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PERMITS AND
INSPECTIONS
Type of Permit
Subdistrict Name _
Mainline Contract No.
Building Permit No. _
Permission is hereby given to:
Property Owner:
of address:
For property located at:
Lot No.
WASHINGTON COUNTY
WATER & SEWER DEPARTMENT
16232 Elliott Parkway
Williamsport, MD 21795
(301) 791-3083
Permit to Connect to Public Water/Sewer System
Subdiv.
Permit No. SCP 150-1398
Issue Date -110/22/98
Void Date 7122/99
Subdistrict No.
v moi__
Owner's Agent: r, D y`E
Agent's Address: o l i -C HAS` 270
Previous Owner:
Fees Paid in Full?
Date Fees Paid
L
Street Address
Phase Sec.
Lateral with Mainline?
Residential EDU's
Fee $ Commercial EDU's ju
WCWSD Alloc./Conn. Fee $ '. �c , Gal/Day Allocation U+
WCWSD/Other Fee $ Building Number
City of Hagerstown Fee $ 5 �) Misc. Number
Total Fee $ 500
Remarks i : 5.
NREU 1-791-'7
When connecting to a public water/sewer system, the installation of the connection and the abandonment of the previous private system shall
conform with the provisions of Maryland State laws and County policy.
This permit does not supersede any local ordinance that is in effect with regard to road excavations, plumbing permits, etc. ALL OTHER PERMITS,
STATE AND LOCAL, MUST BE OBTAINED BY THE PROPERTY OWNER AND ALL RESPONSIBILITY CONNECTED THEREWITH RE-
MAINS WI THE PROPERTY OWNER.
Signed •: Date:
/U z�
INSPECTION: At least 48 hours notice prior to requested date is required.
ON SITE INSPECTION will be made by: Washington County Plumbing Board
100 W. Washington Street, Room 304
Hagerstown, MD 21740-4727
Phone: (301) 791-3070 7
Inspection Date: % 9 Plumbing Inspector: