8125 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 8125
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Jeckel & -Sons Honda
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e Road Street, Road or Ave.
Route 9 - Lake George OWNER of property located at g
Alteration e
in the Town of Queensbury,To Construct or place a Sewage
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. o
1. OWNER'S Address is •
Lake George Road
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Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer Service
3. CONTRACTOR or BUILDER'S Address
53 Fourth St. o
Glens Falls, New York
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
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( )Wood Frame ( ) Masonry ( )Steel ( )
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7. PLANS and Specifications
8 'x8 ' drywell for drain water per plot plan
No. and application submitted.
8. Proposed Use
Sewage system :for auto sales and service
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$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Sept. 26 1985
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the (1-
town of Queensbury before the expiration date.) (D
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26th P.)Se t 83 rt.Dated at the Town of Queensbury this Day of P . 19 rt
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SIGNED BY `]41arl a • for the Town of Queensbury
Building and Zoning Inspector
• TOWN OF QUEENSBURY
TOWN OF QUEENSBURY A E n _ p V 1 .
BUILDING & ZONING DEPARTMENT11
SEWAGF DISPOSAL PERMIT APPLICATION SLr 2 31983
JDNJ , „t1. Owner' s Nme . d /�' / �J$�.{�//1t1(19 ,2 4I5 6
r / .11 a a I P c/ a 11 III 4 1 l a
Address. /f1/ç' ' r'cE e. /J(
Telephone No. —3 P 793 //
2. Property location JIMA/I&
3 . Name of person or firm reponsible for installing system
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c /C: 1 �i,i af�((I te.rui( t Telephone No. 7
Address 02,,) 3 ri4/ f
4. Number of bedrooms (residential buildings only)
5. Daily flow gallons/day
6. Septic tank capacity . gallons
7. Topography: flat rolling, steep
% of slope
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8 . Nature of soil and depth C�` (�
9. If ground water, bedrock or impervious material is apparent at what .
depth does it begin? ft.
10. Percolation test: .A is required
B is not required
C., If required what is the rate (9-5- minutes/inch
11. Water supply: municipalDwell, other
12. Type of system proposed: dryw , tile field, other
Any contractor,, corporation, individual, etc. engaged in'.the. construction
of a sanitary sewage disposal system who covers the same before inspection,
does not have an approved permit, or varies from the approved application
will be _subject to a penalty of. $250 as provided for in Section 6 . 010 ,of the
Queensbury Sanitary Sewage Ordinance I
Date Cf0%. . /7/17 c eZ0f,e
signature f applicant
On separate sheet of paper submit a diagram of the proposed septic• system
with all dimensions, including distance from any structure, distance from
property line and domestic water supply, etc. Include all dimensions of
the system itself..
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72_6( tift,( Cu/11-0(--
Form 3-82 •
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SANITARY SEWER SERVICE
Division of G. P. Drellos, Inc.
53 FOURTH STREET GLENS FALLS, N.Y. 12801
TELEPHONE 792 7257
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