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HomeMy WebLinkAboutLat_13524PennsylvaniaAvenue4 ASHINGTON COUNTY SANITARY DISTRICT 33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-3083/3084 PERMIT NO. _ DATE SUBDISTRICT PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM Permission is hereby given to: For Property Located at: Owned by: Type of Connection: To Service Connection Type of Service: Residential Commercial Meter Size Address: : Units To Main Line: Other Industrial Connection Fee ij .; 14'j.00 Date Paid To connect to a public sewerage/water system (with proper abandonment of previous private system). The installation of the connection and the abandonment of the previous private system shall conform with the provisions of the Laws of the State of Maryland and Washington County Sanitary District Sp3cifications. This permit does not supersede any local ordinance that is in effect with regards to road cutting, etc. ALL OTHER PERMITS, STATE AND LOCAL, MUST BE OBTAINED BY THE PROPERTY OWNER AND ALL RESPON- SIBILITY CONNECTED THEREWITH REMAINS WITH THE PROPERTY OWNER. Secretary -Treasurer Building Permit No. INSPECTION: At least 48 hours notice prior to requested date of inspection is required. ON SITE INSPECTION will be made by: Washington County Plumbing Board 33 W. Washington Street Hagerstown, Maryland 21740 Telephone: 791-3146 Permit Fee Final Inspection Made BY: Date Plumbing Insp or OFF-SITE INSPECTION (in Public Rights -of -Way and Easements) and certain ON-SITE INSPECTION in accordance with applicable approved construction drawings will be made by: Washington County Sanitary District 33 W. Washington Street Hagerstown, Maryland 21740 Final Inspection Made By: Date DISTRIBUTION: Permittee Plumbing Board Field Offi WASHINGTON COUNTY SANITARY L TRICT WASHINGTON COUNTY, M0, 1ANITARY SEWCR LATV, CONSTRUCTION REC(IRf, Project:Msuasnev11e/Orchard Hills Sanitary 5swersas Collection Svstgm Street (or location) : --a r ie)(v ( 12)5;:.;� q s,uNs Yc.VANI A A✓f-) 01,6W E, ry1 LkRe r- Contractor:Lebon Contractors. Inc. MH Gc�9 TO MH GIB Date Installed 0-30-S4 Wye Ste. On Mein / *4-2 q4. w.L 7r t 01&Los PIPE,11 JYPE ITri ULr1 n C.O.LATERAL I TNL LAt; AV. LENGTH LAYING LENGTH 6"x "A6' 6 "6Dee& PVL � *Horz.• Tota Gf}5T 6.4b5Vr- St 1 d. V313pin Horzo Ota: NOTES: Drop 3. so+ 10342- 9.42NOTES: 22.92 LF 74Z I 3,0 /Jjh 45.8ecx1 Depth of Cleanout 6.478 eriow Line Cleanout !9,92' /row -* w,AiV Layed 3,0 AFTER D20T- �= Basement Service STA • k. _4Z (a:" 6o9 9 G, toe 2'SFu b ' a p Amounts pertaining to work completed this periods reviewed and approved* inspector Contractors -Rep. Aft Washington County Sanitary District SEWER SERVICE LOCATION Subdistrict No. SD#15 Contract No. SD15- 3-S Property Address: �3 ? p ISH 609 to MH 618 DWG. #601-324 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. NV. 635.3 MH� R/W — 8"G COISD15-609 04 ��8�� SAN. '� M 5-618 8„ W e }�-- — ' -- — R/W ' I I—OD d �I I 2 ( 21) ( 5) i �I �I ti �OCA'T-c 50 The undersigned agrees that the Sanitary District may excavate an additional five (5) feet inside the property line so as to facilitate, and make less expensive, the owner's connection to the lateral and to prevent damage to the cleanout which will be installed by the District at or near the property line. r Date: (•114Yy 1"l �(��e►'`��c��°� _ Owner )-VN —" '-,� ?. C) - A-. Owner - Attest: "asCo. Sanitary District (Form WCSC-1) Replaces Form WCSC-56 / I �-� N WASHINGTON COUNTY SANITARY DISTRICT /11 33 West Washington Street, Hagerstown, Maryland 21740 ■ (301) 791-3083 To: Lisbon Contractors, Inc. I hereby request the contractor to install the lateral in accordance with the following conditions: /7cL Address ZZZ I Signed Proper y Owner Date 8� �% 'BY Washington County Sanitary District 33 West Washington Street Hagerstown, Maryland 21740 Re: Gentlemen: Maugansville/Orchard Hills Sewers Contract No. SD15-3—S We hereby request permission to install the house lateral of greater than two (2) percent and/or in accordance with the above conditions at no change in contract price at the following location: Requested by Lisbon Contractors, Inc. Approved by W.C.S.D. Inspector Date��'��