HomeMy WebLinkAbout1115 Capuchino Avenue - SL - 2023.11.22 - 10 YearsCity of Burlingame
Public Works Department
Sewer Lateral Test Gertificate
Tesled Dole:
Building Permil #:
t
Encroochmenl Permil #:
Address:
Owner:
Conlroclor Nome:
Cily Stoff Nome:
I
Cleonoul [ocolion:D Front }(Rear tr Left tr Risht
D Existing D New tnstallation
Tesl Type:Woler8 tr AirLolerol Size
Cleonout:
Commenls ond/ or
Skelch:
)x Poss tr Foit
\C o
Sewer Lateral Condition:
No
Portiol Mode 10 Year
10 Year D
New lnstollolion
M . f -a\u^ \'. -- ,
I
25Year D