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q�ASHINGTON COUNTY SANITARY DISTRICT
W, WASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571 (301) 791-308313084
P.O. BOX 571
PERMIT NO. G I 1
DATE ?_'2r`'-;
SUBDISTRICT No. 15
PERMIT TO CONNECT TO PUBLIC SEWERAGEIV ATERSYSTEM j Q�II Maugaiisvi 11e/;Orchard 1Hi JI 'I S''
Permission is hereby given to:
LUl:11sN
For Property Located at: 11 03 O r ^hard H i l s `Pkwy .
Owned by: LOUiS2 l: Ilr' Address: 1102 Orchard Hills Pkwy., 'enc-. MD
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
) Units
Connection Fee � e20 • 1,
To Main Line:—
Other
Industrial
Date Paid
41 22i
To connect to a public seweragely gt& system (with proper abandonment of previous private system). The installation
of the connectipn and the abandonment of the previous private system shall conform with the provisions of the
Laws of the Stafe 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.
a
Water Account No. 0-'6-7925-81 �
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
1Z Plumbing Ins r
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 I Office i
Date
City of Hag. 1
WASHINGTON COUNTY SANITARY DI! ICT
WASHINGTON COUNTYr M0.
+1TARY SEWER LATE'." -
L-ASTRUCTION REC(Ntri
eville10rch rd SAIni= -- -11-
M uoenProjects lgu 11
Street (or location) s r,.QX
- D,0CWAC1D �/ f- [-5 pKW
Contractors Lisbon Contrmactorm, 102,
Data installed ZD 44&/ B�
NOTE 3:
40
R 26 ave la "CD2 Z6
7.49 V. F
MH ('OS TO MH QS
Wye Ste. On Mein Z43 -45m t f.
�►Horz.• Tots
St1d.
Drop I f6.3o ( . F
Depth of Cleanout -7--sv.Or1ov Line
Clesn"t ice M41�1
Loynd 2 AFTER 0200=)
Do�s�3c E Basement Service
�o.7 5(-!6437=27. /Z
PW 57�dS
Amounts per Hing to work completed this period, reviewed and approved.
/i
By s .
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Hep c or on rec ore ep.
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Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SDI 5- 3-S
at, ! l
Property Address: 4+E)- Orchard Hills Parkway
MH (005 to M 5'45 DWG J601-311
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.
N.
R/W
Mm®
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: 4
Vas . Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56
0
I
YVASHINGTON
--.I ,11 -
33 West Washington Street, Hagerstown, Maryland 21740 ■ (301) 791.3083
COUNTY SANITARY DISTRICT
To: Lisbon Contractors, Inc.
I hereby request the contractor to install the lateral in
''accordance with the following conditions:
Address_
Signed
Property Owner
Date
'Washington County Sanitary District
33 West Washington Street
Hagerstown,.Maryland 21740
Re: Maugansville/Orchard Hills Sewers
Contract No. SD15-3-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 Lisbon Contractors,
!Approved by W. C . S . D. Inspector ._�r,
nate
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