HomeMy WebLinkAbout1353 Couombus Ave - SL - 2024.10.29 - 25 YearsAddress: Owner: 1: ::S \.\a,,6 �,:'.> Contractor Name: \ ) 'w:2 WI. e. ') City Staff Name: Cleanout Location: Lateral Size: Cleanout: Comments and/ or Sketch:
Address:
Owner:
Contractor Name:
City Staff Name:
Cleanout Location:
Lateral Size:
Cleanout:
Comments and/ or Sketch:
�Front D Existing � New Installation
� Front
L--\ \ '
D Existing 12!1, New Installation
□RearFace of
D Rear
Curb
Face of Curb
City of Burlingame Public Works Department Sewer Lateral Test Certific�te Tested Date: Building Permit#: )? "l 3 - o l 11.Encroachment Permit#: □left □RightTest Type: * Water □ Status: Pass □ Air Fail Sewer Lateral Condition: Exemption Type· No Repair Needed 10 Year □ Partial Repair Made 10 Year □ New Installation 25 Year �
City of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Tested Date: \o \ 1.. '\ I 1-�1
Building Permit #: 'p 1-"3 - o oS _)
Encroachment Permit#: ---------
□Left □Right
Test Type: A Water □Air
Status: .� Pass □Fail
Sewer Lateral Condition: Exemption Type:
No Repair Needed l0Year □
Partial Repair Made 10 Year D
New Installation 25 Year w