HomeMy WebLinkAboutLat_13103OrchidDrive;°" °°2 WASHINGTON COUNTY
3 WATER & SEWER DEPARTMENT
16232 Elliott Parkway
YLANv Williamsport, MD 21795
(301) 791-3083
Permit to Connect to Public Water/Sewer System
Type of Permit k I11QA Permit No.
Subdistrict Name-�►.►%,,r Issue Date
Mainline Contract No. Void Date 011 t ,
tarn
Building Permit No. �J ;,� Y 1 Subdistrict No. J,;0
Permission is hereby given to:
Property Owner:
of address:
For property located at: _
Lot No.
Owner's Agent: _
Agent's Address:
Previous Owner:
Street Address
Subdlv..� k;_�_ Phase Sec.
Fees Paid in Full? ,
Lateral with Mainline?
Date Fees Paid t
�,[:
Residential EDU's
Fee $
Commercial EDU's
WCWSD Alloc./Conn.
Fee $
Gal/Day Allocation
WCWSD/Other
Fee $
Building Number
City of Hagerstown
Fee $
Misc Number
Remarks
Total Fee $ ,
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-
M(AAIIN,5.WIITH THE PROPERTY OWN
Ir.n r.
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: Plumbing Inspector:
WASHINGTON COUNTY SANITARY DISTRICT
WASHINGTON COUNTY, Ml,
Project: NafdTh lS�eoK�STTes �o%�oTos, Jysrs� S -iso -s' 4
Street (or location) : 01(Ct//r.7 D.A.vc Ge Ts s S-
Contractor: ( j/ v l f. v
Date Installed if/ -z3 -9Z
SANITARY SEWER LATE=
CONSTRUCTION REPORT
MH 415-6 TO MH iis>
Wye Sta. On Main /t -a
WYE
SIZE-
TYPE PIPE
TYPE
C.O.
DEPTH
C.O.
TYPE
LATERAL
EXCAVATION
LENGTH
LAYING LENGTF
b '/
Gas
Pa -
tRa=i
Horiz. = Total
�, ..
It
ST D.
�3 L�
Slope + Horiz. = To
NOTES:
DROP
ye- Fi'>Tr X9.1
13
3
Depth of Cleanout at Flow Line
Cleanout 13 G.,F. From Marti �i�l
Layed at z 0/gi
NQ Basement Service
/t OC6 AT
M HF / /t M H #I: i / s7
`0 O'
Amounts pertaining to^Tork completed this period, reviewed and approved.
% U�
8Y %/ f.W
WCSD INSPECTOR CONTRACTORS REPRESENTATIVE
WASHINGTON COUNTY SANITARY DISTRICT
AUGUST 13, 1984 f