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,WASHINGTON COUNTY SANITARY
33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571
P.O. BOX 571
PERMIT TO CONNECT TO PUBLIC SEWERAGEIVk*ER SYSTEM
DISTRICT PERMIT NO. 792
(301) 791-3083/3084
DATE 8I7/85
SUBDISTRICT No. 15
ilaugansvillejOrchard Hills
Permission is hereby given to: Anthony C. Francis
For Property Located at: 226 Petma r Circle
Owned by: Anthony C. Francis Address: 226 Petmar Circle,_ Hagerstown, �r
Type of Connection: To Service Connection X
Type of Service: Residential X Units
Commercial
Meter Size Connection Fee $620.00
To Main Line:
Other
Industrial
Date Paid 8/7/85
To connect to a public sewerage/A/A%r 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.
Water Account No. 0-15-8870-2
Secretary-Treasure� n
Building Permit No. d•,
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 Ins p ctor
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 Plumbing Board 3
Field Office__
Date
City or Hag. 1
...
WASHINGTON COUNTY SANITARY ! TRICT
WASHINGTON COUNTY, MO.
A amu,
)ANITARY SEWCR LATE'.
CONSTRUCTION REC(Ii;ti
Project: Mauoanevi11e/Orchard Hills Sanitary Sewerage Collection Svata■
Street (or location): 641 --,*-739 VE-rmarz G:RC-L-E 2a'1C15
Contractors Lisbon Contractors. Inc.
i
AN 570
Oats Installed 9-II-rd4 Wye Sts. On Main 0+00 Ll.
21'Sfub'f" Cop
Depth or Cleanout 11-00' •Flow
Cleanout Z3-(-,& row7tu
layed • Z- S
/A 9ssament Service
K)P�,
Line
M0576,
Amounts pertaining to work completed this period, reviewed and approved* r
a % Z. � ,� � S/co
MAD Inspector— on rec ors ep.
Oak
Washington County Sanitary District
LoC_4T Lo.i
SEWER SERVICE LOCATION
�_ (JQ o Pee -T t
Subdistrict No. SD#15
QGS Contract No. SD15- 3-5
I U%IL
Property Address:�X Petmar Circle
out 105"2a.
Mff-5-'�5 o MH 576 DWG #601-308
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.
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\ 8.1 SAN. r
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27
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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.
G r _
Date: �a� / b /t%�iY��J yL' t�/7z AJ �f 1-'9 �.
Owner
a �
Owner
\j
Attest: i
Wa . Co. Sanitary D'st'rict
(Form WCSC-1)
Replaces Form WCSC-56