HomeMy WebLinkAboutLat_19009RockMapleDriveyeaCIT
°" WASHINGTON COUNTY ✓ ►mQ.u,r-
WATER & SEWER DEPARTMENT IC/ aal q ,�
16232 Elliott Parkway
714YLwa Williamsport, MD 21795
(301) 791-3083
Permit to Connect to Public Water/Sewer System
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. Subdiv.
Owner's Agent: _
Agent's Address:
Previous Owner:
Fees Paid in Full?
Date Fees Paid
WCWSD Alloc./Conn.
WCWSD/Other
City of Hagerstown
Remarks
Fee $
Fee $
Fee $
Fee $
Total Fee $
Permit No. _
Issue Date _
Void Date
Subdistrict No.
Street Address
Phase Sec.
Lateral with Mainline?
Residential EDU's
Commercial EDU's J
Gal/Day Allocation
Building Number
Misc. Number
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 supercede 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 WITH THE PROPERTY OWNER.
1! /1
Signed:
Date:
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
Inspection Date: ����/�� Plumbing Inspector:
RECEIVED
OCT 13 1998
WASHINGTON COUNTY
WATER & SEWER DEPT.
PROJECT NAME: /� �i C� l e, VA ll�y �s-�Ae-.5 Sem • %q J PROJECT NO:
PROPERTY ADDRESS: 14 /5DRAWING NO -
M
0. 15-p"
P�1AIN LOCATION. STREET/E:,SEP�SENT �O� i'IA p�G �+"t've DATE INSTALLED:
PROPERTY OWNER NAME: 90i3�/900 MH l07g TO MH 1'919
PROPERTY OWNER ADDRESS: MAIN STATION 4 Gam'
SINGLE: DOUBLE:
CONTRACTOR: �/q �fe 4e CONNECTION @ MH:cl
SIZE &TYPE
INDICATE
SIZE &TYPE
INVERT ®
DEPTH
DROP
�
TEE/WYE
SERVICE PIPE
MAIN (A)
C/O (B)
DEPTH (C)
D
E
F
8X6 SSR 3s-
s
INDICATE TYPE OF LATERAL BY CROSSING OUT OTHERS. FOR CONNECTION TO MANHOLE, CHECK ABOVE,
AND LIST INVERT DIMESION 'B' AND DROP DIMENSION 'C' (IF APPLICABLE).
D E
SHOW LATERAL LOCATION, STATION, UTILITY CROSSINGS AND DIMENSION ALL FERiIiNENT ITEMS
FLOW LEFT
Loi
DOWNSTREAM
MH # /a7�
LIST QUANTITIES FOR PAY ITD.AS HERE:
D!V%J/U;V Cir FURL/ C VVufKi�J
4ASH;%VGT0X iiVvfYl 1, it/:i!'(1Lril Vii
W4 TER Ar /n S r' VER
F' C -P A R D..4 -r A! 7-
RIGHT
UPSTREAM
r:+H #
�./L/'I IRE...CI V E
CO. NAME:
ripVIT'V QF7-M1�G` C�R1!Ir
V'I\. ri .J`YYLI\ �JLI\ VIL+L I
C-01 I ACL. T 1C-jN JI-IEF T
MARCH 1996