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PROJECT NAME: ic/Al , bo.m 14ILLS P,ql9JE -0— PROJECT NO:
PRO$"a&ESS: 51R 1 PES DA IVC DRAWING NO:
MAIN LOCATION: STREET/EASEMENT LD I lql DATE. INSTALLED: :9J2-1 l (o
PROPERTY OWNER NAME: MH r4l TO MH
PROPERTY OWNER ADDRESS: MAIN STATION:
SINGLE: ✓ DOUBLE:
CONTRACTOR: _ 5l-lTk)tF1,f Lb CONNECTION ® MH:
SIZE & TYPE
SIZE & TYPE
INVERT ®
DEPTH
DROP
FOR
CONNECTION TO MANHOLE, CHECK ABOVE,
AND LIST
TEE/WYESERVICE
PIPE
C.O. WYE (A)
C/O (B)
DEPTH (C)
D
E
F
g Z� Pvc Ax.
(A '101 SDA 0 lvC
7)
qo,L)
3.c�
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).
JYIUYV LA I t.KAL LUUA I IUN, 5 I A I ION, UTILITY CROSSINGS AND DIMENSION ALL PERTINENT ITEMS
FLOW LEFT
DOWNSTREAM
MH #/:iq::l
LIST QUANTITIES FOR PAY ITEMS HERE:
BY:
W SHINGTON COUNTY INSPECTOR
DIVISION OF PUBLIC WORKS
4 go MON WASHINGTON COUNTY, MARYLAND
het.I
,pARTVE lT OF
WATER QUALITY
RIGHT UPSTREAM
MH #
CONTRACTOR'S REPRESENTATIVE
CO. NAME:
GRAVITY SEWER SERVICE
CONNECTION SHEET
SEPT OBER 20D4 i S- 13.2