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WASHINGTON
COUNTY SANITARY DISTRICT PERMIT NO.
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571 (301) 791-3083/3084 DATE
P.O. BOX 571
SUBDISTRICT 0' 15
PERMIT TO CONNECT TO PUBLIC SEWERAGEWIR/)6T,EBSYSTEM MaUgatlSvi i -hard Hi i is
Permission is hereby given to: l o a fI n al��` •
For Property Located at: rtoute F , Box G33, Viag `rstovVn, Miff+}yland �1 4t)
-.I-,int�1 Pa Im r ��rl i_Ito !",i, tjn)' %3.3, . HPner town, MO 217, 0
Owned by: Address:. -
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
Connection Fee
To Main Line:
Units Other
Industrial
Date Paid
To connect to a public sewerage/WaMr 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 RESPOW
SIBILITY CONNECTED THEREWITH REMAINS WITH THE PROPERTY OWNER.
Water No. Unavailable
Building Permit No.
/' �5r , �" / Z cu, 0,1
Sec retary-Tread, �erC
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 Inspe r
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 I Plumbing Board 3
Field 1 Office
Date
City of Hag. 1
GoPY
JOANNA PALMER \,�• r L
ROUTE 8 nOX 233 j G �JIr 1—
HAGERSTOWN MD 217
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15- 3-S
lZ15o'-�--pdnn5ylvapIa
Property Address: Route.8 Box 231 Mannsylvania 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.
6" FORCE
MAIN
�-- MH SDIg_ E1.658
806 _ e
X
401 W
SEES Ti
Di
�S8 AN.
MH
S, D_
—729 I
_ t
THRUST
BLOCKS
w
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 Mat or near the property
line.
Date:
Attest:
Wash. Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56
Owner
Owner
WASHINGTON COUNTY SANI' DISTRICT SANITARY SEWER LATEi';':
WASHINGTON COUNTY, MO. CONSTRUCTION RECORI
Project: Mauoanevil_,/Orchard Hills Sanitary Sewerage Collection System
Street (or location): '' -�;- n-
3oa77n van lo,
Coontractor:_�` Lisbon Contractors. I c,
e0n, r,4
MH tYX�, T 0 NIH
Date Installed :Jc_4r7 e- e<34 Wye Ste. On Main,:
DEPTHUYE SIZE— TYPE TYPE EXCAV.
ZE TYPE PIPE C,0-, C.O. LATERAL LENGTH LENGTH
At0k � ,X02 z� (,"SDP-ZG *Horz.= Total
co&JAJ To VC . PVC. . � . ��� �.
P.St' d.
NOTES:
4 Drop I 1
1115 D R 2(P PVL -
Depth
2 °/
0
Depth of Cleanout. /&VF- •Flow Line
Cleanout -�� •'10 rom � M®rT
layed 41 ��— %
Basement Service
Amounts pertaining to work completed this period, reviewed and approved.
BY
Inspector Contractors Rep.