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WASHINGTON CO
WATER &SEWER P9_M
1
16232 Elliott Parkway
Williamsport, MD 21795 JUN 1 1 2001
(301) 791-3083
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 WI THE P70PERT OWNER. n
Date: (4,/71
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: F a `f 7 Plumbing Inspector:
Permit to Connect to Public Water/Sewer System PERM! AND
INSPE_� , SNS
Type of Permit
,
,
Subdistrict Name
RES SEWER Permit No. SCP 150-1540
MAUGAN S / OH
Mainline Contract No.
Issue Date 0 6 / 0 6 / O 1
Building Permit No.
Void Date 06/06/02
P2001-1099 Subdistrict No. 150
Permission is hereby
given to:
Property Owner:
DAVID SHAOOL
of address:
11029PLUMWOOD CIRCLE
HAGERSTOWN MD 21740
For property located at:
18778 D I L LER DRIVE
Lot No. 44
Subdiv. FOUNTA I NV I EW Street Address
Phase 1 Sec.
TH
Owner's Agent:
DAV T D --
Agent's Address
Previous Owner:
11Q29 PURN001) CIRLCE HAGERSTOWN MD 21740
Fees Paid in Full?
Date Fees Paid
YES Lateral with Mainline? YES
0 6 / 0 6 / 01 Residential EDU's 1
WCWSD Alloc./Conn.
Fee $ Commercial EDU's 0
Fee $ $2,300 Gal/Day Allocation 200
WCWSD/Other
Fee $ Building Number
City of Hagerstown
Fee $ $1,200 Misc. Number
Total Fee $ S3,500
Remarks A
FEE DIFFERNTIAL WILL BE CHARGED TO REFLECT ALLOCATION FEE
INCREASE
IF PROPERTY IS NOT CONNECTED BY THE PERMIT VOID DATE
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 WI THE P70PERT OWNER. n
Date: (4,/71
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: F a `f 7 Plumbing Inspector:
PROJECT NAME: low*
low*
PROPERTY ADDRESS: Ti`s' J# fir/ $77K /8'7rdDell eI� PROJECT NO: i�-6!�
MAIN LOCATION: STREET SE EN ADRAWING NO: I Z G+CLT>
PROPERTY OWNER NAME: DATE INSTALLED: 0 - /t -0 /
PROPERTY OWNER ADDRESS: MH =7� `3 TO MH C o
MAIN STATION: _./4/8 Le4-f--
CONTRACTOR: C41Mf�r--2f-4Aln 1 /A., , -,)
•� �����
FLOW ALL F LHTINENT ITEMS
DOWNSTREAM
MH # t,3 c,-3
UST QUANTITIES FOR PAY ITEMS HERE:
BY:
WASHINGTON COUNTY INSPECTOR
DIVISION OF PUBLIC WORKS
WASHINGTON COUNrY, MARYLANO
WATER AND SEWER
DEPARTMENT
hRn►d°
LEFT
RIGHT
UPSTREAM
MH # C. o.
CONTRACTOR'S R1=PRESENTATIVE
CO. NAME:
DOUBLE GRAVITY SEWER LATERAL
CONNECTION SHEET
MAY 2001 1 S -13.2A