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1999-222 BUILDING PERMIT TOWN OF QUEENSBURY VALUE $ 0 No. 99222. TAX MAP NO. 66. -3-11 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to EDMUNDS, RRCHARD & JUDITH OWNER of property located at 9 ORCHARD DR. Street, Road or Ave. in the Town of Queensbury,To Construct or place a SEPTIC ALTERATION 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. 1. OWNER'S Address is 9 ORCHARD DRIVE QUEENSBURY, N.Y. 12804 2. CONTRACTOR or BUILDERS Name . CONDON SEPTIC & DRAIN SERVICE 3. CONTRACTOR or BUILDERS Address • 4. ARCHITECTS Name • • 5.:ARCHITECT'S Address ' • • 6. TYPE of Construction—(Please indicate by X) SEPTIC ( )Wood Frame ( ) Masonry ( )Steel ( 1 7. PLANS and Specifications • SEPT] . ALTERATION AS ;.PER PLOT PLAN SPECIFICATIONS 8; Proposed Use - SEPTIC ALTERATION V $ 25 PERMIT FEE PAID -THIS PERMIT EXPIRES May 7 19 2001 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the- town of Oueensbury before the expiration date.) - Dated at the Town-of Queensbury this - 7 Day of May—: 19 1999 SIGNED BY \ for the Town.of Queensbury Building and oning-Inspector. Application ror ar✓r 111. 1/13rv3I-kL rr,KLV111 Town of Queensbury Dept. of Community Development Permit No. V OC Building &Codes Office 742 Bay Road Fee Paid $ DS,' Queensbury, NY 12804 L J Location of property for installation: ? ©RC AD /) Property Owner's Name:Pt 'f-MOD 1 -0/ £)i i 1VDS - 7 7'3 -3 `1.3� Property Owner's Mailing Address: q Okc/4h " D Installer's Name:ah1 domS Svii`c-4W)/4-ist) SEA :N'tr Phone # 7 cj —S's—if Z Number of bedrooms (if residential): L) Total daily flow: 00 (residential - compute @ 150 gal.f); 6 1999 Topography: )( flat, rolling, steep slope % of slope TOWN OF QUEENSBURY BUILDING AND CODE Soil Nature: X sand, loam, clay, other /depth: Ground water: at what depth? �A�feet / Bedrock or Impervious Material: at what depth?i4 feet Percolation test: not required, required [ rate min. per inch] Domestic water supply: X municipal, well, other If domestic water supply is a WELL, water supply from any septic absorption is feet. PROPOSED SYSTEM - r gXC5tr/t/ Septic tank: l fin° gallon (minimum size: 1,000 gal.) Tile field: each trench ‘O feet / Total system length: 306/ feet Seepage pit(s): number of / size each: ft. by ft. Size of stone to be used: # 2- / depth or thickness / feet HOLDING TANK SYSTEM: (if required) Number of tanks: Size of each: gallons [Alarm system and associated electrical work to be inspected by a certified agency.J For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void. I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature of responsible person: :u Date: b - 3 =3a TOWN OF QUEENSBURY r BUILDING A CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name AK Location az TT Date j / 11 Permit # _ --77 SOIL TY :— a Loam-Clay- Results of Percolltion Te1t- (if applicable) Rate-Min qte/Inch TYPE OF SYSTEM: \ ABSORPTION FIELD: Total Length a2'2- Length of each trench\ if ,/-7.17 -(0e- Depth of trenches Size of stone \i SEEPAGE PITS: Number- \ Size - ft. x \ ft. Stone size PIPING: ize Type Bldg. to Tank _ Tank. to Dist. Box . \\) Dist. Box to Field/P 't 'i \)6 _-x-r, \t:---1f:. � Openings Sealed? / es No Partial LOCATION/SEPARATION ' Foundation to Tank f - feet Foundation to Absorp' ion -z-A- feet Separation of Pits _— feet Conforms as per Plot Plan c-_,YsscNo LOCATION OF SYSTEM 0�. PROPERTY: �\ (circle one) Front - Rear - Left i_de.=Right Side Middle Front,, - Rear COMMENTS: - - • SYSTEM USE APPROVED: %YE r Arrived: ;)11-1F7//- Departed: oc - ) �/� Bu 2' f ng Yn p'ctor ` t(c J,-,1) Atli i) )D' 7/ L :DIYI 0/v P C o ,:J cAvS -_erg c:,,- --p,-/w/v r 'K. tIvc ? 0 A C/ 4A D bA_ 7Q 3 - 3 Y 38 1."4- OMNT i4UEL A rY6F--cffyL a eFfvs2orr ifv, • 1a'-8-o L. v I e s' Ed(S to Y 0.--�'7. • a-° r• 1 • (off _ S 61 • - ti 1-. I 60 - ; 3/ 6r ,1 c I � 66 1tvr;Ii"AA oRS ki/1 T 1 D c,ir-�W &Qf(/un��s Co��� sns e� ECG ! � V, }G l,u �`fc, 1. q O6QCNAADJr N3-3 7 3 1 �L l�fi/7 7- ( A - ZO �7 Z Ou PFAis3 OO �.y ( �'1eNs / s �:Y t 7 x 3° 6 0 r 30 60 6 ° 6 CPO. t C° 9i --Q0,22 -lSD6 CIO 4- -1 EC W D ` MAY 0 6 1999 - • �U�� TOWN OF QUEENSBURY BUILmompoinDING AND CODE "I have seen or observed,or believe I sage tvidenc*ot all objects such as houses, wells,trees,fences,elC., shown on this document. I also represent that I h personally measured the distances set frith en the diairere." 6 Pe - (iu SIGNATURETr