HomeMy WebLinkAboutLat_13938GreenMountainDriveWASHINGTON COUNTY SANITAF3Y DISTRICT
WASHINGTON COUNTY, MD.
Project: _ L�,i;,T�2SD15-Ci-eq %
Street (or location): h %,,,.�,,-
Contractor: C-PArzW-s -L�,
Date Installed G-ZI-%
WYE SIZE- TYPE DEPTH
TYPE PIPE f C. 0. C.O.
5D2 -3E;
�X4X6 1 9'f15o2-z'6 Puc- I LZ
NOTES:
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A1111► SANITARY SEWER LATERAL
CONSTRUCTION REPORT
i
Depth of Cleanout _ /6 'T -*n at Flow Line
Cleanout 4//1 From �oFNR�ti
Loyed at Z%
r`'/A- Basement Service
z -r cy L. r
M H #- zca
M H ## lz(�-1
Amounts pertaining to work completed this period, reviewed and proved.
BY
WCSD INSPECTOR CONT AC ORAS REPRESENTATIVE
WASHINGTON COUNTY SANITARY DISTRICT
AUGUST 13, 1964 S- 2
MH Z0b
TO MH
IZ67
Wye Sta. On Main Zt64
L-1-
L 0--r
TYPE
EXCAVATION
LATERAL
LENGTH
LAYING
LENGTH
ST 'D.
Horiz.
Total
DROP
Slope +
r(z. = Totai
i
Depth of Cleanout _ /6 'T -*n at Flow Line
Cleanout 4//1 From �oFNR�ti
Loyed at Z%
r`'/A- Basement Service
z -r cy L. r
M H #- zca
M H ## lz(�-1
Amounts pertaining to work completed this period, reviewed and proved.
BY
WCSD INSPECTOR CONT AC ORAS REPRESENTATIVE
WASHINGTON COUNTY SANITARY DISTRICT
AUGUST 13, 1964 S- 2
WASHINGTON COUNTY
WATER & SEWER DEPARTMENT
16232 Elliott Parkway
Williamsport, MD 21795
(301) 791-3083
Permit to Connect to Public Water/Sewer System
Type of Permit Ilk , Permit No. SIP
Subdistrict Name !�:: _ Issue Date
Mainline Contract No. Void Date
Building Permit No. Subdistrict No.
Permission is hereby given to:
Property Owner: Su'_" I ITER
of address: VT Tr.: -T R
✓C��B % 9 8
150-1 299
For property located at:
Lot No.— Subdiv. f I N`. 'si��i<,� r Street Address
Phase Sec.
Owner's Agent: ')' STANT "r Fc- f 7,YCCU a,,., -R
Agent's Address: W
Previous Owner:
Fees Paid in Full? Lateral with Mainline?
Date Fees Paid Residential EDU's
Fee $
WCWSD Alloc./Conn. Fee $ Commercial EDU's
WCWSD/Other Gal/Day Allocation
Fee $ Building Number
City of Hagerstown Fee $
Misc. Number
Total Fee $
Remarks
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 spercede
STATE AND LOCAL, MUST BE OBTAINED local
OB AINED BY THE is
OWNER AND ALL RESPONSIBILITYeCONNECTED, etc. ALLOTHEREWITRH MITSRE-
MAINS WITH THE PROPERTY OWNER.
Signed: ^vqt elf j jf Date: y l �F R E C E 1 V E V
INSPECTION: At least 48 hours notice prior to requested date is required.
ON SITE INSPECTION will be made by: Washington County Plumbing Board WASHINGTON COUNTY
100 W. Washington Street, Room 304 WATER & SEWER DEPT.
Hagerstown, MD 21740-4727
Phone: (301) 791-3070 /I r
Inspection Date: Plumbing Inspector:
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