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WASHINGTON
33 W. WASHINGTON STREET
COUNTY SANITARY DISTRICT
HAGERSTOWN, MARYLAND 21740 (301) 791-3083/3084
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM
Permission is hereby given to:
For Property Located at:
Owned by:
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
Address:
Connection Fee
';5_1
To Main Line:
Units Other
Industrial
Date Paid
PERMIT NO.
DATE
SUBDISTRICT
To connect to a public sewerage/water system (with proper abandonment of previous private system). The installation
of the connection and the abandonment of the previous private system shall conform with the provisions of the
Laws of the State of Maryland and Washington County Sanitary District SF3cifications.
This permit does not supersede any local ordinance that is in effect with regards to road cutting, etc.
ALL OTHER PERMITS, STATE AND LOCAL, MUST BE OBTAINED BY THE PROPERTY OWNER AND ALL RESPON-
SIBILITY CONNECTED THEREWITH REMAINS WITH THE PROPERTY OWNER.
Secretary -Treasurer
Building Permit No.
INSPECTION: At least 48 hours notice prior to requested date of inspection is required.
ON SITE INSPECTION will be made by: Washington County Plumbing Board
33 W. Washington Street
Hagerstown, Maryland 21740
Telephone: 791-3146
Permit Fee
Final Inspection Made BY: _ Date --`% �
Plumbin nspector
OFF-SITE INSPECTION (in Public Rights -of -Way and Easements) and certain
ON-SITE INSPECTION in accordance with applicable approved construction drawings will be made by:
Washington County Sanitary District
33 W. Washington Street
Hagerstown, Maryland 21740
Final Inspection Made By:
DISTRIBUTION: Permi
Plumbing Board
Field Office
Date
WASHINGTON COUNTY SANITARY DISTRICT
WASHINGTON COUNTY, MO.
SANITARY SEWER LATE'.
CONSTRUCTION REC(u%r
Project:
Mauasnsvi11e/Orchard Hills
Sanitary
geueraan LOIISCZADI av"20 �_
Street (or
location): r�.4 r - %rovu�
Ti euao der=
T
Contractor: Lisbon contractor._ Inc.
our Or--
MH X38 TO MH��
Date Installed /9,WL.fS4- Wye Sts. On Main ata■v 4.
WYE 5TZE— TYPE DEPTH TYPE 'EXCAYS LAYING
IIZE TYPE PC.O.LATERAL LENGTH LENJTH
*Hors.• Total
covtiEcn 471 V F. St 1 d. 38.1OC..F.
ro 37.&0[...F.
M. N.
NOTES:
Depth of Cleanout�Flou Line
Cleanout 3(,. �_�-- H4W .._
layad
• Kt0 Basement Service
0 -Q
2'Sfubc,:C4� ••'
Amounts peri inin0 to work completed this per.od, reviewed and approved.
BY Inspector on rac ors Rep.
0
0.,.
0
(. N -692A L, i krk MN 5M
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
-3-7(7 Contract No. SD15- 3-S
Property Address: ,�8 Royal Road
MH 538 _ DWG. #601-306
Place an 'X' in the sketch below to indicate where the property
owner wants the service connection (lateral) to enter the
property. Place a wooden stake in the ground at that location.
The undersigned agrees that the Sanitary District may
excavate an additional five (57) feet inside the property
line so as to facilitate, and make less expensive, the owner's
connection to the lateral and to prevent damage to the cleanout
which will be installed by the District at or near the :.o erty
line. p
Date : C I �� . 'q X
9 � (J/
Attest: .0,�Lj
ash. Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56
Owner
WASHINGTON COUNTY SANITARY DISTRICT
33 West Washington Street, Hagerstown, Maryland 21740 ■ (301) 791.3083
n
To: Lisbon Contractors, Inc.
I hereby request the contractor to install the lateral in
accordance with the following conditions:
M
Date 4 - '-? -7 of -i
Washington County Sanitary District
33 West Washington Street
Hagerstown,.Maryland 21740
Re: Maugansville/Orchard Hills Sewers
Contract No. SD15-3-S
Gentlemen:
We hereby request permission to install the house lateral
of greater than two (2) percent and/or in accordance with the
above conditions at no change in contract price at the following
location:
Requested by Lisbon Contractors, Inc..
;approved by W.C.S.D. Inspector