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P-15559 / � ��|T �~"� �� - . �-^ ^`".. . »� ��~v~».�~» ��/�,k �� ^��o � �~,°, ,-.. �~. .. ., 20065 Stevens C �okBNVDNOC (4 08) 253-5173 Cupertino, um /4 Phone (408) ,' ^ ' ' ^ CONNECTION PERMIT R.O.S./P.M./Tract No. 46U Lot No. ' A.P.N.: Book____________PaQa______Parcel Date Property Owner: � Mailing Address: (If different) C If | To\opknno: Sirs: (I/We), being the r(s) (own ,'s agent), hereby makeopplicai for connection WNopro Ay� consisting of the following TYPE OF BUILDING(S): Residential: Single Family ; Mv|Up|oFumi|y________; No. Vnito Commoociu|_______; Industrial_; V(hor__________; No. Vnits________ dohereby request apermit tuconnect tothe sewer system ofthe Cupertino Sanitary District. |NCONSIDERATION OFTHE GRANTING 0FTHIS PERMIT,THE OWNER AGREES: 1. To comply with all existing Ordinances, Rules and Regulations of the Cupertino Sanitary District as now or hereafter amended. 3. Tnmaintain 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). 3. Toacquire uPlumbing Permit Building Department and obtain inspection and approval by said Building Department p1rior to covering of the work or use of the sewer. 4,�Tnfim1expose and inapo�� for oomicauhi|itythe Lateral Sewer (that poAiono/ the sewer vvithinthe ��,eat ,iUht-of'wayor � euoumonV. prior tostarting construction nf the House Sewer. 5, That this permit does not constitute arequest for the issuance ofanencroachment permit for sewer construction inthe street/public right-of-way of the agency having jurisdiction thereover. | 6. To cail'u'ridergrourid Service Alert i 1^WU0^22T'�6O0.'a1least 4i'hours p'orN startinggrading nrdigging u ' rotinno. ' SPECIAL PERMIT CONDITIONS(Enh|bits): " � A BACKIFLOW Protective Device shall be installed on the above property by the owner. Type of device and installation L~� shall comply with the Plumbing Code Requirements of the jurisdiction shown in3above. PEES; Connection Permit Fee: $ ^ ��/ �cxgL Sewer Service charges toJune 3¢ ly-fL��'*-��^-��-/000� x ��,_ nn.: $ \ Inspection Fee for MackYlow protection device: $ 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: ep ,r""''""'"/ Receipt of s 112, acknowledged and permit granted. ' MARK THOMAS&CO.. |WC., District Manager-Engineer Note:See Details onother��eo/�U�;Ponn� ,�� TYPICAL CLEANOUT FOR LATERAL SEWER Distance from Property Line to be as Close as practicable, not to exceed five(5) feet. c 21 J m Removable Cleanout Plug OIL a 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 Lale� House Sewer Lateral sewer elope House Sewer Slope determined by District determined by building deportment —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 Jurisdiction$ FIGURE I FIGURE 2 FIGURE 3 Installed Below Grade Installed Below Grad$ Installed Above Grade Shown Beheun Blrpl Riyhl-of-Way and Building Shawn At Placers Line Clronoul Shawn Adjacent To Building Rsamres Regular Mulnlenance 2 Rabbiru Minimum Maintenance Ream... Minimum Mamlenance Valve To Be Removable Valve Should Be Removable > VALVE ACCESS BOX is wllh,varad Cover FINISH FLOOR ° I FINISH FLOOR KELLY VALVE A. d w_'= Inion Grade VALVE ACCESS BOX KELLY VALVE F �L Finish Grade Finish Grade 9 t BACKWATER m VALVE FLOW s FLOW i i FLOW r 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,