P-15662 (2) PERMIT P-15662
Zs
CUPERTINO SANITARY DISTRICV -
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. g79 Lot No. �l
A.P.N.: Book --3/&_Page / Parcel Date SIU I� P S , /996-1
Property Owner: F155 VC.A& YC'S
Mailing Address: Cr ayatrS Pr—��
(If different) dC
Telephone: �54µ C `Q't'ar C,* 9.J�
coo
Sirs:
(I/We), being the owner(s) (owner's agent), hereby make application for connection of the property at:
20 S t a v/5 - ll - l� G� U
consisting of the following TYPE OF BUILDING(S): o` 2 — Z�$
Residential: Single Family ; Multiple FFaamil y $ No. Units 91
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 anis -
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. To acquire a Plumbing Permit from the n of C1J .( ria Building Department and obtain
inspection and approval by said Building Department rior to covering of the work or use of the sewer.
4. To first expose and inspect for serviceability the Lateral Sewer (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 doe not constitute a request for the issuance of an encroachment permit for sewer construction in the
street/public right-of= ay of the agency havin&juri�sdict on thereover>4
6. To call Underground Service Alert(USA)1-800.227-2600, at least 48 hours prior to starting grading or digging operations.
SPECIAL PERMIT CONDITIONS(Exhibits)), O ly /�.¢ Ln i Ecnnrcl rr
�G.t l cY L�t G GL 5r fxt.�t e � 54 a ' �Y om' L4tG
❑ 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:
Connection Permit Fee: �
$ �—
Sewer Service charges to June 30, 199` 's 36mo. x _mo.: / $
Inspection Fee for backflow protection device: �I U t�lYe ( ��¢��` $
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: Z-e e (SOD fog <
(prin name)
Receipt of$ acknowledged and permit granted.
MARK THOM & CO., INC., District Manager-Engl,leer
by:4z
r i
Note:See Details on other side of this permit.
i
TYPICAL CLEANOUT FOR LATERAL SEWER
Distance from Property Line
to be as close as practicable,
m not to exceed five IS) feet.
J
T
`w
Removable Cleanout Plug
6
O
G. Finish Grade
Wye for Riser Sewer Cleanout Box with Lid to be accessible
and maintained by property owner.
Short length Riser Pipe
1/B Bend
Adaptor coupling
—FLOW m'
LGleral Sewer House Sewer J.
Lateral Sewer slope House Sower slope
determined Dy District determi had 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 Jurisdiction$
FIGURE I FIGURE 2 FIGURE 3
Installed Below Grade Installed Behave Orad. Installed Above Grade
Shown Between street Rightot-Way and Building Shown At property Line Cl....ul Shown Adjacent To Building
Reduirws Rpular Maintenance2 Requires Minimum Maintenance R.aulre.Minimum Maintenance
J Valve To Be Removable Valve Should e.Rempvoale
> VALVE ACCESS BOX FINISH FLOOR
no wlth/Vent.dCorer
C FINI HFLOOR KELLY VALVE
T '9 f InMh Grad.
VALVE ACCESS BOX KELLY VALVE d y'
Fmi.h Grade
,Flni.h Grade n
at
m
BACKWATER
VALVE
FLOWS FLOW A' � FLOW A'
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.