HomeMy WebLinkAbout810 Alpine Avenue - SL - 2022.09.16 (25)Address:
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Owner:��
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Contra cto r Na m e:
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Pa rtialFb pair Made
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City Staff Name:
25 Year
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: / ,I6 1 ��-
Building Permit#:
Encroachment Permit#:
Cleanout location: ❑ Front ❑ Rear ❑ Left ❑ Right
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Lateral Sze:
Cleanout: ❑ Existing New Installation
Commentsand/ or
Sketch:
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Status:
Sewer Lateral Condition:
Exemption Type:
No Repair Needed
10 Year ❑
Pa rtialFb pair Made
10 Year ❑
New Installation
25 Year