HomeMy WebLinkAboutLat_13502MarshPikeWASHINGTON COUNTY SANITARY DISTRICT
33 W. WASHINGTON STREET HAGERSTOWN. MARYLAND 21740
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM
Permission is hereby given to: _
For Property Located at:
Owned by:
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
Address:
(301) 791-3083/3084
To Main Line:
Units Other
Connection Fee
Industrial
Date Paid
PERMIT NO,
DATE
SUBDISTRICT
To connect to a public sewerage/water system (with proper abandonment of previous private system). The installation
of the connection and the abandonment of the previous private system shall conform with the provisions of the
Laws of the State of Maryland and Washington County Sanitary District Specifications.
This permit does not supersede any local ordinance that is in effect with regards to road cutting, etc.
ALL OTHER PERMITS, STATE AND LOCAL, MUST BE OBTAINED BY THE PROPERTY OWNER AND ALL RESPON-
SIBILITY CONNECTED THEREWITH REMAINS WITH THE PROPERTY OWNER.
Secretary -Treasurer
Building Permit No.
INSPECTION: At least 48 hours notice prior to requested date of inspection is required.
ON SITE INSPECTION will be made by
Permit Fee
Washington County Plumbing Board
33 W. Washington Street
Hagerstown, Maryland 21740
Telephone: 791-3146
Final Inspection Made BY: �uz ' ____ __ Date
Plumbing Inspector
OFF-SITE INSPECTION (in Public Rights -of -Way and Easements) and certain
ON-SITE INSPECTION in accordance with applicable approved construction drawings will be made by:
Washington County Sanitary District
33 W. Washington Street
Hagerstown, Maryland 21740
Final Inspection Made By: _ Date
DISTRIBUTION: Permittee Plumbing Board
Field Offi
WASHINGTON COUNTY SANITARY
WASHINGTON COUNTY, MO.
Project: HAUG4U5V1L.E^-
Street (or location):
:STRICT SANITARY SEWER LATERAL
CONSTRUCTION RECORD
CC,*JT ACT 5015-a-5
LAF-4L3 HILLS JAM ITARY SEWER I-jRoj_
ri G.rS ht P, KP �Ee—:E A/o 7 F i^l LOG
226A (27 �oQrdo OC4
Contractor: L15soN CouTRACTUR* `Ck^syti
MH TO MH
Date Installed___ /2- a8 -83 Wye Ste. On Main of4B-5 LT.
1'7
0-- 8" wIL
'I
2''STUB-�CAP I 1
Depth of Cleanout 7.92 V. F. ®Flow Line
Cleanout 2<o.OG From
L a y e d 0._._...=,q F T6.R pF?o C>
Y, -EQ Basement Service
2'srus g;caP - c . v.
C;.. wIL
✓HUNG.
o -)-4.8.S LT -
LENGTH
*Horz.- Total
MH# /0/3 �M4�5 N pi K �
MH# AO
Amounts parte ng to work completed this periocj, revia id�and approved.
8 Y
WCSO Inap ctor Contractors Rep. "~
.i
00^
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15- 3-3
Property Address: d
MH 1013 to MH 1014 QWn- #164
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.
M
0 ()
S 15-101
V
The undersigned agrees that the Sanitary District may
excavate an additional five (5) feet inside the property
line so as to facilitate, and make less expensive, the owner's
connection to the lateral and to prevent damage to the cleanout
which will be installed by the District at or near the property
line.
Date 4/0
Owner
Owner
Attest:
Wash-. Co. Sanitary D'strict
(Form WCSG-1)
Replaces Form WCSC-56