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WASHINGTON COUNTY SANITARY DISTRICT PERMIT NO.
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571 (301) 791-3083 1 3084 DATE 8._2! +84
P.O. BOX 571
SUBDISTRICT 1i0« 5
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM Ttiiaug,a *T0 a,3?Q,z
Permission is hereby given to: Vax-i n 1, i6UAlbAU64
3� 1*2 Hills
For Property Located at: 11 swith Mai -,;a 4t. Tula> gasySisi 1 3,'p 1'd 21767
Owned by: 1,11ar t -i m 131=1 aUgh– Address: t'.G'} TtteX 224 141awginayills, Zd 21767
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
;{ To Main Line:
( �) Units Other
Industrial
Connection Fee _(D QQ Date Paid A -29–i-4
To connect to a public sewerage/90M 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 RESPOW
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: Q�� Cs 1 l�nb� • -.L_.— Date Q - Z L4 –5�
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:
Final Inspection Made By:
DISTRIBUTION: Permittee—1 Plumbing Board
Field Office
Washington County Sanitary District
33 W. Washington Street-P.O. Box 571
Hagerstown, Maryland 21741-0571
Date
WASHINGTON COUNTY SANITARYPKSTRICT
WASHINGTON COUNTY, MO.
AINS SANITARY SEWER Lh s E ?,'.?
CONSTRUCTION RECORD
Project: Maugansville/Orchard Hills SD1S-1-S
-- - - - -- 137 2 /1'lau�c
Street (or location): G,41 2-ULI- AadC(/0=,5 II �NtAt(�t STIz�G-!
Contractor: Calles Contractors Inc.
MH 3(8 TO MH 31q
Date Installer' AL_!a ls+ 11, 1983 Wye Sta, On Plain 22-3Q L�
(5.33 t22=o -
3n. =K::;,'
CcEAM -Our
� I
Depth of Cleanout SFlow Line w�,...
Cleanout 28.33' From q- MAJN
Layed @ (o.q
U
NO Basement Service
inH;` 318
Amounts pertaining to Work completed this
B Y&.�d4 ,
T WCSU Inspector
C -O.
Sl ,n. Zt 30 MH7 3/1?
per'od, reviewed and a prov d.
Contractors Rep. � "�
, . PJ
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15-1S
Property Address: 11 Main Street 13-7q-2 Y1'lauaar,�v� lIZ Rd
MH 318 to MH 319 11 Dwg. #601-031
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.
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:
&0�1- -;(
Owner( rint)
BC., 4et�
Owner's Sigvfature
Attest:
Wash. Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56
N� u
rn D
10
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0 D
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:
&0�1- -;(
Owner( rint)
BC., 4et�
Owner's Sigvfature
Attest:
Wash. Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56
W
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Fo r-
lG[
WASHINGTON COUNTY SANITARY DISTRICT
33 West Washington Street, Hagerstown, Maryland 21740 ■ (301) 791-3083
To: Callas Contractors, Inc.
- I hereby request the contractor to install the lateral in
accordance with the following conditions:
Address J1 S.
Signed, :Z�
/jProperty Ownect
Date �= Iq A � �a':)
Washington County Sanitary District
33 West Washington Street
Hagerstown, Maryland 21740
Re: Maugansvills/Orchard Hills Sewers
Contract No. SD15-1-S
Gentlemen:
We hereby request permission to install the house lateral
of greater than two (2) percent and/or in accordance with the
above conditions at no change in contract price at the followi?Zg
location:
Requested by Callas Contractors, Inc.
Approved by by W.C.S.D. Inspector /
Date ,Xa 0-