HomeMy WebLinkAboutLat_13815GreenfieldAvenueWASHINGTON COUNTY SANITARY DISTRICT
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-3083 1 3084
PERMIT TO CONNECT TO PUBLIC SEWERAGEIWATER SYSTEM
Permission is hereby given to:
For Property Located at:
Owned by:
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
Address:
Connection Fee
To Main Line:
Units Other
Industrial
Date Paid
PERMIT NO.
DATE
SUBDISTRICT
To connect to a public sewerage/water system (with proper abandonment of previous private system). The installation
of the connection and the abandonment of the previous private system shall conform with the provisions of the
Laws of the State of Maryland and Washington County Sanitary District SF9cifications.
This permit does not supersede any local ordinance that is in effect with regards to road cutting, etc.
ALL OTHER PERMITS, STATE AND LOCAL, MUST BE OBTAINED BY THE PROPERTY OWNER AND ALL RESPON-
SIBILITY CONNECTED THEREWITH REMAINS WITH THE PROPERTY OWNER.
Secretary -Treasurer
Building Permit No
INSPECTION: At least 48 hours notice prior to requested date of inspection is required.
ON SITE INSPECTION will be made by: Washington County Plumbing Board
33 W. Washington Street
Hagerstown, Maryland 21740
Telephone: 791-3146
Permit Fee
Final Inspection Made BY: _ ' Date
"Plumbing Inspector
OFF-SITE INSPECTION (in Public Rights -of -Way and Easements) and certain
ON-SITE INSPECTION in accordance with applicable approved construction drawings will be made by:
Washington County Sanitary District
33 W. Washington Street
Hagerstown, Maryland 21740
Final Inspection Made By:
DISTRIBUTION: Permitte
Plumbing Boa
Field Offi
Date
5A
r'
^
! y.
Property Address:
MH 3Z5 co MH 346
A
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#1
i6715 Contract No. SD15-1S
-3-3i�-'Greenfield Avenue
Dwg. #601-066
Place an 'X' in the sketch below to indicate where the property
owner wants the service connection (lateral) to enter the
property. Place a wooden stake in the ground at that location.
T R/W
N.MH SD15- MH SDI5- �N
RK I
P
I I 1 R/ W
4� 463
(132) C� C
.000
The undersigned agrees that the Sanitary District may
excavate an additional five (5) feet inside the property
line so as to facilitate, and make less expensive., the owner's
connection to the lateral and to prevent damage to the cleanout
which will be installed by the District at or near the property
line.
Date: 7- 8Z iy',C-'�iR� A , A 2Z -- -
Owner (Print)
CA _c4tore��
' Owner's Si nature
Attest: '05-- .
Wash Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56
1
0
�i&3 (13 z) G,eEe NF1Ci b Ave. P/,a,u s e -A l l F'e�e
...
Ad%� ,ATEAtgJ
3o?5 -.
WASHINGTON COUNTY SANITARY DISTRICT
33 West Washington Street, Hagerstown, Maryland 21740 • (301) 791-3083
To: Callas Contractors, Inc.
I hereby request the contractor to install the lateral in
accordance with the following conditions:
i-. dress
Signed
'Property Owner
4DS-fe AA
Washington County Sanitary District
33 West Washington Street
Hagerstown, Maryland 2171.0
Re: Maugansville/Orchard Hills Sewers
Contract No. SD15-1-S
Gentlemen:
We hereby request permission to install the house lateral
of greater than two (2) percent and/or in accordance with the
above conditions at no change in contract price at the following
location:
Requested by Callas Contract
Approved by W.C.S.D. Inspect
Date /I 1 j 18 3
WASHINGTON COUNTY SANITA*WMDISTRICT
WASHINGTON COUNTY, MD.
Al SANITARY SEWER LATE -t=?
CONSTRUCTION RECORD
Project: Chau ar.sville Orchard Hills SD15-1-5
13 S/S'
Street .
(or location) : VE, Gs3z 5��3
Contractor: Call s Contractors Inc.
MH 3 Z s TO MH 3 Y8 v
Date Installed_ //-y-C33 Wye Sta. On Main 1ts7.g R �
Wli 01LL-• ITPL ULNIh TYPE
SIZE TYPE PIPE C.O. C.O . LATERAL
�X G X g.. (o /' PVC a
Pvc 3.Z3 St
Sc)a 35 S,PQ Z co
NOTES:
Drop
EXCAV. LAYING
LENGTH _ LENGTH
*Hort.= To
20.ZS
C C E-AA/ou T
1
R'biope+ Hor.z=Tota]
11.15 •+ //-ZI ZZ.3l.'
Depth of Cleanout 3•Z3 • Flow Line
Cleanout /6.0' from �- '41,9".'V-
Layed @Z q i ce ��e op
�o Basement Service
US7.8 P,
0
Amounts pertaining to work completed this period, reviewed and approved.
BY
W C S U I n s pt od' r----n�---
Contractors Rep.