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Type of Permit
Subdistrict Name _
Mainline Contract No.
Building Permit No. _
WASHINGTON COUNTY
WATER & SEWER DEPARTMENT
16232 Elliott Parkway f I ra
Williamsport, MD 21795
V
(301) 791-3083 1r^�
Permit to Connect to Public Water/Sewer System
Permission is hereby given to:
Property Owner: -N rIt MEO
of address:
-r
Permit No. 1`^-1401
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Issue Date
Void Date
Subdistrict No. Fj
For property located at: " } Street Address
Lot No. Subdiv. Phase Sec.
Owner's Agent:
Agent's Address: `
Previous Owner:
Fees Paid in Full?
Date Fees Paid
WCWSD Alloc./Conn.
WCWSD/Other
City of Hagerstown_
Remarks
Fee
Fee
Fee
Fee
Total Fee
Lateral with Mainline?
Residential EDU's _
Commercial EDLI's _
Gal/Day Allocation
Building Number
Misc. Number
When connecting to a public water/sewer system, the installation of the connection and the abandonment of the previous private system shall
conform with the provisions of Maryland State laws and County policy.
This permit does not supercede any local ordinance that is in effect with regard to road excavations, plumbing permits, etc. ALL OTHER PERMITS,
STATE AND LOCAL, MUST BE OBTAINED BY THE PROPERTY OWNER AND ALL RESPONSIBILITY CONNECTED THEREWITH RE-
MAINS WITH THE PROPERTY OWNER.
Date: I% .57 0 ,
INSPECTION: At least 48 hours notice prior to requested date is required.
ON SITE INSPECTION will be made by: Washington County Plumbing Board
100 W. Washington Street, Room 304
Hagerstown, MD 217404727
Phone: (301) 791-3070
Inspection Date:�Z 0-7- g8 Plumbing Inspector:
RECEIVED
DEC Z 1 1994
WASHINGTON COUNTy'
WATER & SEWER DEPT
8
WASHINGTON COUNTY SANITARY DISTRICT
WASHINGTON COUNTY, MD. ^
Project:
Street (or location): /' �c✓s i � -e 1
Contractor: '�a
Date Installed 7- /-7' 94
SANITARY SEWER LATEF
A*4 CONSTRUCTION REPORT
,c T 4'�.r 7
MH ///CJ TO MH
Wye Sta. On Main
WYE
SIZE -
TYPE PIPE
TYPE
C. 0.
DEPTH
C.O.
TYPE
LATERAL
EXCAVATION
LENGTH
LAYING LENGTF
sDe-2G
= Total
Q�!/C
.�U/.4
DHoriz.
STPD.
��•�
Slope t Horiz. = To
NOTES:
DROP
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//
4J11
.(A . .U
Depth of Cleanout D Tem at Flow Line
Cleanout From C4 oc M
Layed at
AJI,9- Basement Service
MH #/)/O
Amounts ain' to work completed this
BY-
WCSD INSPECTOR
period. reviewed and approved.
MHt# ///i
/ . Va�-
CONTRACTORS REPRESENTATIVE
WASHINGTON COUNTY SANITARY DISTRICT FS
AUGUST 13, 1984
-