HomeMy WebLinkAboutLat_13806PennsylvaniaAvenueSHINGTON
COUNTY
SANITARY
DISTRICT
vASHINGTON STREET
HAGERSTOWN,
MARYLAND 21740
(301) 791-3083/3084
PERMIT TO CONNECT TO PUBLIC SEWERAGEIWATER 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:
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 Ins ctor
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: Permittee Plumbing Board
Field Offi
Date
�r !,J �c few ��'► ..�,,
Washington County Sanitary District
SEWER SERVICE LOCATION
V G.tZ4h, Subdistrict No. SD#15
13 �'O cQ
Contract No. SD15- 3-S
Property Address: Pennsylvania Avenue
M 669-A to MH 669 DWG. #601-330
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.
800
\ o (2409)(-'
(2 /
T��22G U-/
3
01
0'-0
oG�A \� CR�
Z-
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. ,
N
Date:
Attest:
(Form WCSC-1)
Replaces Form WCSC-56
WASHINGTON
COUNTY
SANITAFAAwOISTRICT
++ SANITARY SEWER LATE'.'_
WASHINGTON
COUNTY,
MO.
CONSTRUCTION RECOEIr!
Project: MauQansville10rchard Hills Sanitary Sewerage Collection System
Street (or location) : r,,4 r Boo f6deq Penn5${(yanr'a Ave. RTCLre: A C
Contractor: Lisbon Contractors. Inc.
Date Installed �5146y BQ-
IS"x�'x Z& PV. C,
NOTES:
I
soez� I
G. 74 V. r
7%
(v"5DP- z V ALG.
458 Ber-d5 . .
Depth of Cleanout 69.74 � ®Flow Line
Cleanout z5. P' rom ct--Ma/&i
layed
uo Basement Service
MH## &0.4
MH -6,,(,q,4 �T 0 MH &(,9
Wye Ste. On Main 01�5t-7
• .. ..r., Y . Ln 1 11YU
LATERAL LENGTH LENGTH
*Horz.= Tot
St'd. /
510pe + MrZsTota�
Drop 24,.50 L. I=.
53.rl5.50=22.03C_.F.
MH# 1.&q
Amounts parts 'ng to work completed this period, reviewed and approved.
BY �-
D Inspec or Contractors Rep.
/ rnv-rn I.if Sf :A