HomeMy WebLinkAboutLat_14515IndustryDriveWASHINGTON COUNTY SANITARY DISTRICT
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-3083 1 3084
PERMIT TO CONNECT TO PUBLIC SEWERAGEVATER 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
dress: "
L
To Main Line:
Units Other
Industrial
Connection Fee $1 .303.00
Date Paid
PERMIT NO.
DATE
SUBDISTRICT -
I S
To connect to a public sewerageA4tkX 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 SF9cifications.
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 -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
Final Inspection Made BY: Date
Plumbing I ector
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: Date
DISTRIBUTION: Permittee Plumbing Board
Field Office
WASHINGTON COUNTY SANITARY TRICT
449SHINGTON COUNTY, MD.
SANITARY SEWER LATE':-
CONSTRUCTION REConr,
Project: Mauoinsv_ille,/Orchard Hills Sanitary Sguar oe Collection SvataM._____
Street (or location): CAI l' tbI 8 S�we��-yE"'D"J�'� -
Contractor:Lisbon Contrgctors _ Inc. - -
%��/5 Zn/n✓spy QR+✓F MH gtlo TO FlH 81�
Date Installed B-ze S4. Wye Ste. On Main 34-10"25 R
WYE - 51ZE- - TYPE DEPTH TYPE .
HZE PIPE LATERALLENGTH NTH
6•,xG,,A6. G-.6orzz� cmc. *Hors.- Total
r, . S.1 �5 Lr- I Std. 32,00 2 9, o o
NOTES:
Drop
WE
................
Depth of Cleanout 5,113' OFlou Line
Clesnout 2-7,0o row mauu
L a y a d
►a ; .Basement Service
c o
MND 817
Amounts pertaining to work completed this period, reviewed and approved.
8Y i1
nspectorIContractors Repo
1a- 1`f S!
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15 _
Contract No. SD15- 3-S
Property Address: RoirtP A Rox ?094 (Tndi�;U Drive)
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.
R / W _
X — X
(o Dezj� • t
x
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 oimer'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.
Date: '5 1 1 q I _
Atte
Owner
1,4
istrict
(Form WCSC\,.,l
Replaces Fo
WCSC-56
Owner