824 Ivy Lane - Inspection Form4111. Eit of Ea au
Residential Sanitary Sewer Service
Compliance Inspection
Date « / /7) /
/ ': ��
Name } " :.`r) Disk #
PID Number
2 ) 1
House Number: "' ` Street Name
Alternative Mailing Address
Service Lateral Inspection Findings
Owner /Occupant Signature
pliance
No foundation drain connection
No roof drain connection
,p Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Transition r
4" to 6 "Transition:
White Copy: Property Owner
L
}J
Time �! / • b pm
f
Length of Service:
Yellow Copy: City of Eagan
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Record Number !
i
Time • ./ •
•
/ 7
J
Phone - , .w. / L �. =
J 'f
Number of stacks Entered S. L.at
Inspector Signature
Obstruction
Unable to push past
feet
0,am
A P m
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
[•.�.� f !.- o f
' F Cleanout: ' -• "r ' ,y: -�'
Pink Copy: SEH
Total
Number
Correctly
Di
Incorrectly Unknown
Notes •.
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9
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Sump pumps
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( r,
t
Foundation drains
si,
i !
• .
Roof drains
%
4111. Eit of Ea au
Residential Sanitary Sewer Service
Compliance Inspection
Date « / /7) /
/ ': ��
Name } " :.`r) Disk #
PID Number
2 ) 1
House Number: "' ` Street Name
Alternative Mailing Address
Service Lateral Inspection Findings
Owner /Occupant Signature
pliance
No foundation drain connection
No roof drain connection
,p Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Transition r
4" to 6 "Transition:
White Copy: Property Owner
L
}J
Time �! / • b pm
f
Length of Service:
Yellow Copy: City of Eagan
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Record Number !
i
Time • ./ •
•
/ 7
J
Phone - , .w. / L �. =
J 'f
Number of stacks Entered S. L.at
Inspector Signature
Obstruction
Unable to push past
feet
0,am
A P m
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
[•.�.� f !.- o f
' F Cleanout: ' -• "r ' ,y: -�'
Pink Copy: SEH