812 Ivy Lane - Inspection Form
Residential Sanitary Sewer Service
City ! ilr Compliance Inspection
Time • o Pm Record Number J -
Date_,
am
dame j21.1'11 °Disk # /Z f Time _ • o pm
_
PID Number,
House Number =ri Street Name F I/'
s~ a
Alternative Mailing Address Phone
OwnerlOccupant Signature f Inspector Signature
For information call 651.470.2788
Compliance Non-Compliance Obstruction No Access
No foundation drain connection O Clear water conrections to Unable to push past O No one in
No roof drain connection sanitary sewer feet. O Access to service
O Service lateral defects
O Sump pit not connected to lateral needed
O Defective manholes
sanitary sewer O Inspection
O Sump pump connected to sanitary refused
O Sump pump properly piped sewer
X No sump pump O Flexible sump pump piping
Service Lateral Inspection Findings Number, of stacks - Entered S. L. at
Roots
PoorPipejoints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe -
r Transitions
4" to 6" Transition: Length of Service:. Final Cleanout:
Notes
r Discharged
Nu
mbe
Total Correctly Incorrectly Unknown
j
f
Sump pumps
F
Foundation drains
Roof drains r
White Copy: Property Chvner Yellow Copy: City of Eagan Pink Copy- SEH