HomeMy WebLinkAboutLat_14108TarheelCourtN CWASHINGTON COUNTY
3 i WATER & SEWER DEPARTMENT
16232 Elliott Parkway
Williamsport, MD 21795 mtlu�
�7RYLrNO (301) 791-3083
Permit to Connect to Public Water/Sewer System
15o -14(o5
Type of Permit RES SEWER Permit No. SCP
Subdistrict Name MAUGANS OH Issue Date 09/20/06
Mainline Contract No. Void Date 09/20/01
Building Permit No. P2000-1814 Subdistrict No. 010
Permission is hereby given to:
Property Owner: DAVID SHA00 L
of address: 11029 PLUMW OD CIRCLE
HAGERSTOWN MD 21740
For property located at: Street Address
Lot No. TH 2 Subdiv. FOUNTIANVIEW Phase Sec.
Owner's Agent: DAVID SHAOOL
Agent's Address: 0 PLUMWOOD CIRCLE H G S 0 MD 21740
Previous Owner:
Fees Paid in Full?
YES
Lateral with Mainline? YES
Date Fees Paid
Residential EDU's
Fee $
Commercial EDU's
WCWSD Alloc./Conn.
Fee $
Gal/Day Allocation
WCWSD/Other
Fee $
Building Number
City of Hagerstown
Fee $ 20=Misc.
Number
Total Fee $ S.3 bUU
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.
/ �j
Signer Date:
i
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: 9-�'7' L�, Plumbing Inspector:
IN
PROJECT NAME: PROJECT NO: If --o
PROPERTY ADDRESS: -77--/' Z t.-2- DRAWING NO:
LOCATION: STREET/EASEMENT DATE INSTALLED:
PROPERTY OWNER NAME: MH/ -O -/26'y TO MH
PROPERTY OWNER ADDRESS: MAIN STATION: /"60R",'wr
SINGLE: - DOUBLE: t--*"'
CONTRACTOR: CONNECTION 0 MH:
SIZE & TYPE SIZE & TYPE SIZE & TYPE INVERT 0 DEP I I I A 0 (L T) C (L
is/ wyF- UoIJULI lrF%!9j;) SERVICE PIPF MAIN C/o
24-
(KT)
U (R T C (R T' )
�mmmu
(LT}
A
13 C
D
(RT}
NO SCALE
WE, THE UNDERSIGNED, BEING SAID OWNERS OF THIS PROPERTY, REQUEST PERMISSION TO INSTALL THE
(PROPERTY ADDRESS)
DATE:
iOUSE LATERAL AT THE MODIFIED HEIGHT DESCRIBED ABOVE.
PRINILL) NAME
ATTEST:
wASHINC,10M COUNT' WATER & SEWUP DEPT A I IjP;-
THIS FORM SMALL 9E USED IN CONJUNCTION WITH THE GRAVITY SEWER SERVICE CONNECTION SHEET,
STANDARD DETAIL S-3.3.
LIMSION OF PUBLIC WORKS
"419n'lwo MODIFIED SERVICE LATERAL
' "WATER AND SEWER GRAVITY SEWER
JANUARY. 1099 1 S -13-3A