HomeMy WebLinkAboutNoLat_18308PeakCircle�C,ToN WASHINGTON COUNTY
J 3 WATER & SEWER DEPARTMENT
16232 Elliott Parkway
Williamsport, MD 21795
(301) 791-3083
Permit to Connect to Public Water/Sewer System
Type of Permit
Permit No.
Subdistrict Name i{E.0
Issue Date _
Mainline Contract No.
Void Date
Building Permit No.
Subdistrict No.
Permission is hereby given to:
Property Owner: 'u:, i" -R I uE
of address: `'
For property located at:
Lot No.
Subdiv,
A) �
Phase
_Street Address
Sec.
Owner's Agent:
Agent's Address:
Previous Owner:
Fees Paid in Full?
Date Fees Paid
Fee $
Lateral with Mainline?
Residential EDU's
Commercial EDU's
WCWSD Alloc./Conn.
WCWSD/Other
City of Hagerstown
Fee $
Fee $
Fee $
Tota I Fee $
Gal/Day Allocation
Building Number
Misc. Number
Remarks
i4
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:
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 j
Inspection Date: Plumbing Inspector: