HomeMy WebLinkAboutLat_19727MarigoldDriveWASHINGTON COUNTY
WATER & SEWER DEPARTMENT
16232 Elliott Parkway
Williamsport, MD 21795
(301) 791-3083
Permit to Connect to Public Water/Sewer System
Type of Permit
Subdistrict Name ;. Permit No.
Mainline Contract No.
Issue Date
Building Permit No. ^3 y Void Date
Subdistrict No.
Permission is hereby given to:
Property Owner:
of address:
W g/tgI�gsS
For property located at: `".' R?
Lot No. Subdiv. Street Address
Phase Sec.
Owner's Ag 1 Agent's Address: TKE HAvW;;
Previous Owner: -
Fees Paid in Full?
Date Fees Paid Lateral with Mainline? y `'
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,lumbing permits, etc. ALL OTHER PERMITS,
STATE AND LOCAL, MUST BE OBTAINED BY THE PROPERTY OWNER AND ALL RESPONSIBILITY CONNECTED THEREWITH RE-
P
MAINS WITH THE PROPERTY OWNER.
Signe ClL-01141 J 1►, /j 6 l d 1
Date:
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
Inspection Date: 1/1
Plumbing Inspector:
AUG 21 99
WASHIN ' TY
WATE E R D T.
Residential EDU's
WCWSD Alloc./Conn.
Fee $
Fee $
Commercial EDU's
41
WCWSD/Other
Fee $
Gal/Day Allocation
City of Hagerstown
Fee $
Building Number
Total Fee $
Misc. Number
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 County policy.
This permit does not supercede any local ordinance that is in effect with regard to road excavations,lumbing permits, etc. ALL OTHER PERMITS,
STATE AND LOCAL, MUST BE OBTAINED BY THE PROPERTY OWNER AND ALL RESPONSIBILITY CONNECTED THEREWITH RE-
P
MAINS WITH THE PROPERTY OWNER.
Signe ClL-01141 J 1►, /j 6 l d 1
Date:
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
Inspection Date: 1/1
Plumbing Inspector:
AUG 21 99
WASHIN ' TY
WATE E R D T.
^',I VI'JI nI�.I
WASHINGTON COUNTY. MD.
Project:
Street (or
location):
L-1-:5 8Z S2, �)
i}iARJ&OLIp
Contractor:
r--
t ��
( 7 72-1 / l 9 7Z 7
Date Installed 1C4}(p
WYE I SIZE- TYPE DEPTH TYPE
LTYPE PIPE I^ 0. Co. LATERAL
I
3YCxC<�" I`'-SpRZ�
NOTES
E.
IL
��STI� Cnp I ►moi � F, 6.
�"I t>M Z(o
z3'
E!
ST'D.
RM
.��-iIv
CONSTRUCTION REPORT
1 ,SD -Sly
MH -= TO MH 11%1
Wye Sta. On Main t Z1 Rr
EXCAVATIO N
LENGTH
36/
LAYING LENGT'r-
Horiz. = Total
z3'
Slope + Horiz. = To
II� W 9 e- (," X 4I I x LSI
I
Depth of Cleanout _ 13.S' of Flow Line
Cleanout Z3' From c� 8"MAIN ltiu � �• Z)7 -6e- 51Z • b'q
Loyed at -Z-0c)-/,
Basement Service
MH #- 5>7/So-1(71
5T�, (+2-[ {;r
MH # 5D)S0-11 ]Z
a° /a
Amounts
pertaining to work completed this period, reviewed and approved.
9Y G ��
WCSD INSPECTOR
CONTRACTOR'S REPRESENTATIVE
'ASHINGTON COUNTY SANITARY DISTRICT
UGUST 13, 1984