HomeMy WebLinkAboutLat_13712DixieDriveV AS-HINGTON COUNTY SANITARY DISTRICT
13 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571 (301).791-3083/3084
P.O. BOX 571
PERMIT NO.
DATE
SUBDISTRICT
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM �},rwa ug a n s v i _
Permission is hereby given to: u e.r a l -d 'd . `. i✓ e 3 s a r d ;J
For Property Located at: r'4US DiXie Drive, Hagerstown, Mary,1,br0` "21741.
Ownedby: ` eralc W. Spessard Address: .;,103 Dixie Dr., Hagerstown,
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
Connection Fee
To Main Line:—
Units
inerUnits Other
Industrial
620.00 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.
Yater Account :,No. 16-/
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
i
Final Inspection Made BY: Date
Plumbing In ctor
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-P.O. Box 571
Hagerstown, Maryland 21741-0571
Final Inspection Made By:
DISTRIBUTION: Permittee i Plumbing Board
Date
Field Office Y
WASHINGTON COUNTY SANITARY DY 11CT
WASHINGTON COUNTYp M0.
' 'NITARY SEWER LATE'."
„JNSTRUCTION REC(mr.,
Projects Mauasnsvil19Orchard Hills Sanitary Sauaraoe Collection Svatem
137/
Street (or location): CAI 1-11 DixiE 02ivc
Contractor: Lisbon Contractors, Inc.
I
Date Installed ZGJu/y84,
St1d.
NOTES: I
Drop
MH -S40 T O MH 5�i
Wye Ste. On Main,/�- 7(o
*Hors.• Tota
40,30 . F. 36. Z-5 L.F
C
Depth of Cleanout lf. v. F. _•Flow Line
Cleanout 3(, . 3 From
laced •
• k%551r3cz�- Basement Service
Amounts pertainin0 to work completed this
BY
inspector
MHO sQ 1
c•o
...-f'-5h, 6 -', <z-*
period, reviewed and approved.
—mon rec ore Rep.
1 s oo M41541 & Z7° �
C,
4d.
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15- 3-S
Property Address: 2 3 Dixie Drive
171 -_^ H1H 541 DWG #601 321
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.
R/ w <
40 8„SAN
MH SD15- 541 8��
�I--- _ z" w -- _ S q N
oocp I ,
2 0
� (2 0 661 � a
O (24 V3)
X �
I
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: Aj
Owner
Owner
Attest:
Wash. Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56