HomeMy WebLinkAbout1471 Burlingame Avenue - SL - 2015.01.02 - 25 YearsCITY.. �
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City of • .
Public Department
Sewer Lateral Certificate
Address; , Tested Date:
Owner: Building Permit #:
Contractor Name: Encroachment Permit #t:
City Staff Name:
Cleanout Location: El Front El Rear El Left El Right
Face of Curb
Lateral Size: Test Type: J,NaterEl Air
.e
Cleanout; El Existing"� New Installation Status:Ilk' Pass El Fail
Sewer Lateral Condition
Exemption Type:
No Repair Needed
10 Year El
Partial Repair Made
10 Year E
New installation
25 Year lb,i