HomeMy WebLinkAboutLat_13903VillageMillDriveWASHINGTON COUNTY SANITARY DISTRICT
33 W WASHINGTON STREET HAGERSTOWN, MARYLAND 21740 (301) 791-308313084
PERMIT TO CONNECT TO PUBLIC SEWERAGEIWATER SYSTEM
PERMIT NO.
DATE
SSS_UBDIST�ICT_t ' 4 Jw �.
TIE1114
1114
!•� Y
Permission is hereby given to: -- I✓ 'O3
For Property Located at: ary la :-A 21'1C7
Owned by:
Type of Connection: To Service Connection
Type of Service: Residential
Commercial
Meter Size
Address:
Connection Fee
To Main Line:_
Units Other ---
Industrial
Date 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.
Secretary -Treasurer
Building Permit No.
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 v
Plum g Inspector
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
Hagerstown, Maryland 21740
Final Inspection Made By: _ Date
DISTRIBUTION: Permittee Plumbing Board
Field Office t
LIASHINGTON COUNTY SANITAR ISTRiCT
WASHINGTON COUNTY, SID.
#AN SANITARY SELIER L„ T ER i:I
CONSTRUCTION RECORD
Project: Mau ansville Orchard Hills SD15-1-5
Street (or location): Z/Z N• NoI2TH STRcr GA=
Contractor: Calles Contractors Inc,
Date Installed /Z- /o- 8 3
MH 308—TO MH 300) ,/
Wye Ste. On Main o10)(,,5- /21. --
WYE
SIZE
SIZE-
TYPE P 1. 'PE
TYPE
C.O.
DEPTH
C.O.
TYPE
LATERAL
EXCA'V.
LENGTH
LAYING:
LEPlGTI!
*Harz.= T
510Q 35
5 ope + Horz--Total
NOTES:
Drop
Z(.3 S '
Z.SS'+ Z/•95'= ZS!so'
/Z•CeO' $WATt2 CCEAA1OL4T
ys°ij�,vr�s
o Mp�N
Depth of Cleanout 746 oLl Line
Cleanout ZZ•4/o� From
Layed @ Z S
s Basement .Service
o+°)('. S P,
MH;'368
Amounts pertaining to work completed this period, reviewed and approved.
BY
WC3CSi� l7ec Uor
Property Address:
MH 308 to MH 309
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD#15
Contract No. SD15-1S
1390 ��� � � aaQ M;11 or
Dwg. #601-040
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.
ww
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 (Print)
er's Signature
Attest: 9. 4
Wash- Co. Sanitary District
(Form WCSC-1)
Replaces Form WCSC-56