HomeMy WebLinkAboutLat_13945GreenMountainDriveWASHINGTON COUNTY SANITARY DISTRICT
WASHINGTON COUNTY, MD. job. 1 [L
Project: W,,r,-c_r� CStcj 5bi5o
Street (or location): Gagew, —'L>n
Contractor: (fRAgLa5 QSpAvcg
SANITARY SEWER LATER
.mok CONSTRUCTION REPORT
Depth of Cleanout of Flow Line
Cleanout /`► From HA.,',µ,La
Layed at z'/o
u1A Basement Service
M H ## I Zil
Ot QZ • 5 t -r
lJ '
MH # lZ6y
Amounts pertaining to work completed this period, reviewed and approved.
BY
WCSD INSPECTOR CO RA ORAS REPRESENTATIVE
WASHINGTON COUNTY SANITARY DISTRICT
AUGUST 13, 1984 Fs -
MH CZ/ --1
TO MH IZ61
Date Installed -z6 -9d
Wye Sta. On Main 0t9-7•5
L6T-4*-
WYE
SIZE-
TYPE
DEPTH
TYPE
EXCAVATION
TYPE PIPE
C. -O.
C.O.
LATERAL
LENGTH
LAYING LENGTE
Horiz. = Total
STD.
(4"sDn-z6Pv-
7L
Slope + Horiz. = To
NOTES:
DROP .
1
II
Depth of Cleanout of Flow Line
Cleanout /`► From HA.,',µ,La
Layed at z'/o
u1A Basement Service
M H ## I Zil
Ot QZ • 5 t -r
lJ '
MH # lZ6y
Amounts pertaining to work completed this period, reviewed and approved.
BY
WCSD INSPECTOR CO RA ORAS REPRESENTATIVE
WASHINGTON COUNTY SANITARY DISTRICT
AUGUST 13, 1984 Fs -
y`aOT0N CIO
WASHINGTON COUNTY
WATER & SEWER DEPARTMENT
16232 Elliott Parkway
YL �NWilliamsport, MD 21795
A�9R
(301)791-3083►�� C-1cl
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:
Permit No. _
Issue Date _
Void Date _
Subdistrict No.
For property located at: Street Address
Lot No. — Subdiv. Phase Sec.
Owner's Agent: _,mr *•+ W y ... tr=• $t.:-
Agent's Address: = m>+ y .T; m r%D
Previous Owner:
Fees Paid in Full?
Date Fees Paid
WCWSD Alloc./Conn.
WCWSD/Other
City of Hagerstown
Remarks
Fee
Fee
Fee
Fee
Total Fee
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 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 OWNER.
Date: :-_7
s
INSPECTION: At least 48 hours notice prior to requested date is required. R E(~ %"
A V
ON SITE INSPECTION will be made by: Washington County Plumbing Board
100 W. Washington Street, Room 304 JAN 1 91999
Hagerstown, MD 21740-4727
Phone: (301) 791-3070 WASHINGTON COUNTY
WATl & SEVVER DEPT
Inspection Date: Plumbing Inspector:
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