SEWER LATERAL CERTIFICATE

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					Public Works Department Engineering Division

SEWER LATERAL CERTIFICATE
This certifies that the subject sewer lateral complies with the provisions of City of Berkeley Municipal Code Chapter 17.24.

Certificate Number: 07-00001234 Date Issued: February 12, 2007 Date Expires: January 29, 2027 Property Address: 123 MAIN ST, BERKELEY, CA 94701 Property Parcel Number: 055- -1234-055-00 Owner’s Name: STONEWASHED SAMANTHA Owner’s Address: 123 MAIN ST, BERKELEY, CA 94701 Submitted Documentation: CCTV videotape or DVD * Final inspection sign-off of sewer repair work; reference COB Permit # Final inspection sign-off of lateral replacement; reference COB Permit # 07-286 Other

_________________________ Jeffrey L. Egeberg Manager of Engineering JLE:AY
* The issuance of this certificate for compliance with BMC 17.24 does not constitute evidence of compliance with other applicable local, state, or federal laws, codes, and ordinances. Should the City become aware of any deficiencies either in connection with this application or as a result of future work requiring a permit, it may require abatement of such violations at any time, including when it performs sewer work or at such time any permit for sewer or building work is sought.

1947 Center Street, Suite 400, Berkeley, CA 94704-1155 Tel: 510-981-6423 TDD: 510-981-6903 Email: pwengineering@ci.berkeley.ca.us AF4

Fax: 510-981-6340