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HomeMy WebLinkAboutLat_18533IndianCottageRoadWASHINGTON ASHINGTON COUNTY SANITARY DISTRICT it W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-3083 1 3084 PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER 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 :•lauganSvi i ie/0" Ci H i I I S 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 Specifications. 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 RESPOW SIBILITY CONNECTED THEREWITH REMAINS WITH THE PROPERTY OWNER. ,ter Account No. Unknown. 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 —_ 9 Final Inspection Made BY: _ Date Plumbing Insp or 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: Permitt Plumbing Board Field Offi Date WASHINGTON BOUNTY SANITARY D1 RICT WASHINGTON COUNTY, MO. Projects Mauaine-y-i ,NITARY SEWCR LATE',"! - CONSTRUCTION REC(uit} 1- orrAX-6 ACIAD Street (or location): t1I %� 2 11 LL Contractor: Lisbon„ConInc.—- i MH 54;& T 0 MH 553 Date installed $-14-84 Wye Ste. On Main "XC 'x 6 w, -50R 2(o RYL- NOTES: PVA 15,8 v+= st1d. Drop 2'�ub�p i ZO, 40 `"SDFi Z� RvL 2.5`% 45�Sencl ' Depth of Cleanout �I-S�a �f lou Line Cleanout 29.59' From +-MAlll Layed 2'• Jr APTER 020A N A Basement Service M#5-46 , orz.- To ab -t- 2-2,40= 35,4o L. r, 5- A, % t 88, 5 LT, MND .5 , 1 r Amounts pertaining to work completed this periods reviewed and approved. BY � � `fir! sr� • � (� � / �,�1� nspec or Contractors Rep, Cod Tc ©UJ� L; 00, q6 Washington County Sanitary District SEWER SERVICE LOCATION Subdistrict No. SD#15 1v533 Contract No. SD15- 3-S Property Address: 2341 Indian Cottage Road MH 548 to ISH 553 DWG. #601-312 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 st-a�ein e ground at that location. D� i'GTTAG INDIANX G QE:712 (2301) IH 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. r _ Date: Owner (} Owner At t e s CJ`.� Was %o. Sanitary District (Form WCSC-1) Replaces Form WCSC-56