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HomeMy WebLinkAboutLat_17931JenniferLane0" WASHINGTON COUNTY 3 WATER & SEWER DEPARTMENT 16232 Elliott Parkway � ILCL ' Williamsport, MD 21795 7RY�wN (301) 791-3083 ) a�� q q Permit to Connect to Public Water/Sewer System Type of Permit Subdistrict Name _ Mainline Contract N( Building Permit No. Permission is hereby given to Property Owner: Permit No. Issue Date _ Void Date , Subdistrict No. = r of address: 17 0 1 V, _-V T': �! �- CT i, For property located at: - I Street Address Lot No. Subdiv. cv� Phase Sec. Owner's Agent: ..P M_.9 t• EVTFIFI:-- - T 5 P, Agent's Address: +i,�s IlArgv n,RTV RA{'2 1Wpc, N1 r, 1 4r, Previous Owner: Fees Paid in Full? VES Lateral with Mainline? Date Fees Paid ; 0 /J / 98 Residential EDU's Fee $ Commercial EDU's WCWSD Alloc./Conn. Fee $ ,� , Gal/Day Allocation WCWSD/Other Fee $ Building Number City of Hagerstown Fee $ _-'i o CAC Misc. Number Total Fee $ Remarks 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 County 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 RE- MAINS WITH THE PROPERTY OWNER. Signed: ,Pn INSPECTION: At least 48 hours notice prior to requested date is required. ONSITE INSPECTION will be made by: Washington County Plumbing Board JAN 1 it 1999 100 W. Washington Street, Room 304 Hagerstown, MD 21740-4727 WASHINGTON COW TY Phone: (301) 791-3070 INFER & $SE H DEPT Inspection Date: Plumbing Inspector: WASH IrJGTON COUNTY SANITARY UIS I RICT WASHINGTON COUNTY, ME). AAL. Project: jV�y,,J3 f pG✓�u>.3 - SD /S- J'// TYPE LATERAL EXCAVATION LENGTH LAYING LENGTI` Street (or location):.1O..1.rJ.Lc2 . Qn? / 31 Contractor:j��y,��Q/ Date Installed F Sr- 9¢ SANITARY SEWER LATEF CONSTRUCTION REPORT AOk MHS//9 TO MH Giza Wye Sta. On Main �,490 ,e WYE SIZE - TYPE PIPE TYPE C. 0. DEPTH C, 0. TYPE LATERAL EXCAVATION LENGTH LAYING LENGTI` � � s�vC 7,0 ST D. _ S -7. S Horiz. = Total �'/ D Slope + Horiz. = To NOTES: DROP ��A ILA - . Depth of Cleanout % D %rte at Flow Line Cleanout 49• o From Loyed at ? � /° A!/i� Basement Service MH #)))9 Amou pertaining to work completed this BY 5w—� WCS D INSPECTOR Q r N period, reviewed and approved. CONTRACTORS MH#//Z4 REPRESENTATIVE WASHINGTON COUNTY SANITARY DISTRICT —� AUGUST 13, 1984 Is-