4272 Limestone Dr - Inspection Form
Residential Sanitary Sewer Service
City I I. Compliance Inspection
Date , 1 rj_l i i _ Time # 0 pm Record Number
Name! r ? . i'"%1 }'l Disk# Time Y'r~ # fp pm
_
PID Number,
House Number L' ~ Street Name 1 f}
Phone I ° . ,
Alternative Mailing Address
rP
Ownerl0ccupant Signature Inspector Signature
For information call 6S 1.470.2788
Compliance Non-Compliance Obstruction No Access
No foundation drain connection O Clear, water connections to Unable to push past O No one in
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,
No sump pump O Flexible sump pump piping
Service Lateral Inspection Findings Number, of stacks Entered S.L.at
Roots -
Poor Pipe Joints -
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
%4" to b" Transition: Length of Service: ! Final Cleanout: ! ; - ' l
Notes
Number Discharged
Total Correctly Incorrectly Unknown
Sump pumps
Foundation drains s
Roof drains '
White Copy: Property Owner Yellow Copy: City of Eagan Pink Copy: SEH