HomeMy WebLinkAboutLat_19126RockMapleDriveT O ry 00 2 WASHINGTON COUNTY
3 WATER & SEWER DEPARTMENT
16232 Elliott Parkway
Williamsport, MD 21795
�gRyLPN'D (301) 791-3083 �1^'
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
r-•.�- rrm-rr.r
Fee
Fee
Fee
Fee
Total Fee
Permit No. , C,
Issue Date 05,! 9
Void Date "$
Subdistrict No.
Street Address
Phase Sec.
Lateral with Mainline?
Residential EDU's
Commercial EDU's
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.
Signed) 44 Date: ✓ ! Y
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: /1. 4, Plumbing Inspector: r
DEC =f 81998
WASHINGTON COUNTY
WATER & SEWER DEPT.
/**
PROJECT NAME: /-` ^ ��yj0 �� �`"� PROJECT N0: ��� 1 " S8
�o-F
PROPERTY ADDRESS: . DRAWNG N0:
IVlAIIJ LOCATl OiJ: STREET/ EASEE',tENT�' c.V- n �-' DATE INSTALLED:
MH TO MH
PROPERTY OWNER NAME: �4/fib '-'"— `�-
PROPERTY OWNER ADDRESS:
MAIN STATI 0 0 -t- 8 �
SINGLE: DOUBLE:
CONNECTION @ MH -
CONTRACTOR:
INDICATE TYPE OF LATERAL BY CROSSING OUT OTHERS. FOR CONNEC11ON TO MANHOLE=, Ul-ib:K AtsUVL,
ANE] LIST INVERT DIMESION 'B' AND DROP DIMENSION 'C' (IF APPLICABLE).
SHOW LATERAL LOCATION, STATION, UTILITY CROSSINGS AND DiMLNSiUN ALL rtrc IINLN I I It114J
FLOW LEFT '1 0+ --k�?4
DOWNSTREAM
MH # !O$'?.,
LIST OUANTIT1ES FOR PAY ITDAS HERE:
10
Gti'A ^I 1IN"TO" `_. 'vT( 1INSPECTOR
DI'vi ION OF P&E'_rc WORKS
i,m ry 4ASHiNGTON vG'VIVl:, ! ARi LAND
l -V4 TFR ,AA ^!P, ST-INFR
RIGHT
UPSTREAM
F"H # zn-?3
CONTRACTOR'S REPRESE'JTATI`�'E
CO. NAME:
GRAVITY
�ONIVtL I I VIV SHLC I
MARCH 1996
SIZE & TYPE
SIZE & TYPE
INVERT @
DEPTH
DROP
D
E
F
TEE/WYE
SERVICE PIPE
MAIN (A)
C/O (B)
DEPTH (C)
/� /A—if
-!!_1 - Z-11
ga. q 7
---
----
(I ��7
7--- - I
INDICATE TYPE OF LATERAL BY CROSSING OUT OTHERS. FOR CONNEC11ON TO MANHOLE=, Ul-ib:K AtsUVL,
ANE] LIST INVERT DIMESION 'B' AND DROP DIMENSION 'C' (IF APPLICABLE).
SHOW LATERAL LOCATION, STATION, UTILITY CROSSINGS AND DiMLNSiUN ALL rtrc IINLN I I It114J
FLOW LEFT '1 0+ --k�?4
DOWNSTREAM
MH # !O$'?.,
LIST OUANTIT1ES FOR PAY ITDAS HERE:
10
Gti'A ^I 1IN"TO" `_. 'vT( 1INSPECTOR
DI'vi ION OF P&E'_rc WORKS
i,m ry 4ASHiNGTON vG'VIVl:, ! ARi LAND
l -V4 TFR ,AA ^!P, ST-INFR
RIGHT
UPSTREAM
F"H # zn-?3
CONTRACTOR'S REPRESE'JTATI`�'E
CO. NAME:
GRAVITY
�ONIVtL I I VIV SHLC I
MARCH 1996