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WASHINGTON COUNTY SANITARY DISTRICT
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-308313084
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM
Permission is hereby given to: — 1
For Property Located at: - — --
Owned by:
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
Address:
Connection Fee
To Main Line:—
Units Other
Industrial
Date Paid
PERMIT NO
DATE
SUBDISTRICT
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 Specifications.
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 Inspe 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:
DISTRIBUTION: Permitt
Plumbing Board
Field Offi
Date
WASHINGTON COUNTY SANITAP DISTRICT
WASHINGTON COUNTY, MD.
SANITARY SEWER LATE,',,;_
CONSTRUCTION RECbi21
Project: MauQansville/Orchard Hills Sanitary Sewerage Collection System
Street (or location) : SAT 69<5 F� 2 f P,�n���/�ni� Ave. �' ' -
Contractor: Lisbon Contractors. Inc. Ir
Date Installed e6gP,elLe-4
MH (,z8 TO MH 6zg
Wye Ste. On Main j G3T.
UVE
SIZE
SIZE—
TYPE PIPE
TYPE
C.O.
PTH
C.O.
TYPE
LATERAL
EX AU.
LENGTH
A
LENGTH
6.r19V.�
*Horz.= Tota%'
stud.
-
*Slope + orz= o e
NOTES:
Drop
�2.lOL,�
lZrfUt�.7(o= l5•B/L.F.
kb Cap
Depth of Cleanout x.49 V. F. ®Flow Line
Cleanout 4f.!' rromp H.,•r,
Layed 6 Z'---% G1+rler Drop
Basement Service
MH#
c. D.
Cqp...
MH# bz9
Amounts per ning to Work completed this period, reviewed and approved.
BY --
UCSD
YD Insp ctor Contractors Rep.