HomeMy WebLinkAboutLat_13934GreenMountainDriveWASH INGTON COUNTY SANITIAX DISTRICT
WASHINGTON COUNTY, MD.
Project: C--rzeEr.3 5Dr5-679 4�y�/1
Street (or location): Grzc 1VNNTA�N H•��L I
Contractor: C -&2z':5 C
A*ft SANITARY SEWER LATERAL
CONSTRUCTION REPORT
M H zoo TO MH 1-MDate Installed 6'1$•96 Wye Sta. On Main 1�a►.�
Lo-T-,t;e--1
WYE SIZE - TYPE DEPTH TYPE EXCAVATION
TYPE PIPE C. 0. G0. LATERAL LENGTH I LAYING LENGTH
g`�4KE3`�
NOTES
ST D.
I C - .i . I S
1.f -s I
Depth of Cle nout a `raw", at Flow Line
Cleanout From 4'o-rrtA,,,,
Layed at Z�/a
I"IA Basement Service
M H #F zoo
Horiz. • Total
Slope + (z. = Totai
M H # 1Z61
Amounts pertaining to work completed this period, reviewed and iproved,.
B Y
WCSD INSPECTOR CON AC RAS REPRESENTATIVE
WASHINGTON COUNTY SANITARY DISTRICT
AUGUST 13, 1984 S' Z
c° WASHINGTON COUNTY
3 ' �
_ WATER & SEWER DEPARTMENT
16232 Elliott Parkway
Williamsport, MD 21795 /Onb-�-J-
(301)
791-3083
Permit to Connect to Public Water/Sewer System
Type of Permit
Subdistrict Name _
Mainline Contract No.
Building Permit No.
Permission is hereby given to:
Property Owner:
of address:
For property located at:
Lot No.
Owner's Agent:
Agent's Address:
Previous Owner:
Fees Paid In Full?
Date Fees Paid
WCWSD Alloc./Conn.
WCWSD/Other
City of Hagerstown_
Remarks
Subdiv.
Fee $
Fee $
Fee $
Fee $
Total Fee $
Permit No. _
Issue Date _
Void Date _
Subdistrict No.
Phase Sec.
Lateral with Mainline?
Residential EDU's
Commercial EDU's _
Gal/Day Allocation _
Building Number _
Misc. Number
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 supersede 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 WITH THE PROPERTY OWNER.
Signed: llt4ij.j ! 1 Date:�f_ ; I t o !�
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: �r � 2 , - C� � Plumbing Inspector: