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WASHINGTON COUNTY SANITARY DISTRICT PERMIT NO.
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571 (301) 791-3083/3084 DATE
P.O. BOX 571
SUBDISTRICT ►V�
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WAITER SYSTEM
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Permission is hereby given to: J a co b ii - t4 i I me r , J r 1%F?!_�q La
For Property Located at: 2304 Indian Cottage Road
Owned by: Jacob W Gilmer, Jr4ddress: 2304 Indian Cattagy Road,Wa,arg#own- AGi
Type of Connection: To Service Connection
Type of Service: Residential I
Commercial
To Main Line:
Units Other
Industrial
Meter Size _ Connection Fee $620.00 Date Paid
To connect to a public sewerage/.Water system (with proper abandonment of previous private system). The installation
of the connection and the abandonment of the previous private system shall conform with the provisions of the
Laws of the State of Maryland and Washington County Sanitary District Specifications.
This permit does not supersede any local ordinance.that is in effect with regards to road cutting, etc.
ALL OTHER PERMITS, STATE AND LOCAL, MUST BE OBTAINED BY THE PROPERTY OWNER AND ALL RESPON-
SIBILITY CONNECTED THEREWITH REMAINS WITH THE PROPERTY OWNER.
Secretary -Treasure ^,
Building Permit No. 011
INSPECTION: At least 48 hours notice prior to requested date of inspection is required.
ON SITE INSPECTION will be made by
Permit Fee
Final Inspection Made BY
Washington County Plumbing Board
33 W. Washington Street
Hagerstown, Maryland 21740
Telephone: 791-3146
Date
Plumbing Inspector
OFF-SITE INSPECTION (in Public Rights -of -Way and Easements) and certain
ON-SITE INSPECTION in accordance with applicable approved construction drawings will be made by:
Final Inspection Made By:
DISTRIBUTION: Permittee ,i Plumbing Boa
Field Offi
Washington County Sanitary District
33 W. Washington Street-P.O. Box 571
Hagerstown, Maryland 21741-0571
Date
WASHINGTON COUNTY SANITARY D1 AICT
WASHINGTOA COUNTY, MO.
NITARY SEWCR LATE'."_
CONSTRUCTION RECf►I;f?
Project:, Mouoaneville/Orchard Hills Sanitary Seueraos Collection Svatgm
Street (or location) : - r'a r 71 2-4-aaF- zwvert"tf Carr ieaQo�
Contractor: Lisbon-CQntractora. Inc.
Date Installed a -(o- E54
MH S5'3 TO MH 55�
Wye Sts, On Main 1165,¢x.
W 11 21 LL— ITP:. DEPTH TYPE -EXC-AV. LAYING'
TZE TYPE PIPE, C.O.TERA EN TH LENGTH
a'gDe,(-, PvC,. •Hors . • Toti
SVG St 1 d.
124 i -
1
Ps + 1101M,
NOTES: Drop X4,50 6,o0+
23.25
M41U
x-4.20 � 15.25. � 11.24
SDR Rv.c._
o •
a p
a
Depth of Cleanout I I -z4 V1ow Line - • ~
Cleanout �c)-45' Irow -t--►HAIU •----
Layed 2,0 4F--rER mon
• �%�+ Basement Service
M#553
-T-
155$
r
Amounts pertaining to work completed this period, reviewed and approved.
8 Y 4f. /a� l P f f S Itonspec or •f ion t r a c tore -Rip
0
W
Washingtjn County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15- 3-S
Property Address: 2A4 Indian Cottage Road
ISH 553 to MH 554 _ 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 stake in the ground at that location.
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
Attest: a- K.
Wash. Co. Sanitar District
(Form WCSC-1)
Replaces Form WCSC-56
WASHINGTON COUNTY SANITARY DISTRICT
33 West Washington Street, Hagerstown, Maryland 21740 s (301) 791
CEIvED ..
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iaf�Y �t�ill
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To: Lisbon Contractors, Inc.
I hereby request the contractor to install the lateral in
accordance with the following conditions:
T
�. Address �f_�12'
S i ghe v �C- j
Property er
Date ter"y2
Washington County Sanitary District
33 West Washington Street
Hagerstown, Maryland 2I
IF
Re: Maugansville/Orchard Hills Sewers
Contract No. SD15-3-S
• Gentlemen:
A
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 Lisbon Contractors, Inc.
Approved by W. C . S. D. Inspector C, 7)IT7z�
Date