HomeMy WebLinkAbout220 Primrose Road - SL - 2023.07.27 - 10 YearsAddress: _moi. -ti V' j?Y'%sem,YKC (Lo
Owner: %l Uvl1� to
Contractor
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Contractor Name: ���lti.b r -\s 0a l .�{K �0Z f
City Staff Name: jhMt L
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City of Burlingame
Public Works Department
Sewer Lateral Tp -qt rprtifirntw
Tested Date: o-1 I 2 -11 "13
Building Permit #: P 1-7 — 0. q2j
Encroachment Permit #:
Cleanout Location: ❑ Front
Rr Rear
Face of Corb
❑ Left
❑
Right
10 Year ❑
Partial Repair Made
10 Year .5'
___ New Installation
25 Year ❑
Lateral Size: 1
Cleanout: Z Existing ❑ New Installation
Comments and/ or
Sketch:
_Test Type:__,_ _ 0 Water, ❑ Air
Jil� Pass ❑ Fail
Sewer Lateral Condition:
Exemption Type:
NoRepoir_Needed
10 Year ❑
Partial Repair Made
10 Year .5'
___ New Installation
25 Year ❑