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WASHINGTON COUNTY SANITARY DISTRICT
33 W. WASHINGTON STREET
P.O. BOX 571
HAGERSTOWN, MARYLAND 21741-0571
(301) 791-308313084
PERMIT NO.
DATE 7/16
SUBDISTRICTfD. lb
PERMIT TO CONNECT TO PUBLIC SEWERAGEIWATER SYSTEM Q�(]rCft.c�,rd
Permission is hereby given to:
Gerald A. Lee 20 s
For Property Located at: 2547 PeansYlyarl i d Avenue
Ownedby: Gerald A. Lee Address: 2547 PRnnsylvania Avenue, Hagerstewn,40
Type of Connection: To Service Connection To Main Line:
Type of Service: Residential ( �) Units Other -
Commercial Industrial
Meter Size
Connection Fee
Date Paid _41 16.1 k b
To connect to a public seweragelwateT 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. 0-15-7060-9L�"' 0 - "),
Secretary Treasur D 0A
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 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: Permitt
Fiel
Plumbing Board
[OHM
Date
City of Hag. 1
WASHINGTON COUNTY SANITA' DISTRICT
WASHINGTON COUNTY, MO.
SANITARY SEWER LATC,',,:
CONSTRUCTION RECOP%Ir�
Project: Maugansville/Orchard Hills Sanitary Sewerage Collection System
75-41 -
Street (or location): CAL 8
penrrsu/v4�io Ave. 13
Contractor: Lisbon Contractors. Inc.
Date Installed 2/'10!j 84
MH 67�9 TO MH �.?G
Wye Sta. On Main
W I L aicc- ITrL ULFIM ITFt LALAV. LAYING
'SIZE TYPE PIPE C.O. C.O. LATERAL LENGTH LENGTH
�{,Y,•,x6„ G,•SD�Z�oF?v.G. 6'SD�2(� _ - *Hort.= To�
St'd.
NOTES Drop I /g.90L.F
MAIN I
,, 502zc0Pq(-.
/�74-S' Bend
Depth of Cleanout Q-36V.F. ®Flow Line
Cleanout +�.', 'From �f mA►u—
L a y e d ®_ - A `der 0roP
- oss,gcr_ Basement Service
Slope + morz= i otal
2.871 !�•��= ia.48�.F,
MH# I
• - 2 ' �fu b �Ca p .
Amounts pe 'twining to Work completed this period, reviewed and approved.
DUCSInspector Contractors Rep.
0
Washington County Sanitary Distri
SEWER SERVICE LOCATION
Subdistrict No. SD#15
il 3c, ace Contract No. SD15- 3=S
Property Address: 2.6.7 Pennsylvania Avenue
MH 675 to ISH 676 DWG. #601-332
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.
(2535)
819
(253
11
_
8"SAN _
DMi+
fe;lk�
r:
8 0 8 1 822 r
I ) (2% � (25'Y'� 8
(2 i 1
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: Z �, �C/y• ��� ( i>< —
Owner
Owner
Attest:
Was . Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56