HomeMy WebLinkAboutLat_14631PennsylvaniaAvenue'14ASHINGTON COUNTY SANITARY DISTRICT
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-3083!3084
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER 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 f%
Plumbing Inspe,gKr
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: Permitt
Plumbing Bo
Field Office
Date
0 7 r 5°17— 4Z57 V/
Washington .;ounty Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
I hanns�lv.Contract No. SD15- 3-S
Property Addr+ ss : QouTE �JI�C 16-5 X1111 . Ave .
�u� I M ►� �l1C
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.
ly'L#..,h ;y.. �.,:n..;,1,1h F,."-. ti: -+a.-_-' _n..ia„�!!.'_..✓'is'...1c ., .. .. .. -. -.. ..-. �. '
W(ge of nj tic
�L
CC
Iko
F
Ajj
'
ThelunAersigned 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
r
property
lin* a ;
WASHINGTON COUNTY SAN! 1Y DISTRICT
WASHINGTON COUNTY, MO.
SANITARY SEWER LATL"'
CONSTRUCTION REC(1i1%1'
Project: Msuoansville/Orchard Hills Sanitary Jewerage Collection SYsIgm
Street (or location) : GA:f �r
)4-- Wi , , 1��
Contractors. Lisbon l9�3 anns k\10,n% )
Data Installed d! o� ¢
MH 91 C TO MH
Wye Sts. On Maine 5 4
•Hors.• T
OW
St1d.
psi Ort•
NOTES: Drop zt.4. �� c. z,qt 59.5 =GZ•4
5 v4ATE9
Z -e
M
Depth of Cleanout 5{m�arlow Line .-..._
Cleanout Most
Layed • `�
/Ve 8esoment Service
-- --- - --- -- - - --- - c - -
}r
div M"#<_ I;
Amount artaininq to work completed this period, reviewed and approved.
Inspector on rec ore Rep.