4265 Moonstone Dr - Inspection Form
Residential
k rlr Compliance Inspection
Date : L 1 ~5 1_1&52_ Time /0 • O Pro Record Number r~
it C.f • O am
Name t . rf Disk Time • O PM
PID Number ,
House Number > Street Name
Alternative Mailing Address ,-0 Phone!?<
aivnerlOccupant 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
g No roof drain connection sanitary sewer feet O Access to service
O Service lateral defects lateral needed
O Sump pit not connected to O Defective manholes
sanitary sewer O Inspection
O Sump pump connected to sanitary refused
O Sump pump properly piped sewer
i'6 No sump pump O Flexible sump pump piping
Service Lateral Insp ction Findings Number of stacks Entered S L. at P7 -
Roots ``U •J'J'~St1' -
Poor-Pipejoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6"Transition: Length of Service: Final Cleanout:
02
Notes r"
Number • n 'his a e X
Total Correctly Incorrectly Unknown m`r C 6-)D
Sump pumps
Foundation drains
Roof drains
White Copy: Property Owner Yellow Copy- City of Eagan Pink Copy: SEH