5767 BUILDING PERMIT
TOWN OF QUEENSBURY •
No. 5767
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Arthur Gilman
OWNER of property located ati i Corinth Road Street, Road or Ave.
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in the Town of Queensbury,To Construct or place a Sewage 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 R. D. #2 ~
Corinth Road
2. CONTRACTOR or BUILDER'S Name
Reliable Sewer Service
3. CONTRACTOR or BUILDER'S Address R. D. #3
Glens Falls, New York
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4. ARCHITECT'S Name +.
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5. ARCHITECT'S Address 0
6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications
No. Dist. Box and dry well per application submitted.
8. Proposed Use cn
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Sewage system for dwelling
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5. 00 79
PERMIT FEE PAID —THIS PERMIT EXPIRES August 1 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the Fi
town of Queensbury before the expiration date.)
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N.
Dated at the Town of Queensbury this 3 rd Day of May 19 79
SIGNED BY 4,--dAl,e, N for the Town of Queensbury
Building and Zoning Inspector
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TOV1'N OF QUEENSBURY
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..- y &Y & - ,Ig . 1 ROADS RY I M Y �97
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Sf� �PI v C - J GLENS FAILS, NEWYO < .2E01 A.M. dI
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APPLICATION PERMIT
TO COOSTRUCT, ALTER OR ENZARGE
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OCCUPANT'S, NANEL // s),pa
. .� ..a,ADD1 ES= .�_ __a.... ---
TELEPHONE OC3 ,R S NAME
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ADDRESS NUMBER OF BEDROOMS
GAFBME GRINDER? (?T? OR NO) TOPOCRAM?' FUT ROLLING, S :reP SLOPE,
GENTLE a LOPE, OTHER
NATURE OFSOIL: CLAY 0.-.iD1, LOi v16-RAVEL ROC.�1'J ETC
PERCOLATION TEST .� �.. WATER S PPL : mtar.IPA:_!a WELL OTHER
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DIAGRAM OF PROPOSED SEPTIC SYSTEM
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OTHER PERTINENT INFORMATION
IT IS HEREBY AGREED THAT IF THIS APPLICATION . ID PLANS ARE APPROVED,
INSTALLATION OF SWAGE DISPOSAL FACILITIES. RILL BE MADE IN ACCORDANCE
WITH DETAILS SHOWN. B
DATE .. ..._ ._.. SIGNATURE OF APPLICAW „L7-- _ _
?SAX CEORGE PARK C Sit ISSIOiv APPROVAL:
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