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INGTON COUNTY SANITARY DISTRICT PERMIT NO.
33 WASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571 (301) 791-3083 1 3084 DATE
P.O. BOX 571
SUBDISTRICT
PERMIT TO CONNECT TO PUBLIC SEWERAGEIWA`fER SYSTEM EI 6
Permission is hereby given to: jonn M Sandcl^SDn, :ir•
For Property Located at: 1 303 Orc� and Hills PkWy. %a
Owned by:__, ,ohn M Sainder50t1, JY'Address
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
1308 Orchard hi l is ►� , 'y. r'�a. arc ,ai n, Mt)
To Main Line:
Units Other
Industrial
Connection Fee $620.UU — Date Paid 7/22/ti�
To connect to a public sewerage/watier 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 RESPOW
SIBILITY CONNECTED THEREWITH REMAINS WITH THE PROPERTY OWNER.
Water. Account No.. Unknown
Building Permit No.
& Q'. 2aAkegAs�
Secretary -Treasurer V
/` I
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
Plumbin spector
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: Date
DISTRIBUTION: Permittee Plumbing Board
Field Office i
City of Hag. I
WASHINGTON COUNTY SANITARY ..,STRICT
WASHINGTON COUNTY, MO.
SANITARY SEWER LATE'':;-
CONSTRUCTION nEC(ill'!
Project:Msu na it a Urch ra/n'La
1�a
Street (or location) : ,A
F3c�J D �i�� I�KWy •
Contractor: Lisbon ContractOLL, Inc,
Date Inatalled_ �2 Jau4 e -
MH s:fC7 TO MHS
Wye Sts. On Main �fBf.2 Rf• v
UYE 51 .. TYK 1 DEPTH I I TNS. F.0%6" t. ........_
WE TYPEPIPE C.O.C 0 LATERAL LENGTH LENGTH
"50 2toeV . HOrt.s Total
S t' d
ope + Horzallotai
Drop 24.5oL•r-. to.go=22.OgI-
NOTES:
Depth of Cleanout f1.44VF. OFlou Line ..�._
Clesnout From-i-&-M41A-)
L a y e d 4t'!e, Dmp
Basement Service
MH#=
2:5�ubc lap
Amounts parts nin9 to work completed this period, reviewed and approved.
By
UM nap c or Contractors Rep.
Ao Adftk.
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
MContract No. SD15- 3-S
Property Address: S Orchard Hills Parkway
MH 550 to MH 551 DWG. #601-311
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.
S0i5' S50
r-
12 W
g"SAN
- - r
MH SD15-551
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: 5 '� �?� doh /yj . SAN�F.,RSO L
Owner
Owner
7
Attest: �L M,Aq
ash. Co. Sanitar District
(Form WCSC-1)
Replaces Form WCSC-56