SEP-000360-2017 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
QL Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: SEP-000360-2017
Tax Map No: 301.12-1-20
Permission is hereby granted to: IBS Septic
For property located at: 20 HELEN DR
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
Tvce of Construction
Owner Name: MICHAEL DONAHUE Septic Disposal-Residential $0.00
Owner Address: 20 Helen RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
IBS Septic
2 WARREN ST
Glens Falls,NY 12801
Plans&Specifications
Residential Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,June 23,2018
(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 expiration date.)
Dated at the Town of eens nda , on 3 7
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement