structures and underground structures (i.e., pipeline
and septic system; make additional attachments if necessary).
THIS IS NOT A PERMIT
Counuy of Suffolk )
Sta~e of New York )
~/~/~/ ~' /~/%/£ ~-~ ~F~BEING DULY SWORN DEPOSES AND
AFFIRMS THAT HE~SI/E IS ~E APPLIC~T FOR ~E ~O~ DES~IB~
P~IT(S) ~ THAT ~L STAT~TS CONTAIN~ ~R~EIN ~E ~UE TO
~E B~ST OF HIS/H~ ~O~EDGE ~ BELIEF, ~D ~AT WO~ WILL BE
DONE IN ~E ~ SET FOR~ IN ~IS APPLICATION ~ AS MAY BE
APPROVED BY ~ SOUTHO~ ~ BO~ OF TRUST,S. ~ ~LIC~T
AGREES TO HOLD ~ TO~ OF SO~O~ ~ T~ TO~ ~UST~S
H~ESS ~ FR~ ~OM ~ ~ ~ D~GES ~ ~A~ ~SING
~ER OR BY ~R~E OF SAID PE~T(S.), IF G~'~
IN COMPLETING THIS APPLICATION, I HEREBY AUTHOI~iZE
THEIR AGENT(s) OR t~EPRES~/qTATIVE{s), TO ENTER O1T1X
TO INSPECT T~E PREMISES
APPLICATION.
SWORN TO BEFORE ME THIS ~'~
------DAY OF ~
IN CONJUN~ WITH RE~E~
S~GNATU~E
~ 'TRUSTEEs,
M~ PROPERTY
OF THtE
NOTARY PUBLIC
HELENE O. HORNE
Notary P~SJiC, State of New
No. 4951364
Q~eNfied i~ Su~fol~ County ~-~
Co .remission Expires May 22,
Suggested space fOr location Map
THIS IS NOT A PERMIT
/ /- j
L ~OIV L A4U/V/E-~, ~
"c/: F e Edit Vow Toobar Wndow
12 -6 1 473889 Southold Adive
Munier. Leon L Jr RollYe~r: 2013 Ne~Vr 1 Family Res
4030 Great Peconic BDy 81vd L~nd Size: 1.25 acres
P¢S: 1
School: Mattituck Schoe
Land AV: 3.200
Total AV: 7.800
Parcel 128-6:
Exempt(s)
Soec Dist(s)
i Owner(s)
Images
Gis
Site (1) Res
SaleOT/16/02
To~ Bill Mailing Address 3rd Pady Address Bank
Oq#nefs chck lhe e )riale row
Last Name / Company
IMunier
Attentk3n To / In Oare Of:
c/o Alan Fidellow
Street No: Prefix Dir: Street/' :~urel Route:
75 ,~ I~Granite ~prings
Po Box No: City/Towr
York Town Heights
Countr> enter if not "USA" B~rCd
First Nome MI: Jr. Sr. etc:
Leon L Jr
Additional Address:
StSuff~x: PostDir: UnitName: UmtNo
State Zip Code:
:NY ',- 10598:
Ownership: eg L,fe Use OwnerType:
P = Primary
Ready
County of Suffolk
State of New York
DI~OSP_.~ .AIqD APF[~S ~AT H~SHE ~ THE APPLICAN l' FOR ~F. A~VE
DESC~ED PERMff(S} AND ~AT A~ STA~ME~ ~~ ~ ARE
~ rO ~E BEST OF l nS~IER ~OW~GE AND BEUSF, ~D ~AT ALL WO~
W~L BE ~NE ~ ~E ~ S~ tO,TI! ~.~IS ~PLICATION ~D ~ mY
~DER OR BY VIRTUE DP SAID PERMIT[S], IF OR AN~D. ~ CO~LE~O Tm8
.~PLICATION, [ HEREBY AUmORIZE TH~ 'I'gUSI'EES, msm Aa~(S) o~
~MmS m CO~O~ W~, ~mnw o~ ~ms ~mCAT~O~.
8ig.atmc of Property Own*r
SWORN 10 BEFORE ME THIS
Commissior~ Ex, pi~es Js.ua~y 22, 20/~/
OWNER'S ENDORSEMENT
(TO BE SIGNED IF APPLICANT IS NOT OWNER)
STATE OF NEW YORK)
COUNTY Oi~ ~ .SS:
ALAN FIDELLOW
being duly sworn, deposes and says; I reside at:
75 Granite Springs Road; Yorktown Heights
In the County of Westchester and the state of New York , and
I am the (owner in fee) (officer/agent of the Corporation which is owner in fee)
of the premises described in the foregoing appiication and thai ~ have
authorized.
SUFFOLK ENVIRONMENTAL CONSULTING, INC.
to make the foregoing application as described herein.
Signature
If Corporation, name of corporation and Officer
Officer's Title
MUNIER / FIDELLO WProperty
Situate: .1.03o Peconic Bay Boulevard; Mattituck; Town of Southold, NY
SCTM~: 1ooo- 1~8-06-OOl
PROPOSED BULKH£AD R£CONSTRUCTION
APPROVED BY
BOARD OF TRUSTEES
TOWN OF SOUTHOLD
DATE Il ~_
27.!
TO;= ~r
S26'54'50'W
NOV 1 4 2012
118.57'
HA Y
MUNI£R / FID£LLO W Property
Situate: ~o30 Peconic Bay Bo~evard; Mattituck; To,vn of Southold, NY
SCTM#: 1ooo-1~8-o6-001
PROPOSED BULKHEAD RECONSTRUCTION
NOV 1 4 2012
Board Of $outhold' Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO. 4226
DATE: ...~Bgust 31.~ 1993
ISSUED TO
Pursuant to the provisions of Chapter 6t5 of the Laws of
the State of New York, 1893; and Chapter 404 of ('he Laws of ('he
State of New York 1952; and ('he 'Southold Town Ordinance en-
titled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and in accordance with the
Resoluflon of The Board adopted at a meeting held on .A~g~sl: 26
9....~.~, and Tn consideration of the sum of $ 100.00 paid by
of N.Y. and subject fo the
Terms and Conditions listed on ('he reverse side hereof,
of Southold Town Trus~'ees authorizes end permits the following:
Grandfather permit for bulkl~eads, batI~ouse and stairs
as per drawing of Leon Munier and survey by Peconic
Surveyors. Located Peconic Bay Blvd.
all in accordance with the detailed specifications as presented in
the originating application.
IN WITNESS WHEREOF, The said Board of Trustees h~re-
by causes its Corporate Seal to be affixed, and ~'hese presents to
be subscribed by a majority of the seld Board ss of this dst,e.
....
Trustees
Moved by John Holzapfel. second by Bruce Loucka. it was
RESOLVED recommend to the Southold Town Trustees APPROVAL of
the Wetland Application of the NORTH FORK COUNTRY CLUB
I09-[t-7.1 to create new 16th teeing ground and fairway in wooded
area to the east of existing 15th green .and 16th fairway according to
submitted plans. The Council recommends approval with the
understanding that the runoff be contained and native vegetative
buffer areas be maintained.
Main Road. Cutchogue
Vote of COuncil: Ayes: All
Motion carried.
Moved by Patricia Isaksen. seconded by John Hagerty. it was
RESOLVED to recommend to the Southold Town ApPROvAL
of the Wetland Application of which"' is a
Grandfather Permit for stairs s; deck and
bathhouse approximately 12' x 40' located in between bulkheads.
4030 Pecon[c Bay Blvd.. Laurel
Vote of Council: Ayes: All
Motion carried.
Moved by Patricla Isaksen. seconded by John Holzapfel. it was
RESOLVED to recommend to the Southold Town Trustees APPROVAL
of the Wetland Application of VICTOR CATALANO 128-6-13.3 to
replace [within 18") 103 I.f. of timber bulkhead. Wall to be
backfilled with 350 c.y. of clean backfill to be trucked in from
upland source and delivered over owner's property. Remove an
existing concrete stairway and replace with a 5' x 7' wood stairway.
Property damaged by winter storms. The Council recommends
approval and suggests the applicant may wish to tie in the adjacent
bulkheads to create a solid line.
Peconic Bay Boulevard. Laurel.
Vote of Council: Ayes: All
Motion carried.
Moved by John Holpzalfel. seconded by Patricia Isaksen. it was
RESOLVED to recommend to the Southold Town Trustees
DISAPPROVAL of the Wetland Application of ROBERT TAYLOR
126-6-9.1 to construct 581 of timber retaining wall no more that 2'
in front of existing retaining wall. with a 30~ return on the east
property line. Approximately [tO c.y. of clean backfill to be trucked
in in from upland source.
The Council recommends disapproval as submitted because there is
plenty of room behind the existing seaward bulkhead [not retaining
wall); the proposed plan would be 2' in front of adjacent western
bulkhead which would create an angle, which can create erosion
problems. The Council also questions the MHW. it does not appear to
be correct on the submitted plans.
Sigsbee Road. Mattituck
Vote of Council: Ayes: All
Motion carried.
TRUSTEES
John M. Bredemeyer. III. President
Albert J. Krupski. Jr.. Vice President
Henry P. Smith
John B. Tuthill
William G. Albertson
Telephone (516) 765-1892
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
SUI~ERVISOR
SCOTT L. HARRIS
Town Hall
53095 Main Road
P.O. BOX- 1179
Southol& New York 11971
Office Use Only:
Coastal Erosion Permit Application
Coastal Erosion'Variance Application
__--Wetland Permit Application
__Waiver from Chapter 97~Application/i
Trustee Lands Permit Application
aGrandfather AppliCatl~, ~3~A3
__Completed Apps. Date:
Inspection date:
CAC comments-Date: Sent Rec.
---Variance Required: (Y/N)
__Neighbors notified-Date:
SEQRA Type
Coord.: Date sent
SEQR~ Determin./date:
Public Hearing/date:
~- Findings: Approved (Y/N)
Special Conditions: (Y/N)
I (:see file)
[ Permit(s) issued-date:
Applicatio~ Number.:SCTM$1000-[~%ff::~]
DATE REC.:
Application Fee:
.£
Date: T/¢¢3
/
~U/~ ~-~ fiJ ~/~ ~ [ q ~ ~'~ Phone
Interest: (owner, consultant,lessee,etc.)
Owner of Property:
Address y-
?r Phone ( )
Subject Properuy Locatio,x:
(Provide LILCO Pole
location map)
Distance to cross Streets if not on
THIS IS NOT A PERMIT Page 1
Yds. to be excavated: ~--- Yds. to be filled:
Manner in which material will be removed or
deposited:
Width of canal, creek or bay fronting property: I~;O
Depth at low tide: Aver. rise in tide:
Distance to nearest channel: ~ Distance Project
,extends beyond similar projects in area:
Area zoning: ~O Land .area in acres: .~,~~'
Is project for pri~ate or business use: ~%d~__
Intended use of property: ~k~f_~,~
Describe known prior operations conducted on premises:
Has any prior license or permit been issued to erect surucuures,
dredge, or deposit fill on said premises:
Has any license or permit ever been revoked or suspended by a
Governmental Agency:
Project Description
The project description must also include plans for reclamation
of land disturbed during construction of the principle and
accessory structures and underground structures (i.e., pipeline
and septic system; make additional attachments ii necessary).
Page 2
County of Suffolk )
Sta~e of New York )
i~/~/ ~. ~//t?F ~-~.~EING DULY SWORN DEPOSES ~
AFFIRMS THAT HEJSHE IS THE APPLICANT FOR THE ABOVE DESCRIBED
PER~IT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO
THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE
DONE IN THE MANNER SET FORTH IN THIS APPLICATION A~D AS MAY BE
APPROVED BY THE SQUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT
AGREES TO ~{OLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES
HARMLESS AND FREE FROM ~LNY AND ALL DAFLAGES AND CLAIMS ARISING
UNDER OR ~BY VIRTUE OF SAID PERMIT(S), IFGRANTED.
IN COMPLETING THIS APPLICATION, I i HEREBY AUTHORIZE THE ~TRUSTEES
THEIR AGENT(s) OR REPRESENTATIVe(S), TO E~ER ONTO MY PROPERTY
TO Ii~SPECT THE PREMISES .IN CONJU~CTIO~ W1TH REv~ OF THiB
SWORN TO BEFORE ME THIS DAY 0 ,19~-~
NOTARY PUBLIC
HELENE O. HORNE
Notary P~b~ic, State of Ne~ Yolk
No, 495~ 3~
Quai~fi~ i~ Su~dk ~u~ ~
Co~m~ssio~ ~o~ May ~ 19 ~
Suggested space for location Map
THIS IS NOT A PERMIT
C
SURVEY FOR
LEON L. MU/VIEI~,
AT LAUREL
TOil'ti OF
SUFFOLK cOoPrY,
sCaLE, I ~ 40
AREA. 44.62250 FI
OR 1.0244 ~CRE$
SURVEY OF PROPERTY
A T LA UREL
TOWN OF SOUTHOLD ,
SUFFOLK COUNTY, N.Y.
1000-128-06-01
SCALE: I'-- $0"
AUGUST 16, 20'11
PLAN . .
NEW SEPTIC ISYSTEM
( 8 BEDROOMS
TEST HOLE DATA
McOONALD GEOSCIENCE
AREA=43,494 SO. FT.
TO TIE LINE
CONTOUR LINES FROM TOPOGRAPHIC MAP FIVE
EAS~RN TOWNS
I om fomilior with the STANDARDS FOR APPROVAL
AND CONSTRUC~70N OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR SINGLE FAMIL Y'RESIDENCES
ond will obide by the conditions set forth there~ ond on the
permit to construct.
The Iocotlon of wells ond cesspools shown hereon ore
from field observotions ond or from doto obtoined from others,
/
/
Ill=MONUMENT
/
/
NO. 496t~
(6J1) 765-5020 FAX (6J1) 765-1797
P.O, BOX 909 STREET
1250 TRAVELER
Sou~oLo. N.× ,l~t 198-291