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HomeMy WebLinkAboutLat_17804AlpineDriveI!. HINGTON COUNTY SANITARY DISTRICT 33 W. WA8'-IINGTON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-3083/3084 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: Connection Fee 19 To Main Line:_ Units Other Industrial Date Paid PERMIT NO. DATE SUBDISTRICT �a 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: Washington County Plumbing Board 33 W. Washington Street Hagerstown, Maryland 21740 Telephone: 791-3146 Permit Fee Final Inspection Made BY: Date Plumbing Ins ctor 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: DISTRIBUTION: Permittee Plumbing B Field Offic Date WASHINGTON COUNTY SANIV0b— DISTRICT WASHINGTON COUNTY, MD. Project: Maugansville/Orchard Hills Street (or location): y/Z �iGhAdi �• P�i�s�� SD15-1- i SANITARY SEDER LATE�R,..i CONSTRUCTION RECfi;D p►►A2. Dr -"vim Contractor: Call.cs Contractors Inc. MH Z o 3 TO MH Z o S Date Installed L/ye Sta, Oil Bain / f p• y L ..- o.- WYE SIZE SIZE-• TYPE PIPE TYPE. C.O. DEPTH C.O. TYPE LATERAL EXCAL'. LENGTH LAYING LENCTI- 8 x � X $ � �• � PVC .. st � d *Horz.= Total � SDQ 3S rSl.ope+ Horz=Tota. NOTES: Drop 3 3 SQ Z. S f 30• y = 3Z• C0)J C ILE -re ySt 3CN0 Eu cp SE ^1 OCEAN ouT l3�,a;Er� PC c149CE / ZZ•S• I /V1�t•wI WATC-2 CINE e~ M A i.v E y �• l3tCow /QoAD Sy2�ACE Depth of Cleanout (EDFlow Line - Cleanout 3/• S From C MA•,y Layed @ Z j. A f n2 D9 ftp &6 Basement Service Q /f MH;' zo3 w V\ MH1= z s Amount's pertaining to work completed ti,is period, revi'owed and approved. BY ucsi iri-)7,fl�or +P- wr on_-acrors Rep, Washington County Sanitary District SEWER SERVICE LOCATION Subdistrict No. SD#15 Contract No. SD15-1S Property Address: 1'-I904 �I A��e L�r)kl-Q MH 203 to MH 205 Dwg. #601-058 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. 363 ' 1 (412) z , L mom n 1 y I� _ II POW SD 15 - 203 811 SAN. R/W --'Q3 3f3OO - F. H. � 0 T. B.M. 83 f� I • I R/W POW -s :MH SD15-20 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. T � Date: /©22%/92 /2ICRde /< PI TTj,�o�LL� Owner, (print) Owner' Signature Attest: e Wash. Co. Sanitary District (Form WCSC-1) Replaces Form WCSC-56