HomeMy WebLinkAboutLat_18526IndianCottageRoad°N WASHINGTON COUNTY
3 WATER & SEWER DEPARTMENT
`� • 16232 Elliott Parkway
' Williamsport, MD 21795
(301) 791-3083
Permit to Connect to Public Water/Sewer System
Type of Permit RE.. SEWEF. Permit No. 50 -1 3 67
Subdistrict Name " iUGANS/CIi Issue Date 7
Mainline Contract No. Void Date 1,
Building Permit No. PRJ 97 - 2 2 7 7 Subdistrict No. _ 1
Permission is hereby given to:
Property Owner: _..ES HEINTZELMAN
of address: ' FF.![ -,'"HIL) AVENUE
ERS T i i'PN MD 217 {:
For property located at: ig 2' IND I AN
Street Address
Lot No. Subdiv. ORCHARD HILLS Phase Sec.
Owner's Agent: C;HARLwS HEIPYTZELMAll
Agent's Address: 1162 FAIRCHILE, AVENUE, 11A,0 STOWN MD 21740
Previous Owner:
Fees Paid in Full?
YES
Lateral with Mainline?
Date Fees Paid
1 12/
Residential EDU's
Fee $
Commercial EDU's
WCWSD Alloc./Conn.
Fee $
-- r 05^
Gal/Day Allocation
WCWSD/Other
Fee $
Building Number
City of Hagerstown
Fee $
Misc. Number
Total Fee $
Z3,050
Remarks -MNER
MUST _'riL'T THE WASHINGTC> d
NTY V.A'111ER L
11 r` DVANCE TC —-:'HEDULE
CONNECTION.
_ 1) "r 91- 30 C> 3.
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: Date: / "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 r
Phone: (301) 791-3070 f
Inspection Date: /
p � � �� 9� Plumbing Inspector:
G