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Washington County Sanitary ",strict Washington County, Md. Project: SD6-1-S Fountainhead SANITARY SEWER LATERAL CONSTRUCTION RECORD Street (or location): /�.,�s�/�gyi r �yG MH .z 9f to MH Contractor: Corson and Gruman Company Date Wye Sta. Wye I LAILRALS Ion Mainline Size St' or Drop Excay. Lgth. Laying Lgth. Size - Pipe Notes: /, /'%. /,/, ue' PT1e Depth of Cleanout @ Flow Line Cleanout /s!S From Laye@.�_°� Basement Service MI Inspector - Amounts pert2co work c pleted this perioN::on wed and approve By A 6 upe en en n spe (Form WCSC - 4) IF,*, 4 a5q-a�� Washington County Sanitary District SEWER SERVICE LOCATION Subdistrict No. SD -6 Contract: SD6=1S Property Address: Aeld Pennsylvania Ave. Psi -H 298-299 Page 50 of 70 l31sd�( 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. z (0 01 O © ! X rc $., r IV O tr T 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. I Date: �,2l. '' Owner Owner l Attest: tfAl J Wash. Co. Sanitary District (Form WCSC-56) (110878)