4877 Richard Lane - Inspection Form
Residential Sanitary Sewer Service
City I hyfl Compliance , -
~/""""7 GO am
Date T~_.__I Time pm Record Number
S r ` f J I~_ J .L' ip pm
Name Disk # i If Time m
PID Number /
House Number i--~ / .,7S-treet Name
Alternative Mailing Address Phone
Owner/Occupant Signature Inspector Signature
For information call 651.470.2788
Compliance Non-Compliance Obstruction No Access
O No foundation drain connection O Clear water connections to Unable to push past O No one in
r%41 No roof drain connection sanitary sewer feet - O Access to service
O Service lateral defects lateral needed
Sump pit not connected to O Defective manholes
sanitary sewer' O Inspection
O Sump pump connected to sanitary
O Sump pump properly piped sewer refused
O No sump pump O Flexible sump pump piping
service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Jai nts
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition`-
f
'L
4" to 6"Tr'ansition: Length of Service: - Final Cleanout: r 4"~
Notes
known
Total Correctly Incorrectly Unknown
lti
Sump pumps- sr _ a
Foundation drains
~ i
Roof drains
White Copy: Property Oumer Yellow Copy: City of Eagan Pink Copy: SEH