HomeMy WebLinkAboutLat_19731MarigoldDriveWASHINGTON COUNTY
VV /A &SEWER DEPARTMENT aI of
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16232 Elliott Parkway
Williamsport, MD 21795
(301) 791-3083
Permit to Connect to Public Water/Sewer System
1'I
Type of Permit RES SEWER Permit No.
SCP 150-1546
Issue Date
Subdistrict Name Q11
Void Date
Mainline Contract No. Subdistrict No.
Building Permit No.
Permission is hereby given
JOHN R.
OLIVER
Property Owner:
of address:
Street Address
For property located at:
'
Phase Sec. E
Lot No. 301 Subdiv.
Owner's Agent: OLIVER HOMES
D
Agent's Address: 1
E
Previous Owner:
YES
S
Lateral with Mainline?
Fees Paid in Full?
1
Residential EDU's
Date Fees Paid
Fee $
Commercial EDU's
Fee $
Gal/Day Allocation
WCWSD Alloc./Conn.
Fee $
Building Number
WCWSD/Other
Fee $
� Misc. Number
City of Hagerstown
Total Fee $
FERENT I A
�r .,
DATE
Remarks
rERMiT VOID -
It
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
rmits, etc. ALL
permit
AND LOCAL, is
MUST BE OBTAINED BY THE PROPERTY OWNER AND ALL RESPONSIBILITY CONNECTED OTHER TI
CONNECTEDTHEREWIH
STATE RE-
MAINS WITH__THE PROPER y OWNER 1
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 217404727
Phone: (301) 791-3070
Inspection Date:
Plumbing Inspector: ���
F
f<
F
F
r-,ROJECT NO:
ROJECT NAME: / w r — DRAWING NO:
ROPERTY ADDRESS: _ DATE INSTALLED:
/// / 7 /-- TO MH / l 72-
IAIN LOCATION: STREET/EASEMENT � 7 3 f MH
ROPERTY OWNER NAME:
MAIN STATION:
'ROPERTY OWNER ADDRESS: SINGLE: = -- DOUBLE:
CONNECTION 4 MH: J
SIZE &TYPE INVERT ® DEPTH DROP D E
SERVICE PIPE MAIN (A) F
SIZE &TYPE C/0 (B) DEPTH (C)
TEE/WYE
Si(Co rr C r
KATE TYPE OF LATERAL BY CROSSING OUT OTHERS.' FOR CONNECTION TO MANHOLE, CHECK ABOVE,
IND _ C (IF APPLICABLE).
SHOW LATERAL LOCATION, STATION, UTILITY UKu»"`"�
LEFT
FLOW
(or to I (ter l`1
I
DOWNSTREAM RIGHT
MH#117(
LIST QUANTITIES FOR PAY ITEMS HERE:
BY:
WASHINGTON COUNTY INSPECTOR
-51 �Vl
,SION OF PUBLIC WORKS
�1 WASHINCTON COUNTY, AlAffnAVO
WATER AND SEWER
DEPARTMENT
UPSTREAM
MH # 1172
CONTRACTOR'S REPRESENTATIVE
CO. NAME:
GRAVITY SEWER SERVICE
CONNECTION SHEET
MARCH 1996 I S-13.2