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906 Lakewood Hills Rd - Septic Maintenance Form 2020-07-293830 PILOT KNOB ROAD | EAGAN, MN 55122-1810 (651) 675-5675 | TDD: (651) 454-8535 | FAX: (651) 675-5694 buildinginspections@cityofeagan.com SEPTIC SYSTEM MAINTENANCE FORM Date Pumped: # of Tanks Pumped: Total Gallons Pumped: Site Address: Owner’s Name: Owner’s Address (if different from site): Owner’s Email: Owner’s Phone #: Maintainer’s Name: License Number: Private Residence: Commercial: Disposal Location: Condition of Baffles: Type of Tanks: Size of Tanks: Pumped Through: Effluent Sewage Discharge: Yes: No: Comments: You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email updat e on the City’s website at www.cityofeagan.com/subscribe. Please submit completed forms to the Building Inspections Division via mail, fax or email. For Office Use Date Received: _____________________ Staff: ______________________________