HomeMy WebLinkAboutLat_19123RockMapleDriveWASHINGTON COUNTY
3 WATER & SEWER DEPARTMENT
16232 Elliott Parkway ff�,
Williamsport,
MD 21795 ;
(301) 791-3083 =--
Permit to Connect to Public Water/Sewer System MAR o S 11"
V (Yyl�,r
Type of Permit ?� PERE�'iTS AND ��3-]�Cj1
YP ES SEWER Permit No. SCP IV�p�r�„
Subdistrict Name !AUGANS/OH Issue Date
Mainline Contract No. 584 Void Date _ n !o0
Building Permit No. 7`RJ99-028 Subdistrict No. .1k
Permission is hereby given to:
Property Owner: ;.,E VALLEY ESTATES
of address:
For property located at: 19123 ROCK MAPLE Lh!'v is Street Address
Lot No. Subdiv. MAPLE VALLEY ESTATE' Phase Sec.
Owner's Agent: CLi NCE MARTIN
Agent's Address: ? 1 R I NGGOLD PIKE HAGERSTOWN Mn 'i,742
Previous Owner:
Fees Paid in Full?
YE::
Lateral with Mainline?
Date Fees Paid
031
Residential EDU's 1
Fee $
Commercial EDU's 0
WCWSD Alloc./Conn.
Fee $
$2,050 Gal/Day Allocation 200
WCWSD/Other
Fee $
Building Number
City of Hagerstown
Fee $
1 , 000 Misc. Number
Total Fee $
$3,050
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: Vl'6L4�
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
c n p Phone: (301) 791-3070
Inspection Date: J 2—a ' T
Plumbing Inspector: �
Al"k
PROJECT NAME: IqA p (-t- VA 6:S 4A"�'�•%� � PROJECT N0: LS"� - -o
PROPERTY ADDRESS: DRAWING NO: 5� '
MAIlJ LOCATION: STREET/EASEMENT ^��� ��� �'�- �rc✓e� DATE INSTALLED:
PROPERTY OWNER NAME: 1,91-23 MH -�- TO MH
PROPERTY OWNER ADDRESS: MAIN STATION: D -t- g o
SINGLE: ✓ DOUBLE:
CONTRACTOR: ��(e, ->Jyv' 1 t It, CONNECTION ® MH: /083
SIZE & TYPE
TEE/WYE
SIZE & TYPE
SERVICE PIPE
INVERT ®
MAIN (A)
DEPTH
C/O (B)
DROP
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 RIGHT
MH #
LIST OLIANPTIES FOR PA,Y ITEMS HERE:
VVASI IINGTC d CCU ,T'r" I1JSPECTCR
DI'vi ION OF PUCL/C WORKS
�o V%NJK!%Vl�!'V!Y 1-0: M.�R,LVvu
'V4 TSR ,q,A,!n cF IA/FR
1�ERRTA;Tr',R.rr
L
UPSTREAM
MH # /D�f
IV I L V iY 1!111 V L
CO. NAME:
GRAVITY SE'Y°E'ER SEK`:1C�
VI I trIrlur'N rJIl -iltrCrr
MARCH 1996 1 5-13.2