HomeMy WebLinkAboutLat_18612DixieCircleWASHINGTON COUNTY SANITARY DISTRICT
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-3083/3084
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM
Permission is hereby given to:
For Property Located at:
Owned by: 1I( 1 t 41.; J, iow
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
Address:
) Units
To Main Line:
Other
Industrial
Connection Fee $620,00 -- 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
Final Inspection Made B
Washington County Plumbing Board
33 W. Washington Street
Hagerstown, Maryland 21740
I@Mhone: 791-3146
Plumbing Inspector
Date 40;r
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:
Washington County Sanitary District
33 W. Washington Street
Hagerstown, Maryland 21740
Final Inspection Made By: Date
DISTRIBUTION: Permittee Plumbing Board
Field Office
WASHINGTON COUNTY SANITARY DISTRICT
WASHINdTON COUNTY, M0.
Project: Mauamnevi
Street (or location):
Aft
SANITARY SEWER LATCP,°
CONSTRUCTION REEnar.,
Contractort Lisbon Contractors_ Inc.
Date Installed 8-9-e4
CavNEcn
TO
M. H.
NOTE S:
MH 5 ,13 -fig-AM-TEe i
Wye Ste. On ftin aOO 155094.
s.• Total
St1d. I 4 -;.?t-- 1 45,00
/F
4 Gop
Depth of Cleanout I4+ -75•flow Line
Cleanout 3 fa25 f tOm� H4�— •�-
Layed • Z,o x
'A Basement Service
0 -Q
MH# Irl c. MH# 564
2'S�ub�Cv�n ••'
Amounts pertaining to
work completed this period, reviewed end approved.
e Y_„_
., f i 1 TS /G C5
'�WiSD Inspector ron rec ors Rep.
LA a,at, 114 It Mu 644 (g f 55 °
A*N
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15- 3-S
Property Address: 2A8 Dixie Circle
ISH 564 DWG. #601-310
Place an 'X' in the sketch below to indicate where the property
owner wants the service connection (latera dto enter the
property. Place a wooden stake in the gro at that location.
4/,C-
43 4,
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� rod`
I
Ir
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308)
� DIX
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
Owner
00,11, Attest:
Wash. Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56
WASHINGTON
s
COUNTY SANITARY DISTRICT
33 West Washington Street, Hagerstown, Maryland 21740 • (3011791.3083
R k,Q S I V E TJ
WASHINGTON COU1 ITY'
ShMNITARY COMr.ISSIOZV-
To: Lisbon Contractors, Inc.
I hereby request the contractor to install the lateral in
accordance with the following conditions:
v 7111 --
Address_ 3 �'� �� X; - •
r
Signed��,1�
Property wner
Date 7
Washington County Sanitary District
33 West Washington Street
Hagerstown, .Maryland 217.0
Re: Maugansville/Orchard Hills Sewers
Contract No. SD15-3-S
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:
LA
Requested by Lisbon Contractors, Inc. Al �-
Approved by W.C.S.D. Inspector\��L- }
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Date YVlA��Ck-t y