HomeMy WebLinkAboutLat_13839NorthcrestRoad�InTONCOUNTYHHAGERSTOWN,MARYLAND21741-0571 (301) 791-3083/3084
P.O. BOX 571
PERMIT NO.
DATE ( ::
SUBDISTRICT `i0'1 51
PERMIT TO CONNECT TO PUBLIC SEWERAGE11A ATER.SYSTEM M a ug a n -s v I t -(e /I i r c it a rd ail ) is
Permission is hereby given to: Herbert M. Shatze
For Property Located at: 2536 I'd -r thcrc s -t: Road
Owned by: Herbert "•i Sita cr,1.;0 Address.. 2536 IN nrthcrest [1,oadaa9rst.dw a 1(7
Type of Connection: To Service Connection n To Main Line:
Type of Service: Residential
Commercial
Meter Size
1) Units Other
Industrial
Connection Fee o b • 6 _ Date Paid
To connect to a public seweragelwatgr 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: Washington County Plumbing Board
33 W. Washington Street
Hagerstown, Maryland 21740
Telephone: 791-3146
Permit Fee
Final Inspection Made BY:944 Date
Plumbi nspector
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-P.O. Box 571
Hagerstown, Maryland 21741-0571
Final Inspection Made By:
DISTRIBUTION: Permittee Plumbing Board
Field Offi
Date
WASHINGTON COUNTY SANITARY !STRICT
WASHINGTON COUNTY, MO.
SANITARY SEWER LATC,,-;_
CONSTRUCTION REC(ii,:,
Project: MauQansville/Orchard Hills Sanitary Sewerage Collection System
Street (or location) : _ CCAS 955 zl��� NOR i HC -RP; T
Contractor: ,i Lisbon Contractors. Inc. J3$�� -et btf t y'
MH CoSU T 0 MH �S I ✓
Date Installed (Co MARCIA 'S3+ Wye Ste. On Main I+29.3
WTL
SIZE
JILL—
TYPE PIPE
I TF'L
C.O.
ULF'Ifl
C.O.
I IPI-
LATERAL
I- na.nv.
LENGTH
..•.•..•1•
LENGTH
-"i
r7.= Total
►►
SSR ZC�
/- //��
St' d.
PIV
Drop
p
r,;.�ota
NOTES:
sTua 4 CAP
lL
Depth of Cleanout (0.41 Flow Line
Cleanout 1-7From �j'
L a y e d L_
Basement Service
MH# &5v
5TA,.I+7-9.3'R;:
C,v.
M H #
Amounts pertaining to Work completed this period, revi and approved.
BY )
SD In ector ont actors Rep.
j
Mo (050 To MP %S4 Washington County Sanitary District
M SEWER SERVICE LOCATION
-� Subdistrict No. SD#15 _
Contract No. SD15- 3-S
� 3$3
Property Address: '2tt�f-rNorthcrest Road
MH 650-to-MH 65i DWG. #601-341
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.
o CD
a
O o Q , , � (�
o �.
MH SD15-652 (25 6) Oj
1 '
000
(2 )
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 Distri -at or near the property
line.
Date: � 9 --
Owner
eu
i'
&e 1.- 4,,01221.
1 � - Owner
Attest: ._
Wash. Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56