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WASHINGTON COUNTY SANITARY DISTRICT 33 W WASHINGTON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-3083 1 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 seweragelwater 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 A-SFinal Inspection Made BY: ___ Date /Plumbing Inspec 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: Permit Plumbing Bo Field Off Date Washington County Sanitary District SEWER SERVICE LOCATION Subdistrict No. SD#1 Contract No. SD15- 3-5 ly7/S Property Address: Route B Box 190 (Pennsylvania Avenue) H QO to ISH 9bL DWG. #601-357 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. 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: 83t�-l7 L� k��t6�- Owner 0 r Attest: fi,�� _ ,QQ .� ��4'rI hG Wash. Co. Sanitary District (Form WCSC-1) P 0, Replaces Form WCSC-56 WASHINGTON COUNTY SANI600. OISTRICT WASHINGTON COUNTY9 MO. SANITARY SEWER LATE'. CONSTRUCTION REC(►►%r` project: Mauamnsville/Orchard Hills Sanitary Seu rave Coll:rtt_ien lye 98 .�, r 1 � � � r._/ I '10 ?tom C: �+- Vl �N ��Ji ► Y1 C� Street (or location) 6A t5>�- ^' '� Contractor: Lisbon Contlactori Inc. /T -on _Pon n5 f \lan i Ck Date Installed F4 B"x6"x 6. a 2'Sfuh � Can MH 9'0 -7 TO MH 08 Wye Ste. On Main ,LL - 30,_ MAI k, (•"5oR G% I Nors.• Total 31 A I-- i7, Depth of Cleanout 4.o *flow Line ..... Cleanout From .4—MAit,, L a y a d • x • I 0 Basement Service 2:S4u b Fa Cap .O M ©4 S.3 90-7 Amountsertaining to work completed this period, reviewed and approved* By Inspector Contractors Hope