HomeMy WebLinkAboutLat_13902CountrysideDriveWASHINGTON COUNTY SANrTkRY DISTRICT
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571 (301T791-3083/3084
P.O. BOX 571
PERMIT TO CONNECT TO PUBLIC SEWERAGEMAT.ER,SYSTEM
Permission is hereby given to:
For Property Located at: 205 Countryside Drive[ 6`�0 - \
Owned by: Edward G. Forsythe Address
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
PERMIT NO. j63___
DATE 11 —15-84
SUBDISTRICT No. 15
Maugan.aville Orchard
Hills
209 o s d- Drive. •vac
( , ) Units
To Main Line:
Other
Industrial
Meter Size Connection Fee $620.00 __ Date Paid 11 —1 5-"
To connect to a public sewerage/ 87 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 D S V
Building Permit No.
INSPECTION: At least 48 hours notice prior to requested date of inspection is required.
ON SITE INSPECTION will be made by
Permit Fee
Final Inspection Made BY
Washington County Plumbing Board
33 W. Washington Street
Hagerstown, Maryland 21740
Telephone: 791-3146
Plu bing Inspector
Date �eg rlyl �
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: Permitte
Plumbing Boa
Field Offic
Washington County Sanitary District
33 W. Washington Street-P.O. Box 571
Hagerstown, Maryland 21741-0571
Date
'2ASHINIGTON COUNTY SANITY` DISTRICT
UASHINGTON COUNTY, MD. I ,
Project:
Maugansville/Orchard Hills
13go-�L-
Street (or location):
u.✓T/Rv SIDE De�
SANITARY SEL;ER L„ i Er' L
CONSTRUCTION RECC C;C
My
Contractor: Calles Contractors, Inc. ,^
MH z// TD ('1H Z/Z v
Date Installed ( - /V- 83 I:1ye Sta, 0n rlain/f6Z.S
WYE
S17E
SIZE-
TYPE PIPE
TYPE
C.O.
DEPTH
C.O.
TYPL 1
LATERAL f
EXCAV.
LENGTH
LAYING
LENGTH
*Horz.= ToLal
Co'' pvc
y3�
Std,
SDR 3s
soR zc,
Z3•°��
z1.()(0
Slope + Horz=T .
Dr o
NOTES:
G 2ou".A ,_
Q A-1 LuT
-4M t3uRiCo PG CASLE
Depth of Cleanout 1/-3o, T. Flou Line
Cleanout /0).B* Erom
L a y s d 01
• &0 Basement Service
f6Z• S
H1H„' Z //
MH-'Z/Z
Amounts pertaining
to Work completed this period, reviewed and aap�pp,r,oved.
2 -CZ Or L'Of1Lr�.C%QrS FteP,
/ r- -- - I „ -r 1.
Property Address:
MH 211 to MH 212
A*Mk
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
30102 Contract No. SD15-1 S
I -G5 Countryside Drive
Dwg. #601-047
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.
E
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. C
Date:
Owner Print)
tfz At —
✓J
Owner ignature
Attest: a S tA,p
Wash. Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56
n
Lo
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:
C-
I
Address
Property Owner
L , Date
Washington County Sanitary District
33 West Washington Street
Hagerstown, Maryland 21740
Re: Maugansville/Orchard Hills Sewers
Contract No. SD15-1-5
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, I c.
Approved by W.C.S.D. Inspe _,
Date