4706 Walden Dr - Inspection Form40, - Ct of hp
Residential Sanitary Sewer Service
Compliance Inspection
/7 am
Date 1 / / Time 4_ ; • O pm
/1 j
Name � (. T ° : y r? I ) Disk #
PID Number
House Number ` / r' Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
�r� t
- Transition ` ter
4" to 6" Transition:
Sump pumps
Foundation drains
Roof drains
White Copy: Property Owner
Owner /Occupont'Signoture
Total
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
Number of stacks
F d(
Length of Service: / < - Final ';
Number Discharged
Correctly
Incorrectly
Unknown
Yellow Copy: City of Eagan
V
Record Number
Phone
Time
1 74
• ,__. , am
• _ pm
lnspector`Signature
Obstruction
Unable to push past
feet
Entered S -
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes
/ 4/
t
1f o�
Pink Copy: SEH