HomeMy WebLinkAbout1436 Burlingame Avenue - SL - 2015.01.02 - 25 YearsCity of Burlingame
tPublic Works Department
Sewer Lateral est Certificate
tddre
„ 5 Tested Date:
Owner _ Building Permit #:
Contractor Name:Encroachment Permit #: �
:City Staff Nance:
Cleanout Location: ❑ Front 0 Rear ❑ Left ❑ Right
Face of Curb
to
Lateral Size: _ e_ Test 7Y.t?'em..,_. 'Water ❑ Air
Cleanout: ❑ Existing New Installation Status Pass ❑ Fall
Comments and/ or
5 ktc h
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�t 7. ....._ . Y .... a.._, - . Sewer Lateral Exemption type:_, ---
Na Repair Needed 10 Year ❑
__. _ r Partial Repair Made �Ltt Year ❑
® _ ... __... New Installation 25 Year°