4836 Shevlin Ct - Inspection Form1111110- City of Ea i
Residential Sanitary Sewer Service
Compliance Inspection
Datel/
Name le
▪ = x;!34 Disk #
•,„ ' Oam
Time p
PID Number
House Number . Street Name _ ! �` r�-
Alternative Mailing Address
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe } i
Transition
4" to 6" Transition:
White Copy: Proper ty Owner
Owner /Occupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Non - Compliance
0
O
O
O
Service Lateral Inspection Findings
' j
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks 4 Entered S.L.at
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
'7
Phone 3
inspector Signature
Obstruction
Unable to push past
feet
•
• l pm
No Access
O No one in
Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
JLT
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
7 , .` K. Vi c:.
Total
Sump pumps
PP s P
Foundation drains
Roof drains
1111110- City of Ea i
Residential Sanitary Sewer Service
Compliance Inspection
Datel/
Name le
▪ = x;!34 Disk #
•,„ ' Oam
Time p
PID Number
House Number . Street Name _ ! �` r�-
Alternative Mailing Address
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe } i
Transition
4" to 6" Transition:
White Copy: Proper ty Owner
Owner /Occupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Non - Compliance
0
O
O
O
Service Lateral Inspection Findings
' j
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks 4 Entered S.L.at
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
'7
Phone 3
inspector Signature
Obstruction
Unable to push past
feet
•
• l pm
No Access
O No one in
Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
JLT
Pink Copy: SEH