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HomeMy WebLinkAboutLat_13543HalifaxDrive•- "VON00 WASHINGTON COUNTY 3� WATER & SEWER DEPARTMENT 0_ 16232 Elliott Parkway Williamsport, MD 21795 V rm ll � YL."No (301) 791-3083 11 I az I q Permit to Connect to Public Water/Sewer System Type of Permit_ Permit No. 13 Subdistrict Name �A A _ Issue Date ?, Mainline Contract No. Void Date Building Permit No. Subdistrict No. Permission is hereby given to: Property Owner: V of address: r For property located at: Ii Street Address Lot No. Subdiv. �,JJ 1-1-, Phase Sec. Owner's Agent: N Agent's Address: � � T it F► i -.�,F' ; ; _ MIM f4P Previous Owner: Fees Paid in Full? Lateral with Mainline? Date Fees Paid Residential EDU's Fee $ Commercial EDU's WCWSD Alloc./Conn. Fee $ Gal/Day Allocation WCWSD/Other Fee $ Building Number City of Hagerstown Fee $ Misc. Number Total Fee $ !; 1 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 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: V j � o 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: Plumbing Inspector: RECEIVE NOV 12 19yb WASHINGTON COUNTY WATER & SEWER DEPT. WASHINGTON COUNTY SANITARY DISTRICT WASHINGTON COUNTY, MD. SANITARY SEWER LATERAI CONSTRUCTION REPORT Project: 5D-(50-�85 Street (or location): {Irac.�r,o.ti ���i✓ Contractor: C 6r2caNd_ VAS MH TO MH 1Z1� Date Installed 15 07 3 Wye Sta. On Main A14 I7-71 Lois 50 WYE SIZE - TYPE DEPTH TYPE EXCAVATION LAYING LENGTH TYPE PIPE C, 0. C.O. LATERAL LENGTH Horiz. 2 Total g ST ID. 3t{ 502-26-Rtc_ PAN, LA 1'cn(� NOTE`. gInna 4. HAri7 = Tntn'; Depth of Cleanout at Flow Line Cleanout `Z� From Lc-- c,�: �,,, j Layed at IV(A Basement Service VH # f�z'-100 # 12zy 9 Amounts ``pertaining to work completed this period, review nd a p By fes+ -�WCSD INSPECTOR CONTRACTORS REPRESENTATIVE WASHINGTON COUNTY SANITARY DISTRICT AUGUST 13, 1984 [S- 2