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HomeMy WebLinkAboutLat_13537ParadiseChurchRoadWASHINGTON COUNTY WATER & SEWER DEPARTMENT 16232 Elliott Parkway Williamsport, MD 21795 (301) 791-3083 Permit to Connect to Public Water/Sewer System Type of Permit RE : wyWEF, Subdistrict Namek`TU,1"T'-1C' If`F' Mainline Contract No. Building Permit No. Permission is hereby given to: Property Owner: 2;'..LE.= of address: Permit No. _ Issue Date _ Void Date Subdistrict No. For property located at: Com' Street Address Lot No. Subdiv. °`F','` "' Phase Sec. Owner's Agent: qtr= 13CKt'. Agent's Address: g 3 f at �D I SE _ ;ir�GEk.. 21,31Wd Previous Owner: Fees Paid in Full? Date Fees Paid WCWSr) Alloc./Conn. WCWSD/Other City of Hagerstown_ Remarks Fee Fee Fee Fee Total Fee Lateral with Mainline? Residential EDU's Commercial EDU's 4 Gal/Day Allocation Building Number '- Misc. 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 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 Date: 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 21740-4727 Phone: (301)791-3070 Inspection Date:—,l'''` `%moi Plumbing Inspector: DROJECT NAME: /�A DROPERTY ADDRESS: ,1AIN� LOCATION": STREET/EASEMENT PROPERTY OWNER NAME: PROPERTY OWNER ADDRE-'�' 4 -�/�4-sS �ti PROJECT N0: rte- 3' � v DRAWING N0: qq ATE INSTALLED: ld'Z7 - all Q511\ rt MH0�7 TO MH A 07�1 MAIN STATION, -f- Z a SINGLE: gboj-A�- DOUBLE: I, i CONTRACTOR: SIZE & TYPE SIZE & TYPE INVERT ® DEPTH TEE/y�YE SERVICE PIPE MAIN (A) C/O (B) D CONNECTION ® MH: DROP EPTH (C) D E I F F 7.-s 0 Nsxf G.o / sp2--3�I INDICATE TYPE OF LATERAL BY CROSSING OUT OTHERS. FOR CONNECTION TO MANHOLE, CHECK ABOVE, AND LIST INVERT DIMESION 'B' AND DROP DIMENSION 'C' (IF APPLICABLE). D t SHOW LATERAL LOCATION, STATION, UTILITY CROSSINGS AND DIMENSION ALL PERTINENT ITEMS FLOW LEFT DOWNSTREAM MH # lD 7Z LIST QUANJTIT!ES FOR PAY ITD.IS DERE: D 1 . WASI WN' GTC I CC1 ",17; NSPECTOR tJi 4 1-1- JicJr PU'c! rt, VVl �Ki1J qui, i1tii1JtY7/YV !'V/V �v�iv . i1.+n}"r.,'vvu RIGHT UPSTREAM FAH r# /6 -7,9 CC 1-7 "TOR'S PEP RESENJTATI`,E CO. NAME: GRAV!TY SE-%'T'`R ,SE -7F" VilCL C1-\1 I ,. I i- ^ TI n,. I C-' 1 I r r T ki1,4r I— I IIJIV J1-1LG I MARCH 1996 1 F D E D E SHOW LATERAL LOCATION, STATION, UTILITY CROSSINGS AND DIMENSION ALL PERTINENT ITEMS FLOW LEFT DOWNSTREAM MH # lD 7Z LIST QUANJTIT!ES FOR PAY ITD.IS DERE: D 1 . WASI WN' GTC I CC1 ",17; NSPECTOR tJi 4 1-1- JicJr PU'c! rt, VVl �Ki1J qui, i1tii1JtY7/YV !'V/V �v�iv . i1.+n}"r.,'vvu RIGHT UPSTREAM FAH r# /6 -7,9 CC 1-7 "TOR'S PEP RESENJTATI`,E CO. NAME: GRAV!TY SE-%'T'`R ,SE -7F" VilCL C1-\1 I ,. I i- ^ TI n,. I C-' 1 I r r T ki1,4r I— I IIJIV J1-1LG I MARCH 1996 1