HomeMy WebLinkAboutLat_19665MarigoldDriveWASHINGTON COUNTY
3_ WATER & SEWER DEPARTMENT
16232 Elliott Parkway
�1RY rN� Williamsport, MD 21795
(301) 791-3083
Permit to Connect to Public Water/Sewer System
Type of Permit
Subdistrict Name _
Mainline Contract No.
Building Permit No.
t�
Permission is hereby given to:
Property Owner:
of address:
For property located at:
Lot No. — Subdiv
J
Permit No. _
Issue Date _
Void Date _
Subdistrict No.
SQ --1292
Street Address
Phase Sec.
r
Owner's Agent: _= N P OLIVER ^nmtAmv'
Agent's Address: TEE FS£L."
Previous Owner:
Fees Paid in Full?
Lateral with Mainline?
Date Fees Paid
Residential EDU's
Fee $
Fee $
�' Commercial EDU's
WCWSD Alloc./Conn.
WCWSD/Other
Fee $
Gal/Day Allocation
City of Hagerstown
Fee $
Building Number
Misc. Number
Total Fee $
77 . .7_
Remarks - i -
. r L � .
., J
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 County 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 RE-
MAINS WITH THE PROPERTY OWNER.
Signed:
INSPECTION: At least 48 hours notice prior to requested date is required
ON SITE INSPECTION will be made by: Washington County Plumbing Board
100 W. Washington Street, Room 304
Hagerstown, MD 21740-4727
Phone: (301) 791-3070 `a
Inspection Date: O%/f �j Plumbing Inspector:
EJUN 1996
WASHINGTON COUNTY SANITJJW DISTRICT
WASHINGTON COUNTY, MD.
..*, SANITARY SEWER LATERAL
CONSTRUCTION REPORT
Project: /VegT,� IIr,a/� C-sT,,T,s Co//{cTiS-iso-s-d�
Street (or location): AfRff1G01-y
9
Contractor: �� )Lt/Evi//£ GTra cT.r j / �66S
Date Installed Z - -L u- aZ
WYE SIZE-
TYPE
DEPTH
TYPE PIPE
C.O.
CO.
1111
casr
fav c
z'�a 5
NOTES:
MH //c ? TO MH //d s
Wye Sta. On Main o --re 4 r -
TYPEI EXCAVATION
LATERAL LENGTH
ST 'D.
3z CJC
DROP
Depth of Cleanout at Flow Line
Cleanout /7 4 4 From Ma
Layed at Z °/o
Nb Basement Service
MH #P /!67
LAYING LENGTH
Horiz. = Total
27 LF
Slope + Horiz. = Tota
MH ## //a f
Amounts pertaining to work completed this period, reviewed and approved.
BYE �i�w
WCSD INSPECTOR CONTRACTORS REPRESENTATIVE
WASHINGTON COUNTY SANITARY DISTRICT
AUGUST 13, 1984
S-2