HomeMy WebLinkAboutLat_13015OrchidDrivep'0N COe, WASHINGTON COUNTY
3 WATER & SEWER DEPARTMENT
16232 Elliott Parkway
°��RY rNo Williamsport, MD 21795
(301) 791-3083
Permit to Connect to Public Water/Sewer System
Type of Permit Permit No.
Subdistrict Name Issue Date
Mainline Contract No. Void Date
Building Permit No. Subdistrict No.
Permission is hereby given to
Property Owner: OL T C0
of address: S tRG. r kE
Hk 4N
For property located at: ;T b'E
Lot No. _ Subdiv. 1 : % 'd � 7ES Street Address
Phase Sec.
Owner's Agent: ? Mrd F nr� T,,,; F r, -gt r:r TNC
Agent's Address: Fyr. r
Previous Owner:
Fees Paid in Full?
Date Fees Paid
Lateral with Mainline?
Residential EDU's
Fee $
Fee $
Commercial EDU's
WCWSD Alloc./Conn.
WCWSD/Other
Fee $
Gal/Day Allocation
City of Hagerstown
Fee $
Building Number
Misc. Number
Total Fee $
Remarks -FAIR a,_ i
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: r`.>r(f -r % ��
Date:
INSPECTION: At least 48 hours notice prior to requested date is required
ON SITE INSPECTION will be made by:
Washington County Plumbing Board
100 W. Washington Street, Room 304
Hagerstown, MD 217404727
Phone: (301) 791-3070
Inspection Date: _22 Plumbing Inspector:
WASHINGTON COUNTY SANITARY DISTRICT
WASHINGTON COUNTY. MD '"'
Project:/�R� h 13rocr EsTares CoI/t�Tch SysTe�,, S iso a�6
Street (or location):
Contractor: %,-r£rrEvi/i�
Date Installed -,/— ;Z 3 — 77,
WYE
SIZE -
TYPE
TYPE PIPE
a0.
G
PoG saR-: c
GaJ r
£',fog,
y
NOTES
DEPTH
C.O.
SANITARY SEWER LATERA
CONSTRUCTION REPORT
MH ii rs— TO MH its -6
Wye Sta. On Main
TYPE EXCAVATION
LATERAL LENGTH LAYING LENGTH
ST 'D. iHoriz. = Total
DROP Slope t Horiz. = Tota
�/ 3 G F i.3 6- ZDC r [./'
SJo w6/e wYc Filfis�s ' �
Depth of Cleanout'
at Flow Line
Cleanout /3 From
Layed at
No Basement Service
li0f Kr
MH #- /iSS
MH## ii.sb
Amounts pertaining to work completed this period, reviewed and approved.
BY W
WCSD INSPECTOR CONTRACTORS REPRESENTATIVE
WASHINGTON COUNTY SANITARY DISTRICT
AUGUST 13, 1984
S-2
t
R .rUEST TO ALTER SANITARY SE,."�R
SERVICE LATERAL
TO: Washington County Sanitary District
Rt. 3 -Box 1075
Elliott Parkway
Williamsport, MD. 21795
We hereby request permission to install the house lateral
described below, at lVo}Ti, Breok r s i4rzs
Street Name:
Lot Number: Sz
Manhole _ //,S's' to Manhole Y-6
Station oT? , Left / Right
( ) From % to
Grade
( ✓) From Standard lateral to drop'at cleanout_
( ) Depth at cleanout
This request is made on this date
a �
BY:
REPRESENTING: Tah n
13. 04+'ve1- L 0.
4
Representative
APPROVED BY: Wastlington County Sanitary District
W.C.S.D. Representative