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Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD -6
Contract: SDG -1S
Property Address: le?'66 Pennsylvania Ave. Psi -H Ex.12-298 Page 50 of 70
X3031
Place an 'X' in the sketch below to indicate where the property owner
wants the service connection (lateral) to enter the property. Place a
wooden stake in the ground at that location.
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The undersigned agree that the Sanitary District may excavate for
the lateral a total of ten (10) feet inside the property line at the
location indicated above, said ten (10) feet to include five (5) feet of
lateral installation beyond the cleanout, plus an additional five (5) feet
of excavation beyond the terminus of the lateral to facilitate, and make
less expensive, the owner's connection to the lateral and to prevent
damage to the lateral installed by the District in those areas where
rock is encountered.
Date:
Owner
Owner
Attest:
Wash. Co. Sanitary District
.w
(Form WCSC-56) (110878)
Washington County Sanitary/AI►strict
Washington County, Md.
Ir► Project:
,/X
001'
SD6-1-S Fountainhead
-•► SANITARY SEWER LATERAL
CONSTRUCTION RECORD
A9%
Street (or location):l'203� MHS_ to MH���
Contractor: Corson and Gruman Company
1 �7, -15o ue- al�'1!11 , Inspector
Depth of Cleanout z „� @ Flow Line
Cleanout From
Layed @ z.
,4/,_ Basement Service
MH'Ir MH #
Amounts pertaining to work completed this perio , reviewed and ved.
InspectorOOW
By
WCSD Orson & Gruman inten errt
(Form WCSC - 4)