4863 Knottingham Cir - Inspection FormCity of Eagto
Residential Sanitary Sewer Service
Compliance Inspection
Date / 1
Name
PID Number
House Number -5i Street Name
4" to 6" Transition:
Compliance
0 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
White Copy: Property Owner
Time ji ' . • 'Q pm
Disk #
Owner /Occupant Signature
Number. of stacks
Length of Service:
Alternative Mailing Address Phone "!
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
Yellow Copy: City of Eagan
Record Number
Time �: ? w 7t O pm
•
EnteredSLat r
inspector Signature
Obstruction
Unable to push past
feet
For information call 65 1.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits,
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Number Discharged
Sump pumps
Foundation drains
Roof drains
Total
r ,
Correctly
1 10
/v'
Incorrectly
C r
Unknown
Notes
Pink Copy: SEH