HomeMy WebLinkAbout1534 Rollins Road - SL - 2023.05.04 - 10 YearsAddress: \S34 `f:r?.
Owner. tASst. C AtTo iJ� f J bdi/l I.bS �NImAcT 1Rr�Gls
Contractor Name: \V-
City
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City Staff Name: Dhzgyp cecil—r>O aft
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: S1 �jT_7-3
Building Permit#:
Encroachment Permit#: 9w 13 — b l `A C
Cleanout Location: l9 Front ❑ Rear ❑ Left ❑ Right
Face of Curb
Lateral Sze:
Cleanout: In Existing ❑ New Installation
Commentsand/ or
S<etch:
Test Type: 0 Water ❑ Air
Status: Rr Pass ❑ Fail
Sewer Lateral Condition: Exemption Type:
No Flaair Needed 10 Year 53,
Partial Pa air Made 10Year ❑
New Installation 25 Year 11