HomeMy WebLinkAbout1540 Hoover Avenue - SL - 2012.09.26 - 25 YearsCity of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address:
Owner:
Conlroclor Nome:
Cily Sloff Nome:
Tesled Dote:
Encroochment Permil #:
Buirdins Permir#: ?E- qZ5
M.C^va.Ir6-rr
Cleonoul locolion:D Front )( n"",n Left D Right
Foce of Curb
Commenls ond/ or
Skelch:
tr Existing n New tnstallation
Iesl Type:)K woter tr Air
Slolus:p Ro.t n Foil
Sewer Lateral Condition:
No Repolr Needed l0Year tr
Porliol Repoir Mode l0Year tr
New lnstollolion 25 Year x
l54O H,ooVr r t?.eIz
lolerol Size:
Cleonoul: