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V IfASHINGTON COUNTY SANITARY DISTRICT
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571 (301) 791-308313084
P.O. BOX 571
PERMIT TO CONNECT TO PUBLIC SEWERAGEAVAXMSYSTEM
Permission is hereby given to: u it u i d ,2.� L • Car oa u q
For Property Located at: 2516 PennsvIyani a Avenu
Owned by: a ' C a r b a U g h, Address
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
PERMIT NO.
DATE
SUBDISTRICT NO- 15
Maugansville Orohard
UJ.11a
�_'516 Pennsylvania Avenue. Hagerstown, U
To Main Line:
Units Other
Industrial
Connection Fee A20-00 Date Paid
To connect to a public seweragelllo=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.
3e
Secretary-Treasure
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 2
Plumbing In 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-P.O. Box 571
Hagerstown, Maryland 21741-0571
Final Inspection Made By:
DISTRIBUTION: Permittee 1 Plumbing Board 4
Field Offi
Date
WASHINGTON COUNTY SANITARY 01 TRICT
WASHINGTON COUNTY, MO.
RANITARY SEWER LATE1',';_
'NSTRUCTION REC(►i
Project: Mauaansville/Orchard Hills Sanitary Sewerage Collection System
Street (or location): Pe-nn-iuIvan iaAve
.
Contractor sbon Contractors_ Inc. C 'S
Date Installed 2f Mow B4
MH &t 7 TO MH
Wye Ste. On Main Of�s.5J�3r
WTL aILL-11rL NLI'In 1 IrL r -"""Y. I.RIl114u
51 Z TYPE PIPE LOG C.O. LATERAL LENGTH LENGTH
g,��x8" SD22loP.v.C,. (0'S0ee& *Horz.- Total
St d. 20.(1.OL.r. ;'5,'.?
I Drop
NOTES: l
Depth of Cleanout 7• // YF. 41Flow Line
Cleanoutf_ ( OFrom MAIN
L a y e d Q..2- 15 %
Basement Service
MH11
Amounts pe ining to work completed this
BY
WCSD Inspec, or
•CIP
+ Morz-
MH# K t
period, reviewed and approved.
Contractors Rep.
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD##15
Contract No. SD15- 3-9
Property Address: PnnnGy,dyani a . Avenue
MH 657 to SIH *W (001 nir #6n� 3-�
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.
N 6 79, 000
V) r
No, -arJ
1,60
11
NORTH F
--
El I
MH SD15-657
oar
s
91
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: ,
Owncfr
Own
At t
Wa Co. Sanitary District
(Form WCSC-
Replaces Form WCSC-56