HomeMy WebLinkAboutLat_13929DistantViewAvenueVA/ASHINGTON COUNTY SANITARY DISTRICT
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-308313084
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM
Permission is hereby given to: _ For Property Located at:
Owned by: Address: -
Type of Connection: To Service Connection To Main Line:
Type of Service: Residential
Commercial
Meter Size
Connection Fee
) Units
Other
Industrial
Date Paid
PERMIT NO.
DATE
SUBDISTRICT
To connect to a public sewerage/water 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 RESPOW
SIBILITY CONNECTED THEREWITH REMAINS WITH THE PROPERTY OWNER.
Secretary -Treasurer
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
Washington County Plumbing Board
33 W. Washington Street
Hagerstown, Maryland 21740
Telephone: 791-3146
Final Inspection Made BY: A. , 1" . _ Date
Plumbing Inspector
OFF-S!TE INSPECTION (in Public Rights -of -Way and Easements) and certain
ON-SITE INSPECTION in accordance with applicable approved construction drawings will be made by:
Washington County Sanitary District
33 W. Washington Street
Hagerstown, Maryland 21740
Final Inspection Made By: _ _ _ Date
DISTRIBUTION: Permittee _ Plumbing Board
Field Offi
,:,A �-i1%GTON C0UiJiY :-.ANITAfAY^ISTRi%T
UASHINGTON COUNTY, ("D.
CONSTRUCTION iECG
Project:
Ma-uoan;sville/Orch.^rd
Hills
5D1 5 -1-i
Street (or
local- : gag
MT. I�iE�
njq,vE
-Al' -0 297 134 4 t7i3fan+ ✓ems A�e.
Contractor: C�nllcs Contractors, Inc.
Date Installed. 01-o4-63
MHJo;2 —TO f H 37(0
1.1;e Sts, 0n Main 244o.9L.r.�-!
L;YC S1ZE- J TYPE DEPT H J TYPE j EXCAV LAY:Ii'J�:
S7 E TYPE _Pit'E C.D. C.O. i LATERIAL ii LENGTH. L E M C T H y
/. 540 v F Total
St3d.
35 [-.F 33.2oL.P.
NOTES:
2 5TUe
I �
I Drop
ope + Horz=
Depth of Cleanout r -,'Flo,.) Line
Cleanout From mAml
L a y e d Q)
Basement Service
_-j- h4 -r ViEW
a I �
i
MR, 443
F,H_2'z'
Amounts pe in -rig o rk completed t�:is period, reviewed and approved.
WCSD inip c,,or oni�rcictors fiep.
-__r.. I�_-,,_.,,
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15-1 S
Property Address: 322 Mountain View AVenue --
MH 403 to MH 376 Dwg. #601-043
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.
40'R/W
I II
-� 8 1. W -
-s- • R / W '- -
297
322) (3 )
6" SAN DMH SD 15
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.
Date:
Owner (Print)
Owner's Signature
Attest:
Wash. Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56