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SEPTIC DISPOSAL PELC0►Te 0 ice Use Only 742 Bay Road,Queensb r Y � �j Town ofC tens rti rmit#: —6 S Z� �Z 6( 1 P:518-761-8256 www. 3;n ur .net � Tax Map ID#: 301.15-1-58 X16 0 5 2019 P rmit Fee: $ 7 S 00; Invoice#: k(Qq 32 ELK RIDGE DRIVE TOWN o�nu 11wE1'JSi;URY S ptic Variance? Yes No Project Location: OWILMINn t CODES Primary Owner(s) SEAN SPOONER Mailing Address 32 ELK RIDGE DRIVE,QUEENBSURY NY Phone & Email Installer/Builder HOWARD EXCAVATING Mailing Address LUZERNE ROAD,QUEENSBURY NY Phone & Email 5183613243 Engineer NACE ENGINEERING-TOM CENTER Mailing Address 169 HAVILAND RD,QUEENSBURY,NY 12804 Phone & Email TCENTER36@YAHOO.COM Contact Person for Building&Code Compliance: DAVE HOWARD/TOM CENTER Phone: 3613243/7962515 RESIDENCE INFORMATION: Year Built #of bedrooms X gallons per bedroom =total daily flow Garbage Grinder Yes No 1980 or older Installed? (circle one) 1981-1991 Spa or Hot Tub Yes ©o Installed? (circle one) 1992-Present 3 110 330 PARCEL INFORMATION: Topography ✓ Flat Rolling Steep Slope %Slope Soil Nature Sand Loam Clay Other Groundwater At what depth? DEEPER THAN 6' Bedrock/Impervious material At what depth? NONE Domestic Water Supply j Municipal _Well (if well, water supply from any septic system absorption is ft.) Percolation Test Rate: 1"in7' per minute per inch (test to be completed by licensed engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tank size 1000 gallons (min. size 1,000 gallons,add 250 gallons for each garbage cylinder or spa/hot tub System Absorption field with#2 stone Total length ft.; Each Trench ft. Seepage Pit with #3 stone How many: ;Size: Alternative System Bed or other type: 20 X 35 FT BED Holding Tank System Total required capacity? ;tank size ;#of tanks NOTES: 1.Alarm system&associated electrical work must be inspected by a Town approved electrical inspection agency; 2.We will no longer allow systems to be covered until such time as an as-built plan is received and approved. The installed system must match the septic layout on file—no exceptions. Declaration:Any permit or approval granted which is based upon or is granted in reliance upon any material representation 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 and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. PRINT NAME: DATE: g/51//5 SIGNATURE: Town of Queensbury Building&Code Enforcement Revised February 2017