HomeMy WebLinkAboutLat_14211BasoreDriveA,ASHINGTON COUNTY SANITARY DISTRICT
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-3083/3084
PERMIT TO CONNECT TO PUBLIC SEWERAGEIWATER SYSTEM
Permission is hereby given to:
For Property Located at:
Owned by:
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
Address:
Connection Fee
_ To Main Line:_
Units Other
Industrial
Date Paid
PERMIT NO. _
DATE
SUBDISTRICT
�r
To connect to a public sewerage/water system (with proper abandonment of previous private system). The installation
of the connection and the abandonment of the previous private system shall conform with the provisions of the
Laws of the State of Maryland and Washington County Sanitary District Specifications.
This permit does not supersede any local ordinance that is in effect with regards to road cutting, etc.
ALL OTHER PERMITS, STATE AND LOCAL, MUST BE OBTAINED BY THE PROPERTY OWNER AND ALL RESPON-
SIBILITY CONNECTED THEREWITH REMAINS WITH THE PROPERTY OWNER.
Secretary -Treasurer
Building Permit No.
INSPECTION: At least 48 hours notice prior to requested date of inspection is required.
ON SITE INSPECTION will be made by: Washington County Plumbing Board
33 W. Washington Street
Hagerstown, Maryland 21740
Telephone: 791-3146
Permit Fee
Final Inspection Made BY: xx_ Date
Plumbing InVector
OFF-SITE INSPECTION (in Public Rights -of -Way and Easements) and certain
ON-SITE INSPECTION in accordance with applicable approved construction drawings will be made by:
Washington County Sanitary District
33 W. Washington Street
Hagerstown, Maryland 21740
Final Inspection Made By:
DISTRIBUTION: Permittee Plumbing Board
Field Offic
Date
WASHINGTON COUNTY SANT" JISTRICT
WASHINGTON COUNTY, MO.
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SANITARY SEWER LATE';';_
CONSTRUCTION REC HI'l.t
Project: Mauoansvi11e10rchard Hills Sanitary Sewerage Collection System_
Street (or location):
Contractor:_ Lisl
MH WTO FM 7�
Date Installed B -%urre- g,d-- Wye Ste. On Main_:
H X
i IE TYPE PIPE C 0 C.O. LATERAL LENGTH LENGTH
8"Z" X(5'• 6" SDz L6 OY.G. 6"SDs z6 *Hor=. w
Total
eycl 4.40 V. S t I d .
•slops + norz=l oca,
Drop 0 e. 9. 4.4f+ a957C ,F
NOTES:
f6.7'
MA) k1
� I
� I •
2 ��u6Cpp
464f3end5
Depth of Cleanout-4-70V.:c OFlow Line
CleanoutY, romp 72 774,
Layed
Po-5S/r3Lr✓ Basement Service
..2 ' 54u b Cop
MH#
MH# ?zs
Amounts tainilftQ to work completed this periodo reviewed and approved.
BY —
wCSU I spector Contractors Rep.
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15- 3-9
!Mall aa5ore.Drw� —
Property Address: Route 8 Box 242 (Basore Drive)
DWG. #601-347
Place an 'X' in the sketch below to indicate where the property
owner wants the service connection (lateral) to enter the
property. Place a wooden stake in the ground at that location.
The undersigned agrees that the Sanitary District may
excavate an additional five (5) feet inside the property
line so as to facilitate, and make less expensive, the owner's
connection to the lateral and to prevent damage to the cleanout
which will be installed by the District -at or near the property
line.
Date: 12 8'� �/ 'L r�LJ1 I1%
Owner
Owner
1
Attest: AA
Wash. Co. Sanitar District
(Form WCSC-1)
Replaces Form WCSC-56
Washington
County Sanitary
District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15- 3-9
!Mall aa5ore.Drw� —
Property Address: Route 8 Box 242 (Basore Drive)
DWG. #601-347
Place an 'X' in the sketch below to indicate where the property
owner wants the service connection (lateral) to enter the
property. Place a wooden stake in the ground at that location.
The undersigned agrees that the Sanitary District may
excavate an additional five (5) feet inside the property
line so as to facilitate, and make less expensive, the owner's
connection to the lateral and to prevent damage to the cleanout
which will be installed by the District -at or near the property
line.
Date: 12 8'� �/ 'L r�LJ1 I1%
Owner
Owner
1
Attest: AA
Wash. Co. Sanitar District
(Form WCSC-1)
Replaces Form WCSC-56