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HomeMy WebLinkAboutLat_13121OrchidDriveWASHINGTON COUNTY SANITARY DISTRICT Elliott Parkway 70/81 Industrial Park Williamsport, Md. 21795 Telephone 301-223-9416 V, ffaLL,11-1, Permit to Connect to Public Water/Sewer System 3l % g / q F Type of Permit i`E' �;- Li EWhtr Permit No. Subdistrict Name�Issue Date Mainline Contract No. Void Date — Building Permit No. Subdistrict No Permission is hereby given to: Property Owner: a- R H+_'iM.ES of address: ? LE I TERSB1iF' '� PIKE u ,r ER r,r,taA1 tin : 1742 For property located at: Lot No. Su Owner's Agent: _ Agent's Address: Previous Owner: Fees Paid in Full? A 1 0�'r�'" Date Fees Paid 1 - it WCSD Dist./Coll. Sy em Fee $ WCSD Ready to Serve Fee $ WCSD Fee $ City of HA Fee $ Total Fee $ Remarks I L i Y t t� -" --ti tl tl'. li 1 C g i v ed d F L L .- e^ li _... u 1: „%. F P'?t. 1 `J E ,: r 150-124 a Street Address Phase Sec. Lateral with Mainline? Residential EDU'S Commercial EDU'S Gal/Day Allocation Building Number Ptility Number 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 WCSD 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 REMAINS WITH THE PROPERTY OWNER. Signed _ `r. ti je jL "! I", [ -, F Date: INSPECTION: At least 48 hours notice prior to requested date is required. ON SITE INSPECTION will be made by: Washington County Plumbing Board 33 W. Washington Street Hagerstown, Md. 21740 Phone: 791-307 Inspection Date: Plumbing Inspector OFF SITE INSPECTION (in Public Rights of Way and Easements) by WCSD Inspection Date: Inspection Date: WCSD Inspector (Lateral) WCSD Inspector (Connection) Distribution: Permittee City of Hagerstown City of Williamsport WCSD Construction WCSD O&M _ WCSD File Permits Office Plumbing Board Plumbing Inspection THE PRINTING PUCE WASHINGTON COUNTY SANITARY DISTRICT WASHINGTON COUNTY, Mf`- SANITARY SEWER LATE= CONSTRUCTION REPORT Project: NORrA BNo0 C".s-r&Tes Co/7ec7�u1, Street (or location): _ 014GH1 p 124/Vt Lo? ° s.9 Contractor: 1� tr,"r t 111E C o J1Tracs'ay5 3I12- Date Installed MHy9s? ---TO MH J___ ,P Wye Sta. On Main O --i! IT r WYE SIZE - TYPE PIPE TYPE DEPTH TYPE EXCAVATION 4 V C. 0. Cts r C- 0. LATERAL LENGTH LAYING LENGTI• POC Ido n �v„�q�� STPD. Horiz. = Total S4it �3?aSs *A3,e-.J� 23 C NOTES: DROP Slope + Horiz. = To 11 13, Depth of Cleanout of Flow Line Cleanout /3' From Q Mari, Gs;!.rt Layed at 407-0 Nd Basement Service MH 4t- //S7 r M H # //3-,P Amounts pertaining to work completed this V14 period, reviewed and approved. BY F IV V14 WCSD INSPECTOR CONTRACTORS REPRESENTATIVE WASHINGTON COUNTY SANITARY DISTRICT AUGUST 13, 1984