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WASHINGTON COUNTY SANITARY DISTRICT
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571 (301) 791-3083/3084
P.O. BOX 571
PERMIT TO CONNECT TO PUBLIC SEWERAGEIkkl-Fa.-SYSTEM
Permission is hereby giv(
For Property Located at:
PERMIT NO. 365
DATE 1 1 - 1 6 - �'t
SUBDISTRICTNo 15
Maugan.sville/Orchard
T -Ii ll Q
Owned by: john'w- Li#t_1P Address: 246 Bryan plana, LjagPrSi.pwn Pf l 21740
Type of Connection: To Service Connection X To Main Line:
Type of Service: Residential R ( I) Units
Commercial
Meter Size
Other
Industrial
Connection Fee $620.00 _ Date Paid i 1 - .I i_
To connect to a public sewerage/ 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: C o -A R. . �j Q__4er&!, L 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-P.O. Box 571
Hagerstown, Maryland 21741-0571
Final Inspection Made By:
DISTRIBUTION: Permittee Plumbing Board
Field Office
Date
WYE
SIZE
e
TYPE
C,0.
DEPTH
C.O.
:WASHINGTON
COUNTY SANITARYSTRICT
SANITARY
SEWER LATERi L
UASHINGTON
COUNTY, MD.
CONSTRUCTION RECORD
Project:
MaugansvilleZOrchard Hills
5015-1-5
Street (or
location): f5
i8'm3AlpA'ne DreA
r y�y�
Contractor:
Callas Contractors Inc,
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LJ
Z9,i6 [F
MH 3s/
TO MH yo 6 Tekm
Date Installed]
azo-2iSBy
Wye Sta,
On Main I+y7,6
WYE
SIZE
SIZE—
TYPE PIPE
TYPE
C,0.
DEPTH
C.O.
TYPE
LATERAL
EXCAV.
LENGTH
LAYING
LENGTH
CAST
{0,33 VF
HOTZ,- Total
�.V.C,
rao�
St d,
32 �F
Z9,i6 [F
ope + Hor - otal
Drop
NOTES:
co
9.75'
Depth of Cleanout G, 33 Sf lcu Line
Cleanout -R7,/G' From t o r MA,n► l. f n► c-
Layed 2
YiE5 Basement Service
r
n
MH;i- 35-1 SrA f f y7, tc MH# q0 Tl= /p/)7
Amounts pertaining to work completed this perireviewed and app.o ed.
WCSU Inspector Contractors Rep.
J
W
Washingt*'n County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15-1S
Property Address: -454--C-7 ')'^^�" '
MH 3- 1 -rD M fl 40(,,
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.
N
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: / VP2--30t-.1,, U3 I-,k-r-Tt-L_
t Owner
Owner
Attest:
Wash. -Co. Sanitary istrict
(Form WCSC-1)
Replaces Form WCSC-56
/Si C PxeSkIV)
puns --all for lateral to be
WASHINGTON COUNTY SANITARY DISTRICT
A /**%, 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:
Ft, 6) PAT
•
`Address_ /s/ /�eslo l AIE_
fined
Property Owner
1"Date
Washington County Sanitary District
33 Nest Washington Street
Hagerstown, Maryland 21740
Re: Maugansville/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 following
location:
Requested by Callas Contractors,
Approved by W.C.S1.D. Insp�or
Date ) 1\ Is 1'gz
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