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ASt GTON COUNTY SANITARY DISTRICT PERMIT NO.
w -IrVASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571 (301) 791-3083/3084 DATE
P.O. BOX 571
SUBDISTRICT T�0
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM 116 Maugansville%Orchard 11iils
Permission is hereby given to: Earl D_ KI i ne ' ��
For Property Located at: 214 Petmar Circle, Hagerstown, Maryland 21740
Ownedby: `Earl D. Kline Address: 214 Petii1ar Circle, Hagerstown, MD 21740
Type of Connection: To Service Connection X To Main Line:
Type of Service: Residential ( ) Units Other
Commercial Industrial
Meter Size Connection Fee $620.06 Date Paid ( 0/21
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 RESPOW
SIBILITY CONNECTED THEREWITH REMAINS WITH THE PROPERTY OWNER.
Water No. 0 -1S -A40-0
Secretary-Treasur6r' /
Building Permit No.1
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: 44a Date _
Plumbing Insp or
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: Date
DISTRIBUTION: Permittee Plumbing Board_
Field Office
WASHINGTON COUNTY SANIT,
WASHINGTON COUNTY, MO.
Project: Mauoanavil]
14
Street (or location):
DISTRICT
:hard Hills S
SANITARY SEWER LATE
CONSTRUCTION REC(ii1w
T
Contractor:Lisbon Contractors. Inc.�'ne,i�
MH -5-72 TO MH 3-73 I ;
Date Installed �� 4 Wye Ste. On Main
I + (4,-'.
SIZE
SIZE-
TYPE PIPE
TYPE
C 0
DEPTH
C 0
TYPE
LATERAL
EXCAV.
LENGTH
LAYTRr—
LENGTH
r
. 6D L2 Z
k
�'•"�
stud.
*Hort.- Total
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NOTES:
Drop
ops ♦ orz-
46
4.5,7c,
Depth of Cleanout •Flow Line
Clesnout_Z-IG From P"Al,vLtZe
L a y a d • 4� 5
-Y 8eaoment Service
MH# 5 ? Z
2.
MH#
Amounts,"tainin9 to work completed this period, reviewed and approved.
8Y AP
\�
UCSD Inspector Contractors Rep.
00,'''
C-'
OW AIN
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15- 3-S
Property Address: 'A4 Petmar Circle
ISH 572 to MH 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 a or near the property
line.
oe
Date:
Attest:
Wash Co. Sani-tary District
(Form WCSC-1)
Replaces Form WCSC-56
er
Owner
A
40.
WASHINGTON COUNTY SANITARY DISTRICT
33 West Washington Street, Hagerstown, Maryland 21740 a (301) 791.3083
0
To: Lisbon Contractors, Inc.
I hereby request the contractor to install the lateral in
accordance with the following conditions:
e 7
Address_
" Signed
Property Owner
Date
"Washington County Sanitary District
33 West Washington Street
Hagerstown,.Maryland 21740
Re: Maugansville/Orchard Hills Sewers
Contract No. SD15-3-S
Gentlemen:
We hereby request permission to install the house lateral
of greater than two (2) percent and/or in accordance with the
ibove conditions at no change in contract price at the following
.ocation:
Z "-/, L4TE24
Zequested by Lisbon Contractors, Inc.
(57 Aijproved by W.C.S.D0 Inspector
Date 31Z a/, Y G