Sanitary Letter_1CUPERTINO SANITARY DISTRICT
20863 Stevens Creek Blvd#100,Cupertino,CA 95014
Tel(408)253-7071 -Fax(408)253-5173 esnEo+''6 CUPERTINO
SANITARY DISTRICT PERMIT IETTER
Cupertino Sanitary District has adopted Resolution No. 1263.
Building Permit Request
Over-the-Counter)
Single Family Project Multi-Family Project Commercial Project
Project Address: Z) ,`; x(
Permit Number: -'7_0
Scope of Work: 'ewRf
Owner/Applicant Name:TSV kS l wQ`l Phone:
Address: S, `? JZ.
Date:
I'1 l/1(p/i Prepared By:
I '
City Authorized Representative
1,as property owner or authorized agent,acknowledge that all Cupertino Sanitary District requirements
will be met and all required fees will be paid prior to the approval of final inspection for proposed project.
Date: D Signature:
Owner f Authorized Agent
F-
17DCUPERTINO
SANITARY DISTRICT OFFICE USE ONLY
a
e-inspection Required Final Inspection Required
te Scheduled:
Date: Conditional Approval By:
Authorized Representative
Cupertino Sanitary District
District will notify owner of the required fee within 5 days after Pre-Inspection has been completed and cc
City of
CnFee
rro.
Inspection Fee Paid Date Paid:
1 s ctis:
250/unit-Single Family Residential already connected,but new cleanout is required
150/unit-Single Family Residential already connected with existing cleanout in working order
350 Minimum—Commercial and Retail Actual Amount:
O $200/each—Disconnect and/or abandon lateral service
Connection Permit Fees:
D $350/unit-Single Family Residential connecting to existing lateral
D $650/unit—Single Family Residential connecting with new lateral
D $100/unit—Multi,Hotel,Living Units,etc. Actual Amount:
D $500/connection-Commercial and Retail Actual Amount:
Connection Use Fees(See Attached Calculation Sheet):
D Area and Frontage Fees Amount:
D Residential Excess Fees over 3.5 unit/acre Amount:
Commercial and Retail Connection Fees Amount:
O Commercial and Retail Change in Use Fees Amount:
Date: L`— —(Final Approval By:
uthoriz d r sentative
Cupertino S2nita District