HomeMy WebLinkAboutNoLat_13609CraytonBlvdCO WASHINGTON COUNTY
WATER & SEWER DEPARTMENT
16232 Elliott Parkway
- r Williamsport, MD 21795 / l
�gRrI- IN, NO 301 791-3083
\ Permit to Connect to Public Water/Sewer System
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Type of Permit
Subdistrict Name H _
Mainline Contract No.
Building Permit No. Pr_
Permit No.
Issue Date _
Void Date
Subdistrict No.
Permission is hereby given to:
Property Owner: - 1'3fT ,RS (TAKO BELL)
of address: PC, A D
For property located at: 13 Lo (DL 4, 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 $
)IFTE Z i ,
Lateral with Mainline?
Residential EDU's _
Commercial EDU'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.
Signed� / - Q Date:
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 21740-4727
Phone: (301) 791-3070
Inspection Date: 7-17 �06 Plumbing Inspector: -- `
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