15074 (2) - - SEWER CONNECTION PERMIT SENO L P No 1-5074
AUPERTINO SANITARY DISTRICT R.O.S./P.M./Tract No.............. Lot No.:............
20065 Stevens Creek Blvd. A.P.N: Bk.13a5_.17.. . Pg.. ..... Par.P.9.//
Building C
Cupertino, California 95014 [�-,
Phone(408)253-7071 Date.,[�`'9 I.4....2.5................. 199.Q
The undersigned,being the owner(or owner's agent)of the property located at ........................................................
consisting of the following TYPE OF BUILDING:
Residential: Single family.../, ...... Multiple............ No. Units............
Commercial.......::... Industrial............ Other............ No. Units........:...
does hereby request a permit to connect to the sewer system of the Cupertino Sanitary District.
In consideration of the granting of this permit,the undersigned agrees:
1) To comply with all existing regulations and Ordinances of Cupertino Sanitary District and all future regulations and
Ordinances which may be adopted.
2) To maintain the house sewer(that portion of the sewer within private property)and to provide access to the lateral sewer through
a cleanout raised to grade at the property line or at the limits of any existing District easement. (Note—Detail J)
3) To acquire a permit from the . .�.X1.0..................................... Building Depart-
I` • ment and obtain inspection and approvhl 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 sewer prior to starting construction of the house sewer.
Property Owner's Name.V a,�r i B.....'�/v.�/Q ................ Telephone..�`f,`f�.-.2.!.;FL/ ..............
Mailing address if _
different from above...s .(Z:_............................................. ....................................
By..... ..........................
❑ A standard backflow protective device shall be installed, to the satisfaction of the Building Department, for the above
property. (Note—See Detail/)
FEES:
Connection Permit Fee s
o m
rry g. ..
Sewer Service charges to June 30, 195
.!.�.., $.... ...../1110. x. ..mo. V.
Inspection Fee for backflow protection device
t TOTAL $�
Receipt of$ .... acknowledged and permit granted. MARK THO AS &CO. INC., District Manager-Engineer
B ...... -
Y
NOTE.See Details on other side of this permit
CUPERT/NO SANITARY D/STR/CT
NOTES: 411 valves,lo De•accessible and maintained by Properly Owner.
Overflow point at least twelve Inches(12') below lowest finished
floor containing plumbing.
Kelly Valva installed of Property Line to be readily removable s
for Loterol Sewer maintenance,
t
I
u Finish Flo r Leval t 'go-
ry 2$
Kelly Valva Finish Floor Level
Finish Gentle •N{IE
Kelly Valv �E15
T
Valve e
m
Vented
B y
W llh Vented G Ver Va Ve QLLe66 BOY
Backwater Valve
_FLOIN
Figure I I Figure 2 Figure 3 ,
Kelly Valve- Below Surface Backwater Valve—Normally Kelly Valva-Above Ground
Installation-Shown at required installed Ins
al shollowesl point IaslnlI.tion-Shown lalletl
Property Line Cleancul. along House Sewer between close to building,
•-
Property Line`and building.
STANDARD BACKFLOW PROTECTIVE DEVICE {INSTALLATION DETAIL
t .
Distance from R to be as
close as practicable,
J
Removable Cleanout Plug -
a. Finish Grade
.l Wye for Riser
Sewer Cleanout BOY with Lid to be accesslDle t
and maintained by property owner.
' Short length �Riser pipe
Adaptor coupling 1/8 Bend
FLOW n
Home Sewer
• Lateral Sewer � • 4
as-----I TES slope determined by Building Deportment.
dj •LtIl.y¢�ly Sewer Cleanout to be same
size Hs Lateral Sewer, t
Air
i
STANDARD •CLEANOUT ; FOR LyTERAL SEWER GEJL
y
f/1