HomeMy WebLinkAboutLat_13949GreenMountainDriveWASHINGTON COUNTY SANITARY DISTRICT
WASHINGTON COUNTY. MD. /k
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Street (or location): &tom I OUo r :A.a Draw=
Contractor: CHArcL&s R-'PkKe z..�
SANITARY SEWER LATERAI
CONSTRUCTION REPORT
MH IZ19 TO MH
Date Installed_S,j^-w. Z9 , 19% Wye Sta. On Main NIA
LoT�$'1
WYE
SIZE-
TYPE
DEPTH
TYPE
EXCAVATION
TYPE PIPE
C. 0.
CO.
LATERAL
LENGTH
LAYING LENGTH
Horiz. 2 Total
ST D.
1
Slope + Horiz. = Total
NOTES:
I
DROP
3Z1
Depth of Cleanout g' at Flow Line
Cleanout 3z From �o>=MA h Nom
Layed at z
- WDA Basement Service
MH #Plztg
u
31
M H ZZI
, 0-r-# I D
Amounts pertaining to work completed this period, reviewed and a proved.
I
BY j
CSD INSPECTOR CONT ACT 'S REPRESENTATIVE
WASHINGTON COUNTY SANITARY DISTRICT
AUGUST 13, 1984 FS- 2
T°N WASHINGTON COUNTY
G
s WATER & SEWER DEPARTMENT
16232 Elliott Parkway q
Williamsport, MD 21795
(lir' I
��'9RYLHN"
(301) 791-3083
Type of Permit
Subdistrict Name _
Mainline Contract No.
Building Permit No. _
Permit to Connect to Public Water/Sewer System
Permission is hereby given to:
Property Owner:
of address: _.
T' T S,
For property located at:
Lot No. Subdiv.
Permit No. _
Issue Date _
Void Date
Subdistrict No.
Street Address
Phase Sec.
Owner's Agent: r - - r. n"T' "IEW LL:.'/ JJOHN SCIP.° =TER
Agent's Address: T NSTEf? RL , REI S ML 211--`
Previous Owner:
Fees Paid in Full?
Date Fees Paid
WCWSD Alloc./Conn.
WCWSD/Other
City of Hagerstown_
Remarks
Fee $
Fee $
Fee $
Fee $
Total Fee $
fQNt -
Lateral with Mainline?
Residential EDU's
Commercial EDU's _
Gal/Day Allocation _
Building Number
Misc. Number
14iLL _ f±_ L TE
i1.i-1
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.
Signed: j$,, .. I ,( r- Date: 6 a/
i
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 J`
Inspection Date: G�. ��.--C� �!} Plumbing Inspector: ,�. �