HomeMy WebLinkAboutLat_16844PetmarCircle4SHINGTON COUNTY SANITARY DISTRICT
W. WASHINGTON STREET
P.O. BOX 571
HAGERSTOWN, MARYLAND 21741-0571
PERMIT TO CONNECT TO PUBLIC SEWERAGEVATER SYSTEM
(301) 791-3083/3084
Permission is hereby given to: Michael K Ona r i rt c k i
For Property Located at: 212 PBtii1ar Circle
PERMIT NO. /0-3
DATE %f 22/65
SUBDISTRICT No. 15
Maugansvt1le/OrchAd IiilIs
Ownedby: Michael KOItTA-insk1 Address: 212 Da+m v Circle, u
�=*�-r r - -r r-tta-q{it-6-tc1-i1'fit-,--tarp'------
Type of Connection: To Service Connection To Main Line:
Type of Service: Residential
Commercial
Units
Other
Industrial
Meter Size _ Connection Fee $620.00 _ Date Paid
To connect to a public sewerage4gfiir 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 Account No, 0-15-8835-4
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
Plumbi Inspector
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 I
Plumbing Board 3
Date
Field Office C l ty of Hag. 1
WASHINGTON
COUNTY SANITY
DISTRICT
SANITARY SEWER LATL
WASHINGTON
COUNTY, MO.
Ste.
CONSTRUCTION REC(W,'
Project:
Mauannsville/Orchard
Hills Sanitary
Sewerage Collection System
Street (or
location) :
�c-��tiic4� L,2G c�f
,I T "73 Z
Contractor: Lisbon
Contractors, Inc.
Michqud mCtY in,ki
Oats Installed 9_h_ -7 Q
MH
_ -7 Z
TO MH 5.73
TYPE
LATERAL
Wye
Ste.
On Main tv /'
SIZE
SIZE -WYE
TYPE PIPE
C.D.
-DEPTH
Coo*
TYPE
LATERAL
EXAV.
LENGTH
LAYING
LENGT11
�8��
�,`5a�2 Z(0
6 "?,IL
u . ` J
St'd.
*Horz.= Total
NOTES:
Drop
orza
/ASF- K
IT( -VZ
wleA?
Depth of Cleanout Gev6 ®Flow Line
Cleanout From -,
Layed It 205
yam=- ? -Basoment Service
Vt vq
M"#
572.
Amounts pe=ni towork completed
8Y
lucso Inspector
MH# -S73
this period, reviewed and approved.
r,Contractors Rep.
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
( u8,(4q 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.
i
(o)
Z07 \ �,
732
( 212) t
8" SAN.
Nil
U-)
in
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.
f
Date: Z Z
Owner
Owner
Attest:i!7 I - %-
Wash Co. Sanitary. District
(Form WCSC-1)
Replaces Form WCSC-56
5'73
10
WASHINGTON! COUNTY SANITARY DISTRICT
it
V/�33 West Washington Street, Hagerstown, Maryland 21740 • (301) 791.3083
To: Lisbon Contractors, Inc.
I hereby request the contractor to install the lateral in
accordance with the following conditions:
— '� l����J �}T �je o�PTy � ii►t�
Addressp2��
Signed '
Property wner
Date
Washington County Sanitary District
33 West Washington Street
Hagerstown, Maryland 217)0
Re: Maugansville/Orchard Hills Sewers
Contract No. SD15-3-S
0
` Gentlemen:
We hereby request permission to install the house lateral
of greater than two (2) percent and/or in accordance with the
above conditions at no change in contract price at the following
location:
Requested by Lisbon Contractors, Inc.
Approved by W.C.S.D. Inspector
Date 2Z7/ D `/