2006-636 VOID TOWN OF QUEENSBURY
` 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201: 4y
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20060636 Application Number. A20060636
Tax Map No: 523400-302-018-0002-041-000-0000
Permission is hereby granted to: NORMAN &ANNA MARIA VAN DIEST
For property located at: 125 GRANT Ave EXT
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: NORMAN &ANNA MARIA VAN D
15 ARBOR Dr Septic Alteration Residential
GLENS FALLS,NY 12801-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2006-636
SEPTIC ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,January 21, 2012
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expira. ..te.)
Dated at the Toyvi o e .�� J . y-January 21, 2011
SIGNED BY ` r for the Town of Queensbury.
Director of Building&Code Enforcement