HomeMy WebLinkAboutLat_13605DixieDriveASHINGTON
33 W. WASHINGTON STREET
COUNTY SANITARY DISTRICT PERMIT NO.
HAGERSTOWN, MARYLAND 21740 (301) 791-3083/3084
DATE
PERMIT TO CONNECT TO PUBLIC SEWERAGEIWATER SYSTEM SUBDISTRICT
Permission is hereby given to:
For Property Located at:
Owned by:
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
Address:
Connection Fee
To Main Line:
Units Other
Industrial
Date Paid
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 RESPON-
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: Washington County Plumbing Board
33 W. Washington Street
Hagerstown, Maryland 21740
Telephone- 791-3146
Permit Fee
Final Inspection Made BY: Date n
Plumbing I pector
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 B
Field Office
Wt°HIM.' TON
COUNTY
SANITARY DT 41CT
'NITARY SEWER LATE'.":
WASHINGTON
COUNTY,
MO.
JNSTRUCTION REcwirl
Project: Mauo�vi
Street (or location): CAI (o-7-7 �A* Vi�qM P&'Y-l=)
Contractor: Lisbon Contractors. Inc.
I
MH S6 z TO MH 563
Date Installed -2-e4 Wye Sts. On Main
WYE 312M -rYPE BEPTH TYPE MING
HZE TYPE ELM, C. 0. C 0 --LATERAL LENGT; LENGTH
eHorz.• Total
St'd. 2-1.10 Z,o,ob
NOTE 3:
Drop
Depth of Cleanout I fl,s° •flow LineClesnout 19-0e, From
~�
Laced • 3 x
N1A Basement Service
Ste^
Amounts pertaining to work completed this
a
Inspector'
prA , I -r46
9
C.n
-41
---.25kub c;e-,�
r
period, reviewed and approved.
r
Contractors Rep,
04 5�
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Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
1 05- Contract No. SD15- 3-5
Property Address:2 4 Dixie Drive
MH 562 to MH 563 DWG. #601-310
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.
i
rT, i
c�
677
:A) , � � (2304)
3
678
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.
f
Date: & t ` • e"'V_
Owner
Attest:
as Co. Sani y District
(Form WCSC-1)
Replaces Form WCSC-56
er