HomeMy WebLinkAbout1901 Carmelita Avenue - SL - 2001.11.05 - 25 YearsCity of Burlingame
Public Works Department
Sewer Lateral Test Certificate
Address:
Owner:
Controclor Nome:
Cily Sloff Nome:
i!\r.'red Dore:t\-5 - o\
oBuilding Permit #:
Encroochmenl Permit #:
Cleonoul tocqlion:D Front tr Rear n Left tr Right
toce of urb
Lolerol Size:
Cleonoul:
Commenls ond/ or
Skelch:
Test Iype:.)Kwoter tr Air
tr Existing Hruew lnstallation Slolus:)uapo.t tl Foil
Sewer Lateral Condition:
No Needed 10 Year
Portiol Mode 10Year
New lnstollollon 25 Year