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WASHINGTON COUNTY SANITARY DISTRICT PERMIT NO.
JJ w. wASHINGtON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-3083/3084
DATE
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM
Permission is hereby given to: ��e
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
inerUnits Other
Industrial
Date Paid
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 SF3cifications.
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: LIZ
Date
Plumbing I ector
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 B
Field __ Offi
Date
WASHINGTON COUNTY SANITAR IISTRICT
WASHINGTON COUNTY, MO.
SANITARY SEWER LATE',,;_
CONSTRUCTION RECKII'-
Project: MauQansville/Orchard Hills Sanitary SeweraQB Collection System
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Street (or location) : S 3-11
AI 17g 2d t 2 Pe, ,7-1 1l on(o Ave.
Contractor:Lisbon Contractors, Inc. CCL-4n+Y'Li
MH L�?-T TO MH
Date Installed 2(,4ne1(_ e4- Wye Sta. On Main /+49 Far.
UYE SIZE- TYPE DEPTH TYPE EX AV. LAYI
S1ZE TYPE PIPE C.O. C.O. LATERAL LENGTH LENGTH
P. VC_ �D2z6 *Hort.= Tota,
Pvc._ 7.32�/.F.
St'd.
NOTES:
nrnn
Slope+ Horz=Tota
6,J&+7e7=f4.25L.F
Depth of Cleanout 7.32VF ®Flow Line ~+��
Cleenout_q=FTrom-q�- Mq;n
L a y e d 6 _d- ___% ,J�� ,- L ---,-op
/ Basement Service
MH// 627
MH# 62f,
Amounts per ing to Work completed this periodg reviewed and approved.
BY [✓I��i /S��
'_UCSD Insp ctor Contractors Rep.
/r___ rarer+ A%
IW
5d
LocAma tusrra-. 04qow L,llw
Otx&K c
WashingLon County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
HU 11 Contract No. SD15-1S
Property Address: 9 -39 -8 -Pennsylvania Avenue
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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\,,,,9bkeiY L u E 5' 111ov2-r N1
amr Or
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.
Date: 5
Attest:
(Form WCSC-1)
Replaces Form WCSC-56