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Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD -6
d,16 Contract: SD6-1S
Property Address: Longmeadow Road M -H 075 Pap -,e 18 of 70
/076
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.
Q7S
iii. 07 ti.. ft 5
The undersigned agree that the Sanitary District may excavate for
the lateral a total of ten (10) feet inside the property line at the
location indicated above, said ten (10) feet to include five (5) feet of
lateral installation beyond the cleanout, plus an additional five (5) feet
of excavation beyond the terminus of the lateral to facilitate, and make
less expensive, the owner's connection to the lateral and to prevent
damage to the lateral installed by the District in those areas where
rock is encountered.
Date: !2
Owner
Owner
f' 'I
Attest:
ash. Co. Sanitary District
(Form WCSC-56) ���� ��� (110878)
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Washington County SanitarAO'04istrict
Washington County, Md.
""* SANITARY SEWER LATERAL
CONSTRUCTION RECORD
At", Project: SD6-1-S Fountainhead `-�
Street (or location) :,651L�„m.,,�p.7ozJ �� i ! MHD7r to MHoI±!_
Contractor: Corson and Gruman Company
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Depth of Cleanout @ Flow Line
Cleancat ,s' From
Layed @ _
Basement Service
MH O % '�
, Inspector
1 \.
000, Amounts rtaining to work completed this period, reviewed
By
nspec or Torson &
(Form WCSC - 4)
prL�ved.
man )uperintenaen
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