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1,-ASHINGTON COUNTY SANITARY DISTRICT PERMIT NO. $53
P. WASHINGTON STREET HAGERSTOWN,MARYLAND21741-0571 (301) 791-3083/3084 DATE 1 ul t) 1 /85
P.O.. BOX 571
SUBDISTRICT NO. 15 -
PERMIT TOCONNECT TOPUBLIC SEWERAGE/WATERSYSTEM MaUgansvi l le/Orchard
Permission is hereby given to:
Franklin R. Gelwicks J�,8C90 Hills
For Property Located at: 204 Petmar Circle, Hagerstown, Maryland 21740
Owned by:
Franklin R. GelwickS Address: 204 Petmar Circle, Hagerstown, MD 21740
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
Connection Fee
To Main Line:
Units Other
Industrial
620.00
Date Paid
To connect to a public sewerage/Wa?tgr 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. 1-15-8815-8
Secretary-Tre, Surer
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
Telepho 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-P.O. Box 571
Hagerstown, Maryland 21741-0571
Final Inspection Made By: Date
DISTRIBUTION: Permittee i Plumbing Board 3
Field 1 Office 1 City Of Hag. 1
WASHINGTON COUNTY SANITARY L TRICT
WASHINGTON COUNTY, M0,
IANITARY SEWER LATE',"
CONSTRUCTION RECoor?
Project: Mouamnevillel-Orcherd Hills Sanitary Sgwerage Collection Sretgm_
KAU(
Street (or location) : _ CAI `%�Q' �-ZO 4- Pr-r"Ari C►r -CF-)
Contractors Lisbon Contractore- Inc. -
Date Installed 9-14--'B4
MH 568 TO MH 569 ,
Wye Ste. On Main0-1-G�9 R1_
WTC .71LL. 1ir[. LFL. rIn IIr.. ..n..nV. a.n.a—
TYPE- P P C.0LATERAL LENGTH LENGTH
x�"n(5- C",;5Orl:Z(,PI.c. +►Hors.• Total
Pvc_ 10,51 St' d. 2-3,00 LF
20,00 L,F.
pe4 Hot-Z=Twa
Drop
NOTES:
AIN
i
L" SDR 2(o P-/
2.
2. t)%
2 Shu b c Cu p
Depth of Cleanout i•flow Line
Clesnout 113-0o' From
Layed • 2 • "�
Basement Service
�- 5TA , o t09, 9
56a o S69
0
r
Amounts pertaining to work completed this period, reviewed and approved*
napec or g
rac ors Rep.
WashingtcAfilvACounty Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15- 3-S
I uli Cha
Property Address: K4 Petmar Circle
MH 568 to MH 569 nrni- I/-n._�n4
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.
Date.
Owner
Owner
Attest: Q r7 ' �ict as . Co. Sanitar.
(Form WCSC-1)
Replaces Form WCSC-56