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Home My WebLink AboutLat_19207OldeIpswichCircleWASHINGTON COUNTY SANITARY DISTRICT 00"" Elliott Parkway 70/81 Industrial Park Williamsport, Md. 21795 Telephone 301-223-9416 Permit to Connect to Public Water/Sewer System Type of Permit Res yp Sewer Permit No. SCP 150- 1075 auganvi 1 01f Subdistrict Name 15 0Mainline Issue Date _ Contract No. _ Void Date Building Permit No. 3 6 _ Subdistrict No. Permission is hereby given t• 3ohn Porter, Jr. I (� �� (,� Property Owner: - I `_ of address: 5JU Gordon i rc -e Hagerstown MD For ro er .Located at: p p pswic Lrc e Street Address Lot No. ' ' Subdiv.Phase Fountain [lea North Sec. Owner's Agent: R.B. Keener Previous Owner: Agent's Address: 2121 Fairfax Rd, Hagerstown, MD 21740 Fees Paid in Full? yes Lateral with Mainline? yes Date Fees Paid 'r Residential EDLI'S 1 lam` WCSD Dist./Coll. System Fee $ 15 C' 0 Commercial EDLI'S WCSD Ready to Serve Fee $ Gal/Day Allocation 200 WCSD Fee $ Building Number 1 City of Hagerstown Fee $ 420 Lateral Contract No. Total Fee $ 1920 Remarks No connection can tie made until sewer construction completed 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 WCSD policy. This permit does not supercede any local ordinance that is in effect with regard to road excavations, plumbing permits, etc. ALL OTHER PERMITS, STATE AND LOCAL, MUST BE OBTAINED BY THE PROPERTY OWNER AND ALL RESPONSIBILITY CONNECTED THEREWITH EMAIN WITH THE PROPERTY OWNER. Signedf4�lii''!<�� Date: �� G INSPECTION: At least 48 hours notice prior to requested date is required. ON SITE INSPECTION will be made by: Washington County Plumbing Board �\ 33 W. Washington Street )`Hagerstown, Md. 21740 Phone: 791-307 Jpr� Inspection Date: �_?-� q�) Plumbing Inspector OFF SITE INSPECTION (in Public Rights of Way and Easements) by WCSD Inspection Date: WCSD Inspector (Lateral) Inspection Date: WCSD Inspector (Connection) Distribution: Permittee City of Hagerstown City of Williamsport WCSD Construction WCSD O&M WCSD File Permits Office Plumbing Board Plumbing Inspection W CONSOLIDATED BUSINESS FORMS, INC. - HAGERSTOWN, MD 21740 GOOD BUSINESS IS A MATTER OF FORM! COUNTY COMMISSIONERS FOR WASHINGTON COUNTY PERMIT APPLICATION & ZONING CERTIFICATE PERMIT NO. DEPARTMENT OF BUILDING PERMITS & INSPECTIONS 9C r l YD � SS DATE ISSUED 33 W. Washington Street, Hagerstown, Maryland 21740 • 791-3070 /\2 q �O r^j--7-- I JOB LOCATION L F rn C R AL DATE NEW ADDITION ALTERATION1 L T N0. SEC, NO. PLAT NO. TAX MC�AP BLOCK NO. NO. ZONING t T M IDIVISIONNAME/APPRr FAMILY Y FAMILY FAMILY BD OF APPEALS BUILDING �PARCEL I A REFERENCE DEPT. NON RESIDENTIAL DESCRIPTION RESIDENTIAL DESCRIPTION 1 / 0 HEALTH ACCOUNT NO. IMPROVEMENT ELECTION DIST. LIBER FOLIO ACREAGE LOT IZE N N OFF STREET PARKING PROPOSED MIN. BY ORD. PROPOSED MIN. BY D. ZONING I • 3 5 lo3 A, fC C10 C> LOT AREA PER FAMILY LOT WIDTH 0 MIN. BY ORD. PROPERTY OWNER(S) c �d PHONE NO. W FRONT YARD SETBACK REAR YARD „: 1 • E' U - N PROPOSED MIN. BY ORD. FIRE • `�' • - 4n , .4.0 MARSHAL E I GHT SIDE YARD PROPOSED MIN. BY ORD. PROPMIN. BY ORD. PROPOSED SPECIAL R F PR ERTY OWNER( S DRESS CITY STATE ZIP C 0 R 5 N NAME/OWNERS REPRESENTATIVE PHONE NO. T % n- Ams' .�3 CTRAC 0 TCONTRACTOR'S OR'S .ADDRESS - CITY STATE Q� ZIP HOME IMPRT�a1 DESCRIPTION OF WORK r , W EST. VALUE D I , E EF N _ 7 V / ` PERMIT FEE C 0 J R O 1 R IM M �j B P A 0Q , / I T I uLDlIQUMS LZTLIOOR FIN FOUNDATION SIZE PORCH SIZE GARAGF S17F CARPORT SIZE DECK SIZE 0 N 0 N EXIST. TOTAL --nd N0. PULL BATHS NO. HALF BATHS UNITS ®SEWER IC GAS [ELEC. TY EAT PUBLIC ®WATER PRIVATE ❑ WELL C( 1,,' Z O N 1 N G 8l S T E P L CAUTION I have carefully examined and read this application and know the same is true and correct, and that in doing this work, a!' provisions of Washington County Regulations and State Laws will be complied with, whether herein specified or not. I further understand that to begin construction before a building permit placard has been issued and displayed on the job is tlaatio the law. A Use and Occupancy permit must be received before permitting occupancy. 3 / 90 WCINIS SIGNATURE DATE A ZO N 'YARD SETBACK BUILDING LINE VERIFICATION LOT SHOWN ON SUBDIVISION RECORD PLAT NOTED ABOVE AND APPROVED BY PLANNING -3o COMMISSION REQUIRES GREATER SETBACK OR YARD REQUIREMENTS THAN MINIMUMS PRE - N SCRIBED BY ZONING ORDINANCE. 7 F ❑ YES ❑ NO ❑ NOT APPLICABLE INITIALS lam' O R M A 25T 61 O N t Or = S W I G f••! C i Qc AGENCY APPROVALS NAMES DA NEW ADDITION ALTERATION1 ONE TW MULTI BUILDING FAMILY Y FAMILY FAMILY BD OF APPEALS BUILDING REFERENCE DEPT. NON RESIDENTIAL DESCRIPTION RESIDENTIAL DESCRIPTION HEALTH DEPT, LOT TRACT AREA OFF STREET PARKING PROPOSED MIN. BY ORD. PROPOSED MIN. BY D. ZONING fC C10 C> LOT AREA PER FAMILY LOT WIDTH PROPOSED MIN. BY ORD. PROPOSED MIN. BY ORD. / c �d o o cy o '70 FRONT YARD SETBACK REAR YARD „: 1 • E' U - PROPOSED MIN BY ORD, PROPOSED MIN. BY ORD. FIRE • `�' • - 4n , .4.0 MARSHAL - LEFT SIDE YARD GHT SIDE YARD PROPOSED MIN. BY ORD. PROPMIN. BY ORD. PROPOSED SPECIAL /Z.15 / Is 6 CONDITIONS A ZO N 'YARD SETBACK BUILDING LINE VERIFICATION LOT SHOWN ON SUBDIVISION RECORD PLAT NOTED ABOVE AND APPROVED BY PLANNING -3o COMMISSION REQUIRES GREATER SETBACK OR YARD REQUIREMENTS THAN MINIMUMS PRE - N SCRIBED BY ZONING ORDINANCE. 7 F ❑ YES ❑ NO ❑ NOT APPLICABLE INITIALS lam' O R M A 25T 61 O N t Or = S W I G f••! C i Qc WASHINGTON COUNTY SANITARY DISTRICT WASHINGTON COUNTY, MD. Project: JTx* l r;bo tJ t}-4ErA-,'j-> (SO ;33 S Street (or location): OL►�� =�sWict-k �'�t��' ��a�� Contractor: -}2�y&TPzNIL-C— �o�-c;cozs SANITARY SEWER LATERAL CONSTRUCTION REPORT MH %0kS-1094 TO MH SDIS-10915 Date Installed �2q MIArQ,CN CIO Wye Sta. On Main Q+-10 1-M WYE SIZE - TYPE DEPTH TYPE EXCAVATION TYPE PIPE I CO. LATERAL LENGTH LAYING LENGTH 8'ijc 4 u� 8 r1 � i�302 oZ�v f -VC NOTES: 4/ pvc- SDtz.-do Horiz. a Total STPD. 50•D L -r.- T-7 4..,.c7 Slope t Horiz. = Total I 1 -1 - Depth of Cleanout /O.U' -71---rri? of Flow Line Cleanout From Layed at �• °o ��n N� Basement Service v MH #%095 MHi# jd9y Amountspertaini to work completed this period, reviewed and approv . BY WCSD INSPYaTOF�- CONTRACT S REPRESENTATIVE WASHINGTON COUNTY SANITARY DISTR-*T AUGUST 13, 1984 S " 2 WASHINGTON COUNTY SANITARY DISTRICT WASHINGTON COUNTY, MD. Project: }'b�NTpi�( N-��►7 �� s - �� Street (or location): OLS :a -n -W10114 01 r'L9=- Contractor:�/lu�% �w�rtC#�CrescS SANI IAKY Jtwth tNl LNAL CONSTRUCTION REPORT MH 5ok5-I0g4 TO MH SDI 5-109S Date Installed �2q MA'Q,CN Qc:) Wye Sta. On Main 0+10 1.cr. WYE SIZE - TYPE DEPTH TYPE EXCAVATION TYPE PIPE C. 0. CO. LATERAL LENGTH LAYING LENGTH Sr��1�8�t ��3D2a� �I��/�✓C �o.0 STPD. SO Horiz. a Total -0 L.r-. NOTES: Depth of Cleanout /O.D" -7ZE177'li? at Flow Line Cleanout From -mP,i 0 Loyed at a• °o ��n Basement Service MH Slope t Horiz. = Total v MH # IcAq Amounts pertaini to work completed this period, reviewed and approv . 8Y ya WCSD INSP CONTRACT S REPRESENTATIVE WASHINGTON COUNTY SANITARY DIST AUGUST 13, 1984 S-2