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