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)HINGTON COUNTY SANITARY DISTRICT ,3 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-3083/3084 PERMIT NO. DATE SUBDISTRICT PERMIT TO CONNECT TO PUBLIC SEW ERAGE/WATER�SYSTEM Permission is hereby given to: For Property Located at: Owned by: I , , , ; Address: Type of Connection: To Service Connection To Main Line: Type of Service: Residential ( ) Units Other Commercial Industrial Meter Size Connection Fee Date Paid To connect to a public sewerage/vMWi 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. 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 ` r� Plum g Inspector 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: Date DISTRIBUTION: Permittee Plumbing Board Field Off WASHINGTON COUNTY SANITARY 'TRICT 100 SANITARY SE VCR LATE,!.:'- -ONSTRUCTION IIECtu;r' VASHINCTON COUNTY, MO. �L;Z0Q Projects Mauoinovilla/Orchard Hills Sanitary Seueracs Collection Sys a■ -a(�)N V� Street (or loostion) t /SLA ticT ► -i $ e,nr►_�y 1 a 1 Contractors Limon MHe3,' TO MH 33 ata Installs uye Sts. on Main 3+ I(o.3 u. 2154ub % cup Depth of Cleanout Cleanout /5' From Laced • • Basement Service lou Line .••2:544bf;Gep --per- - -- — Mq . C' r Amount• po n, q.to work completed this period, reviewed and approved, a "`77 yC30 nspec or Contractors Rep. SANITARY SEWER LATE' WASHINGTON COUNTY SANI'h ..Y DISTRICT CONSTRUCTION REN11"l? WASHINGTON COUNTY. M0, Project: Mauaanaville/Orchard Hills Sanitary s.uaraoe C0119ntiOn System . Street dor location) : 7.�V r? t ( ��Y Y?^�IN /y$78�nn�y van icy Cantractort._,!„Lilelb4� ,Qn Conrsctors_ Ine, -- MH 3 3 T 0 MH 4 - Date Installed Wye Sts. On Main �r1?•��� WYE 51ZE_ . TYPE p p C 0 LATERA LENGTH EN TN B"X6"x�'j' (o'SDQ26RYG *Hors.• Total St' d. z 2©e {o NOTES: Drop MA, I Ai 2'54u6 � can (J)" 5PP' Zxp RvC- rr L% Death of Cleanout 4,•Flow Line Clesnout 1 5. L from MAlll Layed • 7 • Yi=S Basement Service 25�u b Ei Gap c•b. V MMS Amounts pertaining o work completed this perlodo reviewed and approved. 8Y C -,A L , oi nspsc orContractors op. Sl2`l Washington County Sanitary District SEWER SERVICE LOCATION Subdistrict No. SD#15 . Contract No. SD15- 3-S 14675Pwnn5yktantq Property Address: Route 8 Box 211 (Pennsylvania 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. L p E Ta tA�i A s P�5 C, TD55� /838 / (RT. 8 BOX 211) TA 8" W MAC.) 8° SAN. 18 CMP 4 DRAIN 3 I MH co \ 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. (o Z 3 ��� w Owner Owner Attest: -1.LQA Wash. Co. Sanitary District (Form WCSC-1) Replaces Form WCSC-56