applicationTOWN OF QUEENSBURY
APPLICATION FOR
DEMOLITION PERMITaeBlaRLFEEPAID $_A)—
INSTRUCTIONS FOR COMPLETING THIS APPLICATION.
1,All applicable spaces are to be completed.
2.‘TWO Plot Plans are to be submitted,drawn to scale,showing:
a,Lot boundaries with dimensions and adjacent roads &streetsb.All existing structures,with indications as to those to be removed
c.Location of all utilities
3,Fee submitted per current Fee Schedule,payable to "Town of Queensbury".
THE OWNER OF THIS PROPERTY Is:Duawe Watje
P.O.Address:NONE Qeceasen)TEL.N/A
Property Location:Mfr esol Ave Tax Map NoJR7/|_/1h
Street number or building lot number
Person Responsible for work ‘Kaymown __C,Adams
Address PO.Boy 179 Fort Aud NY Telephone 747°S 33Qinga?
‘The following building(s),located on the property described above,aretoberemovedfromthatproperty.
Reason ror REmovaL_Dave Hath Orpeeen
Previous use of building (circle one)
~Garage -Storage -Business -Other__4 othey b dgs
Have all utilities been disconnected?Gas___Electric X Propane___Water X
Size of building(s)
1._Q8 ft.x YO ft.Location on property.mivwesota Ave
2.at tti.x 36 tt.W.Glevs Falls Wy.3.74 ys Ft:
3.No.lot Stories!a
4.Foundation type (circle one)full cellar -{rawl space>slab.
Foundation will remain ‘be remove é
5.Another structure will__will not_X.,replace this building.Replacement ofstructurewillrequireapplicationforBuildingPermit.
stoNaTURE CAD
Owner,owner@Jagent,archichect
Contractor
SPECIAL NOTES: