5999 BUILDING PERMIT
TOWN OF QUEENSBURY No. 5999
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Gary $ervilio (San Souci)
OWNER of property located at Cleverdale Road Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Sewage System for Restaurant
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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1. OWNER'S Address is
Star Route
Glens Falls, N. Y.
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2. CONTRACTOR or BUILDER'S Name
Scott McLaughlin
3. CONTRACTOR or BUILDER'S Address
R. D. #1
Lake George, N. Y.
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( 1 Masonry ( )Steel ( 1
7. PLANS and Specifications U]
1000 gallon concrete tank, dist. box, 200 ft. tile field
No. and #3 stone per application submitted
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8. Proposed Use
Sewage System for Restaurant
$ 5. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Nov. 1 19 79
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this 30th Day of July 19 79 to
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SIGNED BY /'� • / '�' for the Town of Queensbury 0
Build and Zoning Inspector rf
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