HomeMy WebLinkAboutLat_19703MarigoldDrivey.�CIT °N c°2 WASHINGTON COUNTY
WATER & SEWER DEPARTMENT
16232 Elliott Parkway / J
Williamsport, MD 21795 /
'�RYLwN
(301) 791-3083
Permit to Connect to Public Water/Sewer System
Type of Permit
Subdistrict Name _
Mainline Contract No.
Building Permit No.
Permission is hereby given to:
Property Owner:
of address:
Permit No. _
Issue Date _
Void Date _
Subdistrict No.
For property located at: ART -GOLD DRIVE Street Address
Lot No. Subdiv. N1DRThBF.0-,_;: ESTATES
Phase Sec.
Owner's Agent: 7L i V ER iu
Agent's Address: i:,;F ` ' R ✓nUR r i 'HAC=ERSTO WN MD 17 q
Previous Owner:
Fees Paid in Full?
Date Fees Paid
Fee $
WCWSD Alloc./Conn. Fee $
WCWSD/Other Fee $
City of Hagerstown Fee $
Total Fee $
Remarks
Lateral with Mainline?
Residential EDU's J_
Commercial EDU's
Gal/Day Allocation
Building Number
Misc. Number
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.
-A,j,,_ Date:
INSPECTION: At least 48 hours notice prior to requested date is required.
ON SITE INSPECTION will be made by:
Washington County Plumbing Boats
100 W. Washington Street, Room 3
Hagerstown, MD 21 740-4 72 7
Phone: (301) 791-3070
Inspection Date: `'
-% Plumbing Inspector:
WASHINGTON COUNTY SANITARY DISTRICT
WASHINGTON COUNTY, M- AL
Project: Neffrh lS,tiik Ac 574Qr.s G//�cTroa y YsT+�,-s'—rio-6 Gb
Street (or location):
Contractor:
Date Installed
SANITARY SEWER LATE=
CONSTRUCTION REPORT
MH//S �_ TO MH /,/6 `l
Wye Sta. On Main of"y
WYE SIZE - TYPE DEPTH TYPE EXCAVATION
TYPE PIPE C.O. C.O. LATERAL LENGTH
410-1 c acs r
PUG rxoV,
s ,
8�x IV At 5�,�-� 6 oxtss ST D. 3 0 LF
NOTES
13
M
Depth of Cleanout at Flow Line
Cleanout 15 L.F. From `ria;, 4/;VE
Loyed at 2. 1/0
IVO Basement Service
0+/447-
M
+/4RTM H
LF
LAYING LENGTF
Horiz. = Total
q5- LF
Slope + Horiz. = To
MHS //6y
Amounts ��rttaining t ork completed this period. reviewed and approved.
B Y / IF �✓
WCSD INSPECTOR CONTRACTORS REPRESENTATIVE
WASHINGTON COUNTY SANITARY DISTRICT
AUGUST 13, 1984
IT