HomeMy WebLinkAboutLat_19113RockMapleDriveWASHINGTON CO
i -
WATER & SEWER DEPA �'MENT
R
16232 Elliott Parkway �R 1
Williamsport, MD 21795
(301) 791-3083
Permit to Connect to Public Water/Sewer System J
Type of Permit RES SEWER
Subdistrict Name MAUGANS OH
Mainline Contract No. 584
Building Permit No. PRJ99-0175
Permission is hereby given to:
Property Owner: MAPLE VALLEY
of address:
HAGERSTOWN
For property located at:
Lot No. Subdiv.
Owner's Agent: _
Agent's Address:
Previous Owner:
Permit No. SCP 150-1410
Issue Date_ 03/09/99
Void Date_ 03/09/00
Subdistrict No. 150
19 //.3 tL'I� L '
ML 21740
LE VALLEY ESTATES
�ONSTRUCTION & MO
7121 DAM # 4 ROAD
kb
Phase Sec.
Fees Paid in Full? YES
Lateral with Mainline?
Date Fees Paid
Residential EDU's
Fee $
Commercial EDU's 0
WCWSD Alloc./Conn.
Fee $
52, Gal/Day Allocation 200
WCWSD/Other E
Fee $
Building Number
City of Hagerstown
Fee $
Misc. Number
Total Fee $
Remarks
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.
Signed-JDate:'ZqM
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 �1
Inspection Date: 5-l" - rj' Plumbing Inspector: �ltiC
SIZE & TYPE
ice►.
Am%
DEPTH
/&(A P I -e-,
PROJECT NAME:�
V#A �;4A �-
_ A � PROJECT NO:
PROPERTY ADDRESS:
e{ -.11
DRAWING NO:
C/O (B)
MAIN LOCATION: STREET/EASEPYIENT lc ��' /KAP
`� DATE INSTALLED:
PROPERTY OWNER NAME:
�Qll3
MH 129 �
TO MH
PROPERTY OWNER ADDRESS:
MAIN STATION:
/ +34
SINGLE: ,/
DOUBLE:
CONTRACTOR:
CONNECTION ® MH:
SIZE & TYPE
SIZE & TYPE
INVERT @
DEPTH
DROP
TEE/WYE
SERVICE PIPE
MAIN (A)
C/O (B)
DEPTH (C)
D
E
F
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).
SHOW LATERAL LOCATION, STATION, UTILITY CROSSINGS AND DIMENSION ALL PERTINENT ITEMS
FLOW LEFT
DOWNSTREAM
MH # log(
LIST OUANT!T!ES FOR PAY ITDAS HERE:
m
hA�HI^GT+ :C'T'IPJC(UJ-) OR
DIVISIONDIWSION OF Pbz3Lr(, WORKS
�G'y Nti'iiJ1'7!%4V1VlY vVV%MI f, �v�rilt �7 L/iIVU
lvVATER AMS) QF-wFR
n TA. I�7-,NIT-
RIGHT
UPSTREAM
h^H # logz
CONTRACTCR'� REPRE._iL1YT^T1�'E
CO. NAME:
GRAVITY
u1J1vt1�Tiviv �r-1�� �
I
MARCH 1996