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WASHINGTON COUNTY SANITARY DISTRICT PERMIT No.
33 W. WASHINGTON STREET HAGERSTOWN,MARYLAND 21741-0571
P.O. BOX 571 (301)791-3083/3084 DATE X:XXXX.XXX,X 10-15-84
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM SUBDISTRICT _--ivy
1g4ugansvi110/Orchard
Permission is hereby given to: 11artha A. _Pei -re Hills
For Property Located at: :, 6 l U e Mt. C r v P
Owned by: Aartha A. Petre Address: 225 Blue Mt. 11ri
i`Ir711Q.'iitCl.' T + �
Type of Connection: To Service Connection _ X To Main Line:
Type of Service: Residential
Commercial
Meter Size
) Units Other
Industrial
Connection Fee ____:620 • UJ .— Date Paid
To connect to a public sewerageaQW -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
Permit Fee
Final Inspection Made BY
33 W. Washington Street
Hagerstown, Maryland 21740
Telephone: 791-3146
Date
Plumbing Ins ctor
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:
Final Inspection Made By:
DISTRIBUTION: Permitt
Plumbing Board
Field Offi
Washington County Sanitary District
33 W. Washington Street-P.O. Box 571
Hagerstown, Maryland 21741-0571
Date
lu:ASHINCTON COUNTY SANI?" `'Y( 'STRICT
UASHINCTON COUNTY, MD.
SANITARY SE,yER LATUf';_
CONSTRUCTION RECORD,
Project: Maucansville/'Orchard Hills SD15-1—S
)3R10
Street (or location) : CQE C,s�-r 3Z S
Contractor: Calls Contractors, Inc.
Date Installed 7- 5- t 3
MH ZZ Z TO MH Z Z'-�
WYE Sta. On Main Z 4 8.y,4JZ L
WYE
SIZE
SIZE--
TYPE PIPE
TYPE
C.O.
DEPTH
C.O.
TYPE
LATERhL
� EXCAV.
LENGTH
LAYI{,;G
LENGTH
8'
(V,. PVC-
St'd,
_
*Hort.= Total -.
Svt 3S
sop- zc�
Pve-
/D.zo
/9. 7o
/7.70 '
3�Slope+ Horz=T ya
NOTES:
Drop
Depth of Cleanout /0. ztl ' C':)Flow Line,
Cleanout 1S. 5 From' p %,.j ;vE---��-•-- --
Layed C 5-
u,VK,v♦wn/ Basement Service
N
Z f
M H;;= Z Z Z
Amounts pertaining to work completed -hi,
BY
Incz•jC7Lor w
MH;;~ Z Z
period, �feviewed and approved.
r
.. A*k
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
i 3`l 10 Contract No. SD15-1 S
Property Address: 22 -5 -Blue Mountain Drive
MH 222 to MH 223 Dwg. #601-044 -�
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.
Z rn
00
C9 3 U) 0
co w
325 3
(22 5) (2 ) CL
o
w1 W W
l i
Z W
J 3 c
4o'ww _ MH SD15-223 (MAC.) ' FORCE
--1—� -- _ r.. I--- -- -- -- - —
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: t'0 27Gh z ( tc
// l /Owner (Print)
Owner s Signature
00*1
Attest:
Wash. Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56
WASHINGTON COUNTY SANITARY DISTRICT
33 West Washington Street, Hagerstown, Maryland 21740 ■ (301) 791.3083
/ //
To: Callas Contractors, Inc.
I hereby request the contractor to install the lateral in
accordance with the following conditions:
O Z4
Address�ti�%"
n:
'Property Owner
Date �"
Washington County Sanitary District
33 West Washington Street
Hagerstown, Maryland 21740
Re: Maugansville/Orchard Hills Sewers
Contract No. SD15-1-S
Gentlemen:
We hereby request permission to install the house lateral
of greater than two (2) percent and/or in accordance with the
above conditions at no change in contract price at the following
location:
Requested by Callas Contractors, Inc
Approved by W.C.S.D. Inspec
Date