building permit 401111°‘ TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: SEP-0627-2018
Tax Map No: 266.1-1-14.10
Permission is hereby granted to: Ellsworth& Son Excavating
For property located at: 17 OAK VALLEY WAY
In the Town of Queensbury,to construct or place at the above location in accordance with application together
with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Type of Construction
Owner Name: KURT JAEGER Septic Disposal-Residential $0.00
Owner Address: 17 Oak Valley Way Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Ellsworth&Son Excavating
76 ELLSWORTH LN
Lake George,NY 12845
Plans&Specifications
Residential Septic Alteration
$ 75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday, September 30, 2019
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration da -.)/
Dated at the Town o ueen j 4frri•: .4 •tember 28,2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement