HomeMy WebLinkAboutLat_13801PennsylvaniaAvenue,WASHINGTON COUNTY SANITARY DISTRICT
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571 (301) 791-308313084
P.O. BOX 571
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM
2 jOr%
Permission is hereby given to: Iii J= R o (1 tZ a h n I Z?w
PERMIT NO.
DATE
SUBDISTRICT
For Property Located at: 2404 .Pennsylvania {vent!`
a,3u-.t i_.:Koutz hit Address: '404 Penns✓lvania Avenge, Hag..,: RD
Owned by:
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
To Main Line:
Units Other
Industrial
Connection Fee $b�Q-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 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.
Water Account No Unkncan.
Secretary-Treasur
Building Permit No
INSPECTION: At least 48 hours notice prior to requested date of inspection is required.
ON SITE INSPECTION will be made by
Permit Fee
Final Inspection Made BY
Washington County Plumbing Board
33 W. Washington Street
Hagerstown, Maryland 21740
Telephone: 791-3146
46� Date l
Plumbing Ins for
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-P.O. Box 571
Hagerstown, Maryland 21741-0571
Final Inspection Made By:
DISTRIBUTION: Permittee Plumbing Board
Field Office
Date
WASHINGTON COUNTY SANITARY„DISTRICT
WASHINGTON COUNTY, MO. AO
SANITARY SEWER LATE!
"'0' CONSTRUCTION REC(fl"
S015 -3-S
Project: Maugansville/Orchard Hills Sanitary Sewerage Collection System
Street (or location) : 0EivAi. AVEC L
Contractor: Lisbon Contractors. Inc.
6 RovN v " r
Z's yes t%CAP
(o" SDC_ Zb RV.0 .
iv" SDR3aSTd 2(0 Ao4,p ma,
io"xb"�arz 3S WYE
4
Depth of Cleanout '7." VFVlow Line
Cleanout 14rom � p►71 ._._..
Layed ® 2
-YE6 Basement Service
Z' SVM ,4 CAO -
7 C''n. .--
04 ZT I
--
04ZTI L.T
MH# 63s
MH# 63C,
Amounts parts% ng to wo k completed this period, reviews and appr ed.
BY
Inspect r ontractors Rep.
(Form WCSC-4)
MH F,3�T0 MH (o3G ✓
Date
Installed
/D- z5 -e0
Wye Sta. On Main of 27 i _.r.
Y
IZ -
TYPE
DEPTH
TYPE
EX AU.
LAYING
SIZE
TYPE PIPE
C.O.
C.O.
LATERAL
LENGTH
LENGTH
�' K F
St'd,
*Hort.= Total
�D�e 35
P_V.G.
QV/.G.
Zo L.F.
i(o L.f=.
0✓L .
rz= ops + oa
I
Drop
NOTES:
6 RovN v " r
Z's yes t%CAP
(o" SDC_ Zb RV.0 .
iv" SDR3aSTd 2(0 Ao4,p ma,
io"xb"�arz 3S WYE
4
Depth of Cleanout '7." VFVlow Line
Cleanout 14rom � p►71 ._._..
Layed ® 2
-YE6 Basement Service
Z' SVM ,4 CAO -
7 C''n. .--
04 ZT I
--
04ZTI L.T
MH# 63s
MH# 63C,
Amounts parts% ng to wo k completed this period, reviews and appr ed.
BY
Inspect r ontractors Rep.
(Form WCSC-4)
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#1!
13801
Contract No. SD15- 3-S
-
Property Address: a4Q4 Pennsylvania Avenue
_MH 635 to ISH 636 DWG #601-360
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.
890
`. (2404)
� a
v
8 \�
(2 8) \
M
o.op�
ai
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 a.t or near the property
line.
Date.
7�T Own4fr
Owner
Attest:
Wash. Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56
WASHINGTON
COUNTY SANITARY DISTRICT
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:
- � �lt'.7.ar..�l.,yi<- h �-� ��?-e•c-�f /J /!Z Z.4� ��.�.�.
Address o � Pz
Signed Lai
Proper y Owner
Date
Washington County Sanitary District
33 West Washington Street
Hagerstown, Maryland 21740
Re: Maugansville/Orchard Hills Sewers
Contract No. SD15-3-S
Gentlemen:
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