HomeMy WebLinkAbout721 Rollins Road - SL - 2023.03.23 - 25 Yearsa
Address:
Owner:
Contractor Name:
City Staff Name:
Cleanout Location: ❑ Front
M
Lateral Sze:
Cleanout: ❑ Existing New Installation
❑ Rear
Comments and/ orSketch: FIN k -Z< �A
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date:
Building Permit#: _ f
Encroachment Permit #:
Left
�—
❑ Right
Water ❑ Ai
Sewer Lateral Condition: Exemption Type:
No Pa air Needed 10Year ❑
Partial Repair Made 10 Year ❑
New Installation 25 Year