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WASHINGTON COUNTY SANITARY DISTRICT tj j
Elliott Parkway 70/81 Industrial Park Williamsport, Md. 21795
AV*, Telephone 301-223-9416
Type of Permit
Subdistrict Name
Mainline Contract No.
Building Permit No.
Permit to Connect to Public Water/Sewer System
RES Sewer
MAUGANSVILL
ewer-
MAUGANSVIL.L /OH
335
Permission is hereby given to:
Property Owner: LE
of address: 12
HAG
For property located at: 111
Lot No. Sub
Permit No.
Issue Date
Void Date
Subdistrict No.
is M. Coss
W. L.ONGMEADOW ROAD
ER`aTOWN M1,` `1740.
L.ONGMEADOW ROAD
div_ FOUNTAIN HEAD NORTH
SCP 150-- 1089
5/10/91
/09/92
Street Address
Phase Sec.
Owner's Agent:
LEWIS
M.
COSS
Previous Owner:
N/A
Agent's Address:
126 W •
LONGMEADOW ROAD,
HAGERSTOWN , MD
Fees Paid in Full?
YES
Lateral with Mainline?
.YE'`>
Date Fees Paid
5%09, :11
Residential EDU'S
1
WCSD Dist./Coll. System
Fee
$
1500
Commercial EDU'S
0
WCSD Ready to Serve
Fee
$
0
Gal/Day Allocation
200
WCSD N AFee
$
°>
Building Number
N:`A
City of HAGERSTOWN
Fee
$
4_`0
Lateral Contract No.
150150'
Total
Fee
$
1920
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 WCSD 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 REMAINS WIT THE PROPERTY OWNER.
Signed: _1l �/iLir r',.g� Date: z ,
INSPECTION: At least 48 hours notice prior to requested date is required.
ON SITE INSPECTION will be made by: Washington County Plumbing Board
33 W. Washington Street
Hagerstown, Md. 21740 Phone: 791-3072
Inspection Date: T_1q -9t Plumbing Inspector s> A.Z- —4
OFF SITE INSPECTION (in Public Rights of Way and Easements) by WCSD
Inspection Date: WCSD Inspector (Lateral)
Inspection Date: WCSD Inspector (Connection)
Distribution: Permittee City of Hagerstown City of Williamsport
WCSD Construction WCSD O&M WCSD File
Permits Office Plumbing Board Plumbing Ins VV
MAY 2 9 1991
WASHINGTON CO
SANITARY DISTRICT
WASHINGTON COUNTY SANITARY DISTRICT
APPLICATION FOR SANITARY SEWER ALLOCATION /
Subdistrict No. Date
APDLTrANT-
,,p.
NamE
Addr
f 2V
Phone 7 3 3
OWNER: (If other than Applicant)��
Name �+�r� r_a✓ L `/
Address
Phone
DEVELOPER: (If other than Applicant/Owner)
Name /U /A
Address
Phone
PROPERTY TO BE SERVED:
Property Map/Parcel No. LA 3 9 Acreage Zoned
PROPERTY LOCATION INFORMATION:
- - ---- - /,..5_-0 /5 0 %
PROPOSED DEVELOPMENT: 3 q 7
A.
B.
C.
Residential
Type of Unit(s)
Commercial —�
Type Yj1/ Floor Space/Number of
gpd rocess waste
Industrial, Number of Employees
gpd Process Waste
PROJECTED OCCUPANCY: (Date or Number of Years)
Initial
Total
Number of Units
Employees
NOTE: Acceptance of this application by the District does not
guarantee sewer service nor does the date received neces-
sarily establish any priority relative to service.
Estimated Flow
Service Area A ect
emar s:
Hpprovai nate a q4- Gontrac
Approved by
WASHINGTON COUNTY SANITARY P'STRICT
WASHINGTON COUNTY. MD. A011b.
Project: �bc.i�T.9,.�_ �/�c',•ai7 1116e>f1, /yyWi ~ 1Z_
LG Ivq. a.d ow K d
Street (or location):
Contractor:
Date Installed x-1-3— ?9
SANITARY SEWER LATERA
CONSTRUCTION REPORT
•ak
MH TO MH
Wye Sta. On Main -011?
WYE
SIZE -
TYPE
DEPTH
TYPE
EXCAVATION
TYPE PIPE
C. 0.
Co.
LATERAL
LENGTH
LAYING LENGTH
Horiz. = Total
Co' t1dy�'
C
NOTES:
AM
Slope t Horiz. = Tota
fi7
Y3
Depth of Cleanout -7at Flow Line
Cleanout ITS From env. j ,� C ry1/1-/Og7
Layed at It.
Basement Service
MH 4t)k,;
Amounts pertaining to work completed this period, reviewed and approved.
BY
WCSD INSPECTOR CONTRACTORS
WASHINGTON COUNTY SANITARY DISTRICT
AUGUST 13, 1984
M!'� 17e=?
REPRESENTATIVE
FS- 2