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16HINGTON COUNTY SANITARY DISTRICT HIND I UN J l HEL T HAGERSTOWN, MARYLAND 21741-0571 1 PERMIT TO CONNECT TO PUBLIC SEWERAGEVATER SYSTEM Permission is hereby given to: John D d V (301) 791-3083/3084 PERMIT NO. DATE 7/29/35 SUBDISTRICT '' ' ' 1 J iMaugansv x I /orc i-,ar ai irI -i For Property Located at: 215 Pet;ma r Circle L Owned by: JahM DdVi dUk Address: 215 P-�tfa r CirCle, Hai rSfin wn LiD - Type of Connection: To Service Connection A To Main Line: Type of Service: Residential Commercial Meter Size Units Other Industrial Connection Fee_ $b20-00 — Date Paid 7/2-9:18 5 To connect to a public sewerage/9mt.or 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 id©. 0-15-8925-3 Secretary-Treas rer 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 r - j. Final Inspection Made BY: Date Plumbing In 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 Field Office Date WASHINGTON COUNTY SANITARY [ TRICT 'ANITARY SEWER LATE', WASHINGTON COUNTY, MO. CONSTRUCTION RECORr.! Project: Maucaneville/Orchard Hills Sanitary Sawarage Collection Svstee Street (or location):, l,dl 746 f�+�s PI�►'v►AR- CJ LE� Johr, Contractor: Liabon_Contgactore. Inc. MH 572 TO MH S73 Date Installed 9 -13-84 Wye Sts. On Mein1 +6; d"kc "x E;" 1!c"S0R -Z F71 NOTES: 9-61 VF 2'54ubp C0 ATERA ENGTH LE16 F1 NGTH *Horz.• Total ad,51VV: St'd. j+ orz• Drop 7- z + z7.zs 31, B D c.r— Z 9. So I -F, MAI 140 z15,z5 "SOR Z� ovL i. 59`-1 I 45" Se ncl ' " • �S I • Depth of Cleanout 9151 V -F leFlov Line Cleanout ?-&,54' rom -t--M41Q •-r— Layed 0 z.o AFTER Cl20r., f9asement Service 2 54116 %C"P C. F 6 .t_ STA • 14(o0,5 ur. M0573 Amounts pertaining to work completed this per;odp reviewed and approved. BY C• 2 1 s WCSU napec oron rac ora Rep. Washington County Sanitary District SEWER SERVICE LOCATION Subdistrict No. SD#15 Contract No. SD15- 3-S Property Address: Petmar Circle MH 572 to ISH 573 DWG. #601-309 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. r Date: �� - !D ` �i 3 �m 45 e;" _ Owner Owner Attest: Was Co. Sanitar istrict (Form WCSC-1) Replaces Form WCSC-56 41 �b 748 � 3 (215) 3 (2)(1 44j 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: �� - !D ` �i 3 �m 45 e;" _ Owner Owner Attest: Was Co. Sanitar istrict (Form WCSC-1) Replaces Form WCSC-56