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SEWER CONNECTION PERMIT SERIALNO. P y` '15208
CUPERTINO SANITARY DISTRICT R.O.S./P.M./Tract No....?.V... Lot No....9.......
20065 Stevens Creek Blvd. A.P.N. Bk..:✓'4Z...... Pg..�...... Par.00..�..
Building C
Cupertino, California 95014
Phone (408) 253-7071 Date. .......... 19.r�
The undersigned,being the owner or orvner's agent)of the property located at
..........................................................................................
consisting of the following TYPE OF BUILDING:
Residential: Single family.....K. 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
40 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 ... ..l..1 g Depart-,,,
C.� ... .....�?.�...�-��/"�,r%� ...�G�a.:................... Buildin De art-.�
ment 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 sewer prior to starting construction of the house
sewer.
Property Owner's Name... 7./n, '.... !�� ............. Telephone (-5/0) W / . ! 0G7
............
Mailing address if / / � �I / / �f p
different from above.. `�...SYl� 7G7ZJ.I1 �... a 7`?U....;�J1�,at.. d?..../�J��c�
F] A standard backflow protective device shall be installed, to the satisfaction of the Building Department, for the above
property.(Note—See Detail I)
FEES:
Connection Permit Fee $. CP..�........
�p p{ QJ
Sewer Service charges to June 30, l9 92, $.� .- ....../mo. x.G?..mo. ...c......
Inspection Fee for backflow protection device
TOTAL $�
ew
peceipt of$'A��' . ... acknowledged and permit granted. MARK
THOMAS&CO. INC., District.Manager-Engineer
By. ...............................................
NOTE.•See Details on other side of this permit
CUPERT/NO SANITARY DISTRICT
NOTES. All valves to be accessible and maintained by Property Owner.
Overflow point of least twelve inches(12') below lowest finished
floor containing plumbing.
Kelly Valve installed at Property Line to be readily removable
for Lateral Sewer maintenance.
J.
s �
J
a Finish Floor Level Finish Floor Level
a ~'E —Kelly Valve —(—
Finish Grade NLS
Kelly Valve J]-E
v
Valve Access B D. ^ m'
with Vented Ckuur q-E Valve Access Bos 'E
Backwater Volve -- --
Figure I Figure 2 Figure 3 .
Kelly Valve- Below Surface Backwater Valve-Normally Kelly Valve-Above Ground
Installation-Shown at required Installed at shallowest Point Inslallolian-Shown installed
Property Line Cleououf. along House Sewer between close fo building.
Property Line and building.
DETAIL
STANDARD BACKFLOW PROTECTIVE DEVICE INSTALLATION I
Distance from R to be As
close as practicable.
J
Removable Cleanout Plug
.a. Finish Grade
who
Wye for Riser
—Sewer Cleanout Bos with Lid to be accessible
and maintained by property owner.
Sher! length �Riser Pipe '
Adaptor coupling I/B Bentl
_ ,FLOW m
Lateral Sewer I House Sewer �nimum slope determined by Building Department.
Lateral Sower Cleanout to be same
size a Later of Sewer.
DETAIL
STANDARD CLEANOUT FOR LATERAL SEWER J