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33 VV. WASHINGTON STREET
P.O. BOX 571
COUNTY SANITARY DISTRICT
HAGERSTOWN,MARYLAND 21741-0571 (301) 791-3083/3084
PERMIT TO CONNECT TO PUBLIC SEWERAGE/WATER SYSTEM
Permission is hereby given to: Paul 114. o h a g (3�
For Property Located at: 2 1 5 0 R D w l d ri d Road, j -i ei gi
Owned by
. Shank
Type of Connection: To Service Connection
Type of Service:. Residential
Commercial
Meter Size
PERMIT NO.
DATE
SUBDISTRICT No,
i V I ie/0rcn'ard Hi i
rstuwn, Maryland 21 �4O
Address: 21SO Rowland Road,Hager
,iuwr, ii1 2;740
To Main Line:
Units Other
Industrial
Connection FeeDate Paid
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 Specifications.
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.
dtter Account No:: 015-727.0-9
Building Permit No.
Gt-%ZltC
Secretary-Treas r
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 Spector
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-P.O. Box 571
Hagerstown, Maryland 21741-0571
Final Inspection Made By:
DISTRIBUTION: Permittee Plumbing Board
Field Office
Date
s0 Aft►,
l _ -
Washington County Sanitary District
r � /
Poll.
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD1 -
5 3—S.
Property Address: Drive ; 3,�D�rc� qc lKpac�
' ✓J
MH 615 to MH 616 _ nwr, fins ,n?
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.
s1-rgtc-e-
The undersigned agrees that the Sanitary District may
excavate an additional five (5) 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 property
line.
Date:
Owner
Owner
op"' At s t . Yolk
Was o. Sanitary District
(Form WCSC-1
Replaces Form WCSC-56
If
; IASHING70N,- COUNTY SAMIT
ARY DISTRICT
33 Weal Washlngton Sireei,gagers!own, Maryland 21740 �r (301) 791 3083
{
Ypp
4
Mfr rs '
:V
mo: Lisbon Contractors, Inc.
I'hereby request the contractor to install the
accordance wi+h the following conditions: lateral in
x�
r
J„ar
AddressatA
del
/ a •
Signed
1-�-h
a4 roper y caner
4
Washington County Sanitary•
33 West Wash etDistrict
Hagerstown, Mar�vlandtr�1 t
?40
-Gentlemen;
We hereby
Re: Maugansville/Orchard Hills Sewers
Contract No. SD15-3-3
recsue,st permt$aiOn to ` install the house lateral
two &. erten .awnd/or 1n accordance with the
h
euF�SJ2tract
( the following
,(/ryy;"qpuery
•� `�'l t . ; '"( 1 d .F'i�' f °'.0 iri [_L i•� 4h•t S Inc.
.14
A�H:. d bar W*09S»1). Inspector - :G
i�� Dater rAm V.- /
•
R LATE'"�
WASHINGTON COUNTY SANITArtY DISTRICT SANITARY 9EWC
WASHINGTON COUNTY, MO. CONSTRUCTION RECmu.,
Project: Mauoansville-/Orchard Hills Sanitary Seweraae Collection Svstsw
Street (or location): x,41
Contractor: Lisbon
Data Installed "-$4
8"A(,"A 8" ISO"SOR ZC, RY.L-
Parc. 1 6,01 I St1d.
MM b i s T O !IM! 6l G✓
Wye Sts. On Main 3-t 1-7 L4,
LENGTH
s.• To
Drop 5.00t 2t.1600
NOTES: I 1 1 27,70 Z -F Z6, 1& [.r
MAW
lel
6.01 vF
3. Sfl�
� "5DR 2to L2VL I
1
•' 45"Sent! ,o '
Depth of Cleanout Flow Line
Cleanout z 2.<o(o' '.Iroow +_MA�—
Laced �' ]u AFTER r-20CP
• LS/A Basement Service
..Z Slab � Gu P
8'
6
e
5M.3+17 LT
"61(0
r
Amounts pertaining to work completed this period, reviewed and approved.
BY
G ' �
nspec orContractors ep.