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�C. �T0N WASHINGTON COU
3� G WATER & SEWER DEPA l
16232 Elliott Parkway
Williamsport, MD 21795 JUN 2001
(301) 791-3083
Permit to Connect to Public WateriSewer System PEP -
[
EP - .i��
[ME
Type of Permit RES SEWER Permit No.
SCP �
Subdistrict Name MAUGANbIONIssue Date
Mainline Contract No. Void Date
Building Permit No. Foevoi-109TSubdistrict No.
Permission is hereby given to*
I D SHAOOL
Property Owner:
of address:
187 16 s
For property located at: Street Add IM
Lot No. 43 Subdiv. Phase Sec.
Owner's Agent:
DAVID SHAOOL
M
Agent's Address:
Previous Owner:
Fees Paid in Full?
YES
Lateral with Mainline? YES
Date Fees Paid
Residential EDU's
Fee $Commercial
EDU's
q GAA 200
WCWSD Alloc./Conn.
Fee $
J'jGal/Day Allocation
WCWSD/Other
Fee $
200 Building Number
City of Hagerstown
Fee $
500 Misc. Number
Total Fee $
'
rtz
FFERNTIAL
Remarks
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 -
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: /tq 'a - 0� Plumbing Inspector:
'ROJECT NAME: ' �'=`�fa' �'`e`� _ PROJECT NO:
'ROPERTY ADDRESS: `t�' �t3� 7# f yy16 Ile=a= DRAWING NO: S
dAIN LOCATION: STREET tract i DATE INSTALLED: /0
'ROPERTY OWNER NAME— MH %� TO MH
'ROPERTY OWNER ADDRESS: MAIN STATION: —�
.. T.,n. / .-nf:il% nA/C> I ]Al /rA1
CONNECTION ® MH:
SIZE & TYPE
SIZE & TYPE
SIZE & TYPE
INVERT ®
DEPTH
A B (LT)
C (LT)
TEE/IN1'E
DOUBLE TEE/WYE
SERVICE PIPE
MAIN
C/o C/0
K
�5b2-35
ir�y
�5��'L6
6 q / t �1 l�
5 ;
v5�7,e-2-G
B (RTC
(RT)
T,
(LT)
A
B*(R
SHOW LATERAL LOCATION, STATION, UTILITY CROSSINGS AND DIMENSION ALL PERTINENT ITEMS
FLOW
DOWNSTREAM
MHii��+�
LIST QUANTITIES FOR PAY ITEMS HERE:
m
WASHINGTON COUNTY INSPECTOR
DIVISION OF PUBLIC WORKS
',scan cl+ WASHINGTON COUNTY, MARYLAND
'' .4 WATER AND SEWER
DEPARTMENT
LEFT
RIGHT
UPSTREAM
MH#c.c.
CONTRACTOR'S REPRESENTATIVE
CO. NAME:
DOUBLE GRAVITY SEWER LATERAL
CONNECTION SHEET
MAY 2001 S-1 3.2A