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HomeMy WebLinkAboutLat_13645VillageMillDriveWASHINGTON COUNTY SANITARY DISTRICT 33 W. WASHINGTON STREET HAGERSTOWN, MARYLAND 21741-0571 (301) 791-3083 1 3084 P.O. BOX 571 PERMIT TO CONNECT TO PUBLIC SEWERAGESYSTEM Permission is hereby giv( For Property Located at: PERMIT NO. "S45 DATE 11-5-54 SUBDISTRICT N©. 15 Maugans,ville/Orchard Hills Owned by: Pearl V Keefer Address Type of Connection: To Service Connection Type of Service: Residential Commercial Meter Size X P.O. Box 111 Maugansville MD. 21767 To Main Line: 2 ) Units Other Industrial Connection Fee $1 240.00 _ Date Paid ± - �- `-�i To connect to a public sewerage/i' 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 RESPOW SIBILITY CONNECTED THEREWITH REMAINS WITH THE PROPERTY OWNER. Secretary -Treasure pbo Building Permit No INSPECTION: At least 48 hours notice prior to requested date of inspection is required. ON SITE INSPECTION will be made by Permit Fee Final Inspection Made BY: Washington County Plumbing Board 33 W. Washington Street Hagerstown, Maryland 21740 Telephone: 791-3146 Plumbing Inspector Date 1 � " `q ^ i___I, 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: Final Inspection Made By: Washington County Sanitary District 33 W. Washington Street-P.O. Box 571 Hagerstown, Maryland 21741-0571 Date DISTRIBUTION: Permittee 1 Plumbing Board 4 Field Office 1 La-vaaL � �1 136 142o C 1SXWk-RN � P/0 Washington County Sanitary District SEWER SERVICE LOCATION Subdistrict No. SD#15 Contract No. SD15-1S Property Address: 412^rth -t�t i3GgS Vi pqe- Mi'0 1--jri'Je MH 13 4'`%lki iib Dwg. #601-037 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. �D TS,RE. D u� �5 The undersigned agrees that the Sanitary District ma excavate an additional five (5) feet inside the property dine 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: Z 1 PA V. /1 T -J Owner (Print) ner s Signature Attest: iq..j..nQ Wash. Co. Sanitary District (Form WCSC-1) Replaces Form WCSC-56