1985-116 BUILDING PERMIT
TOWN OF QUEENSBURY 85_116
10 WARREN COUNTY, NEW PORK
PERMISSION is hereby granted to Top O ' The World Associates
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OWNER of property located at old Farm House — Lockhart Mountain Street, Road or Ave. 100
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in the Town of Queensbury, To Construct or place a Se�+4'ag�' Alteration
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. (D
t . OWNER'S Address is R.D # 1 Box 1390 lo^S
Lake George, New York ¢
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2. CONTRACTOR or BUILDER 'S Name O
same t7
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3. CONTRACTOR or BUILDER'S Address 0
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same
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by XI
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f ) Wood Frame i Y Masonry f ) steel i 1
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7. PLANS and Specifications
1000 gallon holding tank , 150 LF file filed
No. 3 laterals @ 50 ' per application submitted .
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8. Proposed Use M
Sewage system for dwelling �
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April 15 r
PERMIT FEE PAID — THIS PERMIT EXPIRES A p 1J $ 7 (D
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the lS
town of Queensbury before the expiration date.) r
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April 85 0
Dated at the Town of Queensbury this '-�--y5t.�h Day of A p �B t:1
SIGNED BY //! for the Town of Queensbury
Building and Zoning Inspector
TOWN OF OUEFNSBURY �TOWN ap
BUILDING & ZONING DEPARTMENT �
SF1TAGF DISPOSAL PERMIT APPLICATION IR
1 . Owner ' s Name P.
Address,� r rGJ'�7 �i /
� L � f�c�" d '?' J Telephone No
2 . Property location s � , Nr A050cfS
3 . Name of person or firm responsible for installing system �� d
Telephone No . J`
Address
4 . Number of bedrooms ( residential buildings only )
5 . Daily fIowrd2: ,E2 'rpa yf,,!Sb&=f,,,,,, gallons/day
5 . septic tank capacity 4 42LX2 gallons
7 . Topography : flat , rolling , steep
% of slope
8 . Nature of soil and depth �,�,�. ,.
9 . If ground water bedrock or impervious material is apparent at what
depth does it begin? ,3, z r` 7- f t .
10 . Percolation test : A is required
B is not required
C If required what is the rate minutes/inch
ll . Water supply : municipal , well , other //�A=7AL �
12 , Type of system proposed : drywell , the field , otherD�/�a,Jp( �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 apprgaxed application
will be subject to a penalty of $ 250 as prov ' d for in a tion 6 . 010 of the
Queensbury Sanitary Sewage Ordinance . ,
Date
lcjvffitu�r�k. 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 .
Form 3 - 82