4619 Cambridge Dr - Inspection FormCity of 1a p
Residential Sanitary Sewer Service
Compliance Inspection
Dated ] / ) ;
Name fi. •" j /i / - Disk #
PID Number
House Number.
0 No sump pump
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
Service Lateral inspection Findings
• (i{1 , 0 am
Time i • o pm
Street Name
d2
Fizi I—
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Alternative Mailing Address
L ..c
Time
Number of stacks I Entered S.L. at
one , l D _. ,' ; J
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Roots
PoorPipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 4 4 -
�`1k} am
0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
f
Pink Copy: SEH
Number Discharged
Correctly Incorrectly
Unknown
Notes
)
41 � , ' () - = ' r,s ; �,--::'-'--3 l % / ? c' f i' 4
n ! 1
fr
Total
Sump pumps
®-
--®
Foundation drains
Roof drains
s
City of 1a p
Residential Sanitary Sewer Service
Compliance Inspection
Dated ] / ) ;
Name fi. •" j /i / - Disk #
PID Number
House Number.
0 No sump pump
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
Service Lateral inspection Findings
• (i{1 , 0 am
Time i • o pm
Street Name
d2
Fizi I—
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Alternative Mailing Address
L ..c
Time
Number of stacks I Entered S.L. at
one , l D _. ,' ; J
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Roots
PoorPipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 4 4 -
�`1k} am
0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
f
Pink Copy: SEH