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WA$,HINGTON COUNTY SANITARY DISTRICT PERMIT NO. 931
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571 (301) 791-3083/3084
P.O. BOX 571 DATE 12/20/85
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM
Permission is hereby given to: Joan M. Wieland
For Property Located at: 1204 Indian Cottage Rd., H
Owned by: Joan ►'4 • Wieland Address: 1204 In
Type of Connection: To Service Connection
Type of Service: Residential « ( 1) Units
Commercial
Meter Size
Connection Fee
$620.00
SUBDISTRICT No. 15 —
augansville/Orchard Hills
stown I�iD 2174U �Hi�ls0l kwa d
Cottage Rd.,Hag@rstown MD 21740
To Main Line:
Other
Industrial
Date Paid 12,/20/85
To connect to a public sewerage/A/AtAr 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.
Water No. Unavailable
Secretary-Treasu er
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: �"lit%" f `Date Z�k
Plumbing Inspec
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__
City of Hag. 1
WASHINGTON COUNTY SANITARY DU 'ICT
WASHINGTON COUNTY, MO.
Projects Mouoanavi
Street (or location)t
-41TARY SEWCR LATCO:
ASTRUCTION RECovr!
Contractors Lisbon Can ractori. Inc. r , P
i
Date Installed Zd Ju/u 8Q
D e Zb ovt, r �
NOTE 5:
MH sa-7 TO AH 5-46
Wye Ste. On Mein o f 79'
St'd. *Hors.• To
Drop I Z6.50L.=. I ---r- - ----------
9. 271 eo. 00 = z . Z7L•F.
Laced Is3 % AFTgq DizpA
��,��� Basement Service
G.O.• ••.
r
Amounts pert Ainq to work completed this per:odp reviewed and a proved.
neper or Contractors Pop,
(0/s 1a3
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
6 53 ri Contract No. SD15- 3-S
Property Address: 1k4 Orchard Hills Parkway
MH 547 to MH 548 _ 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.
SAN �� 4
____ MN SV \ "
MH SDI -5478 SAN k
- o —
C R /W
N f
714 _- 1
(1204)
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:
Owner
Owner
Attest:
Wash. Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56