HomeMy WebLinkAboutLat_14136TarheelCourtO T° N C,0 WASHINGTON COUNT j CE�VE
3 WATER & SEWER DEPART NT
�A
16232 Elliott Parkway JUL 1 1 2001
Williamsport, MD 21795 1013 o �
RyLNN" (301) 791-3083
PERIi IT,S, AND
Permit to Connect to Public Water/Sewer System INSPECTIONS
Type of Permit RES SEWER Permit No. SCP 150-1565
Subdistrict Name Issue Date
Mainline Contract No. Void Date
Building Permit No. e L u u j -1 v a` Subdistrict No.
Permission is hereby given to:
Property Owner:
DAVID SHAOOL
of address:
w L RSTOWN
—mi) 21740
For property located. at:
14.1. 3 6
Street Address
Lot No. 11
Subdiv. FOUNTAINVIEWPhase
tec.
Owner's Agent:
DAVID SHAOOL
Agent's Address:
Previous Owner:
Fees Paid in Full?
YES
Lateral with Mainline? yEb,
Date Fees Paid
Residential EDU's r,
Fee $
Commercial EDU's 200
WCWSD Alloc./Conn.
Fee $
Gal/Day Allocation
WCWSD/Other
Fee $
Building Number
City of Hagerstown
Fee $$
6Q QAA Misc. Number
A
FEE FFERE�YT I
rCHAROED -AEibeE!A9F1eN FEE
Remarks
J
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 -
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: Plumbing Inspector:
Alk '00w*e
PROJECT NAME: / uun �4"IVi e4✓ �dcJ1J hdrrtPROJECT NO:
PROPERTY ADDRESS: -TH 11 4 l2-- DRAWING NO:
FAIN LOCATION: STREET DATE INSTALLED:
PROPERTY OWNER NAME: MIT /.Sa- 706 To MH 15-a - /2`Y
PROPERTY OWNER ADDRESS: MAIN STATION: /f 6141 R�Rr/Fr
l SINGLE: DOUBLE:
CONTRACTOR: CONNECTION ® MH:
SIZE & TYPE
(:5/WYE
8�X 1p��Xod
' soy --3s
SIZE & TYKE SIZE Ac IYElF
DOUEILE TEE SERVICE PIPF
NAr Sr>-2� �f
2 �sDQ-26
D E (RT) E ('r) F
1 81 1 1 1 4' I
INVILRI 0 DEE1111 A 8 (LT) C (L1)
MAIN C/O
73 s .3
13 (RTIC (RT)
NO SCALE
WE, THE UNDERSIGNED, BEING SAID OWNERS OF THIS PROPERTY, REQUEST PERMISSION TO INSTALL THE
(PROPERTY ADDRESS)
DATE:
10USE LATERAL AT THE MODIFIED HEIGHT DESCRIBED ABOVE.
ATTEST: �j^� e
WASHINGTON COUNT) WATEp SCJ/C(? DEPT
PRIIJ lEb r,IA,\AE
SIGVIATI)P;:-
THIS FORM SHALL BE USED IN CONJUNCTION WI7I1 THE GRAVITY SEWER SERVICE CONNECTION SHEET,
STANDARD DETAIL S-3.3.
DIVISION OF PUBLIC WORKS
WASII/NGTON COUNTY, ANRnANO
s WATER AND SEWER
DEPARTMENT
711 1l AV
MODIFIED SERVICE LATERAL
GRAVITY SEWER
JANUARY, 1999 I S--13.3 A