No preview available
 /
     
1260 Deerwood Dr - Septic Maintenance Form 2022-09-0701 1IFF" Cityof EaTa 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Email: commdevelopment(&citvofeagan.com --------------------- For office Use I I ( Date Received: 2 2 2 ( I f i I Staff. --------- SEPTIC SYSTEM MAINTENANCE FORM Date Pumped: 7 ' f# of Tanks Pumped: Total Gallons Pumped: oOL-3 Site Address: Owner's Name: G tV L A- (Z M V Owners Address (if different from site): Maintainers Name:��� License Number. Private Residence: _� Commercial: Disposa': Location: #2 & - L. Condition of Baffles: 6 6(1 o Type of Tanks: Size of Tanks: Pumped Through: 'Ito/6 Effluent Sewage Discharge: Yes: No: V Comments: Please submit completed forms to the Building Inspections Division via mail, fax or email.