8641 BUILDING PERMIT
TOW'UN OF QUEENSBURY
No. 8641
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to `7• Michael Blackburn 4
OWNER of property located at Upper Ridge Road .
Street,Road or Ave.
N.
in the Town of Queensbury,To Construct or place a One-Family Dwelling
at the above location in accordance to',application together with plot plans and other information hereto filed and N approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
30 W. Notre Dame Street
Glens Falls, New York x
a
0
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2. CONTRACTOR or BUILDERS Name
Same
3. CONTRACTOR or BUILDERS Address
Same
4. ARCHITECT'S Name (ropp
f'1
5. ARCHITECTS Address a
W
M
W
O
6. TYPE of Construction—(Please indicate by'X) W
a
(x)Wood Frame ( )Masonry ( )Stool ( )
7. PLANS and Specifications
361x40' per plot plan, specifications and
No. application submitted including sewage system,
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8. Proposed Use
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One-Family Dwelling
F�•
$5. 00 C/O Paid *C
$ 126. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES February 1 1985 E
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the M
town of Queensbury before the expiration date.) I
Dated at the Town of Queensbury this_ 116th Day of "I 19—_ tq
SIGNED BY a• for the Town of Queensbury
Build ng and Zoning Inspector