HomeMy WebLinkAboutLat_13944GreenMountainDriveWASH INGTON COUNTY SANITAAaY DISTRICT
WASHINGTON COUNTY. MD.
Project: [�,j,N;T, c (,moor., qJ�
Street (or location): GrzQr,-,.,
Contractor: CKrvztcs �3r7tkK� z.,`
Date Installed _�".,,.� Z6,k41L
SANITARY SEWER LATERAi
^' CONSTRUCTION REPORT
M H _ I Z61 TO MH I?68
Wye Sta. On Main /-><o-7 cT
Le; r' L1
WYE SIZE- TYPE DEPTH TYPE EXCAVATION
TYPE PIPE C.O. C- 0. LATERAL LENGTH LAYING LENGTH
Horiz. ■ Total
ST 'D.
NOTES: DROP Slope t Hor - Totai
Depth of Cleanout 9 '-110J`+P at Flow Line
Cleanout 3 9 1 From
Layed at "f-'16
101A Basement Service
1401 UT
MH
M H # 12643
Amounts pertaining to work completed this period, reviewedan pproved.
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-
C INSPECTOR CON AC ORS REPRESENTATIVE
WASHINGTON COUNTY SANITARY DISTRICT
AUGUST 13, 1984
S-2
COZ WASHINGTON COUNTY
3 WATER & SEWER DEPARTME T
16232 Elliott Parkway
Williamsport, MD 21795
��1RY`rNv (301) 791-3083
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.
Permit to Connect to Public Water/Sewer System
Subdiv. �W!,
Permit No. _
Issue Date _
Void Date _
Subdistrict 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
Fee
Fee
Fee
Fee
Total Fee
P1 H \ Street Address
Phase Sec.
Lateral with Mainline?
Residential EDLI's
Commercial EDLI'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 supercede 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 OWJNER.
Signed: �aL4 {�t�i Date:
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: F_ - Z 7 Plumbing Inspector:sif/