HomeMy WebLinkAboutLat_16808PetmarCircleASHINGTON COUNTY SANITARY DISTRICT
W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21740 IJul) ai-ovooi ovuY
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 SF,3cifications.
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 u
Plumbing I pector
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 B
Field Offi
Date
WASHINGTON COUNTY SANITARY DISTRICT
WASHINGTON COUNTY, A0.
Projects MaugansALille Orchard Hills S6anitory S�ItIS
Street (or location)t-- (,dl 740 ( P2-rMAp- (flec-4-c-
SANITARY SEWER LATE':
CONSTRUCTION RECoiu.,
Contractors!_ iabon
MH Seo T 0 FM
Data Installed 9-15-64 Wye Ste. On Min,
g"xC "x 8"�(o"sOR 2� F7YL
NOTES:
PVc-
(0,51 VF I St'd.
Drop 1Z3,50 LF
WSJ*" ♦ Norzo
4,76-Y 1-7,1
21,92 L -F,
Depth or Cleanout (0,51 ` 1f lou Line .....
Cleanout Vbj50 From +-mAiu
Layed ��►� AF7ER D2C7P
Basement Service
STA %*59
r
Amounts pertaining to work completed this per:odo reviewed and approved*
UCSD Inspector cont ractors ep.
v�
Aoft AM^
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15- 3-S
Property Address: Petmar Circle
MH 566 to ISH 574 DWG #6D1-308
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.
741
(230)
0
M
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. r
Date: $3 I�t��I��AM -0
Owner
-
Ownerr
Owner
Attest:
Was Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56