4750 Cypress Pt - Inspection Form
Residential Service.
city kr I+i Compliance Inspection
Date r ! Time 1 pm Record Number,
! ~o am
t } p8°~
Name ) / 1' Disk# Time PM
PID Number,
House Number 4-- 7 E Street Name
Alternative NlailingAddress Phone
[:~~ant Signature f - Inspector Signature
For information call 651.470.2788
Compliance Non-Compliance Obstruction No Access
~0 No foundation drain connection O Clear water connections to Unable to push past O No one in
,Q No roof drain connection sanitary sewer feet. O Access to service
O Service lateral defects lateral needed
Sump pit not connected to 0 Defective manholes
sanitary sewer O Inspection
V O Sump pump connected to sanitary refused
ZC+ Sump pump properly piped sewer
O No sump pump O Flexible sump pump pipin`g-
Service Lateral Inspection Findings Number- of stacks f Entered S I~ at
Roots
Poor Pipe joints -
Mineral De-osits i1 - -
Sag/P
Damaged Pipe -
Transition
64
4" to 6"Transition: Length of Service:,, _e-Final Cleanout:
Notes r
12 -~r 7611
fTo al Correctly Incorrectly Unknown t L, 7,
Sump pumps
Foundation drains
Roof drains
White Copy- Property Owner Yellow Copy: City of Pagan Pink Copy: SFH