Loading...
P-15677 PERMIT P-15677 CUPERTINO SANITARY DISTRICT Santa Clara County 20065 Stevens Creek Blvd., Bldg C, Fax (408) 253-5173 Cupertino, California 95014 Phone (408) 253-7071 CONNECTION PERMIT R.O.S./P.M./Tract No. Lot No. _Is-''ll A.P.N.: Book 36)9 Paged ( Parcel m b Date Ju /t, Property Owner. l�da A G 0,f �r/[ `5 Mailing Address: !a [C (If different) Telephone: Sirs: (I/We), being the owner(s) (owner's agent), hereby make application for connection of the property at: / fQ if 86 MAIAn(1M LAtJE CyPEF-T7.Uo consisting of the following TYPE OF BUILDING(S): Residential: Single Family; Multiple Family ; No. Units Commercial , Industrial ; Other ; No. Units do hereby request a permit to connect to the sewer system of the Cupertino Sanitary District. IN CONSIDERATION OF THE GRANTING OF THIS PERMIT,THE OWNER AGREES: 1. To comply with all existing Ordinances, Rules and Regulations of the Cupertino Sanitary District as now or hereafter amended. 2. To maintain the House Sewer(that portion of the sewer within private property) which includes a cleanout (raised to grade and accessible) located at the point of connection with the Lateral Sewer (that portion of the sewer in the street right-of-way or District Easement). / I 3. To acquire a Plumbing Permit from the C� of Building Department and obtain inspection and approval by said Building Department prior to covering of the work or use of the sewer. 4. To first expose and inspect for serviceability the Lateral S)ver (that portion of the sewer within the street right-of-way or _ easement), prior to starting construction of the House Sewer."' 5. That this permit does not constitute a request for the issuari,b of an encroachmen) permit for sewer construction in the street/public right-of-way of the agency having jurisdiction thereover. 6. To call Underground Service Alert (USA) 1-800.227-2600, at least 48 hours prior to starting grading or digging operations. i SPECIAL PERMIT CONDITIONS(Exhibits): ® A BACKFLOW Protective Device shall be installed on the above property by the owner. Type of device and installation _ shall comply with the Plumbing Code Requirements of the jurisdiction shown in 3 above. FEES: �y 0 Connection Permit Fee: V>-mo.: J $ '//'�'Bp Sewer Service charges to June 30, 1917 ,$ 1 1)tr /mo.x V> mo.: $� Inspection Fee for backflow protection device: $ / 50 Considerations and Restrictions of this Sanitary Sewer Connection Permit with attached Exhibits (when noted), are hereby agreed to and acknowledged by the undersigned Owner(or Owner's Agent). Failure to comply will void this permit. Acknowledgment:^; Owner's Agent: (print name) Receipt of$ 2Z/ acknowledged and permit granted. MARK THOMAS&CO., INC., DistrictManager-Engineer Note:See Details on other side of this permit. TYPICAL CLEANOUT FOR LATERAL SEWER Distance from Property Line to be as close as practicable, W not to exceed five(5) feet. C J Ay Removable Cleanout Plug n 0 CL Finish Grade Wye for Riser Sewer Cleanout Boz with Lid to be accessible and maintained by property owner. Short length Riser Pipe Adaptor coupling 1/8 Bend FLOW m Lateral Sewer House Sewer Lateral Sewer slope House Sewer slope determined by District determined by building department —CLEANOUT TO BE SAME SIZE AS LATERAL SEWER— Notes: 1. Distance from the property line not to exceed five(5')feet. 2. Property Line Cleanout, Lateral Sewer Cleanout,to be same size as Lateral. 3. The maintenance of the Lateral Sewer Cleanout is the responsibility of the Property Owner. 4. House sewer minimum slope determined by local Building Department plumbing code requirements of the agency having jurisdiction thereover. TYPICAL BACKFLOW PROTECTIVE DEVICE INSTALLATION TYPICAL BACKWATER VALVE TYPICAL KELLY VALVE INSTALLATIONS INSTALLATION Jurisdictional Restrictions Accepted By All Jurisdictions FIGURE I FIGURE 2 FIGURE 3 Installed Below Grade Installed Below Grode metalled Above Grade Shown Between Street Riebi-oFWoy and Building Shown At or aperty Line Cleanout Shown Adjacent To Building Requires Regular Maintenance z Requires Minimum Maintenance Requires Minimum Maintenance Valve To Be Removable Valva Should Be Removable VALVE ACCESS BOX FINISH FLOOR is wuhivented Cover oA Level or FINISH FLOOR KELLY VALVE .N f Finish Grode A ACCESS BOX KELLY VALVE �'""""]]7����I Finish Grade Finish Grade g A c n i BACKWVALV FLOW Dl FLOW l9 FLOW J0' Notes: 1. The Backflow protective device to be located on site in the house sewer. 2. The type, location and installation of the Backflow Protective Device shall comply with the local Building Department plumbing code requirements of the agency having jurisdiction thereover. 3. Device to be accessible and maintained by the Property Owner. 4. If a Kelly Valve is installed at Property Line, it is to be readily removable for Lateral Sewer Maintenance.