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P-15665q�,.4 <+z•�,1 'ht'>•WF" __ �. �1 ,�',nw„lHa'��+i����.v:M«=s—�i�;^==r-=:::; .. :ry t' Y•,-.. -..y. qy., v ..: x .. w `f 1 -• f , ;PERMIT P-15665 CUPERTINO SANITARY DISTRICT ' 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. S367 Lot No. .7 A.P.N.: Book y1� Page Parcel / 2-7— Date Property Owner: p55 Ve,4-44j r o 5 Mailing Address: ';'/ 4-t e-vi e 5 (If different) Telephone: P.lr Sirs: (I/We), being the owner(s) (owner's agent), hereby make application for cpnnection of the property at: Lt Gtil/l & -// - consisting of the following TYPE OF BUILDING(S): Cv -3( _ -3 g Residential: Single Family , Multiple Family X; No. Units ZO 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 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. To acquire a Plumbing Permit from the of Building Department and obtain inspection and approval by said Building Dep artmenVror to covering f 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 streetiright-of-way or easement), prior to starting construction of the House Sewer. 5. That this'permit does not constitute a request for the issuance of an encroachment permit for sewevonstruction"in the street/public right-of-Jay of the agency havin'juriijdiction thereover. 6. To call UndergroundServiceAlert(USA) 1.800-227-2600, at least 48 hours prior to startng grading or digging operations. tl ' ) SPECIAL PERMIT CONDITIONS(Exhi Its NO Y 14Y-5 / t-A-L -1-70IJ 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: 1 Connection Permit Fee: fir' $ Sewer Service charges to June 30, 19 ,$ �o00mo.x_ mo.: ,/- -,/1' #/ $ d Inspection Fee for backflow protection device: 60-JA 5 (.�v L (�' f $ / �>�4zt Lo ., 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:641 aoO n / Owner's Agent: .LGA. COOD..eft , fprfnt name) Receipt of$ �acknowledged and permit granted. MARK THO & CO., INC., District Manager-Engineer by: _ Note:See Details on other side of this permit. TYPICAL CLEANOUT FOR LATERAL SEWER Distance from Property Line ii practicable, m IS') feet. c J T Removable Cleanout Plug n a a` h Grade Wye for Riser wer Cleanout Box with Lid to be accessible d maintained by property owner. Short length r Piped Adaptor coupling FLOW m' Lateral Sewer House Sewer Lateral Sewer slope House Sewer slope determined by District determined 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 Junvamtlonal Rovinlone ACcl BY All Juriediviane FIGURE I FIGURE 2 FIGURE 3 Installed Below Grade Installed Below Grade InUalled Above Grade shown Be,nun Strut Rehl-al-Way no Bnitdlne Shown At Properly t+ne Cleaaaul Shown Adlacut To Buddma Requires Regular Mointenonca z Requires Minimum Maintenance R.Vuwn Minimum Malnbnonc• Valve To Be Removable Valve Should Be Removable F VALVE ACCESS BOX FINISH FLOOR W with/Ve lea Covu A. T KELLY VALVE If Ale d VALVE ACCESS Bo% EFinish GradeFinish Grade � m BACKWATER VALVE F0�_Al FLOW dT FLOW sl 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.