4370 Nicols Rd - Inspection FormAO
Eity al ka ap
Residential Sanitary Sewer Service
Compliance Inspection
Date f c 1 T ime 7_3 • pm
Name f ,/ /a,c7., ` 4A4"
PID Number
House Number � Street Name
Alternative Mailing Address
1!
, {f
--e/
Owner /Occupant Signature
For information call 651.470.2788
Compliance
,t foundation drain connection
l: No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Al No sump pump
4" to 6 "Transition: /,-///1A-
White Copy: Property Owner
Disk#
Non - Compliance
O
O
O
O
0
S 1�
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks
�;
Roots ��� l � �f � � "S rv\L 00A-Ce Aoot'S At
Length of Service:
Yellow Copy: City of Eagan
Record Number
F5- • 0am
Time • q pm
Phone
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
Entered SL. at C'
O Access to service
lateral needed
O Inspection
refused
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition (///
r
Pink Copy: SEH
Number Discharged
Unknown
Notes
Total Correctly Incorrectly
Sump pumps
PIIMMEIM
MEM
Foundation drains
Roof drains
`y ki-/
MEE
AO
Eity al ka ap
Residential Sanitary Sewer Service
Compliance Inspection
Date f c 1 T ime 7_3 • pm
Name f ,/ /a,c7., ` 4A4"
PID Number
House Number � Street Name
Alternative Mailing Address
1!
, {f
--e/
Owner /Occupant Signature
For information call 651.470.2788
Compliance
,t foundation drain connection
l: No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Al No sump pump
4" to 6 "Transition: /,-///1A-
White Copy: Property Owner
Disk#
Non - Compliance
O
O
O
O
0
S 1�
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks
�;
Roots ��� l � �f � � "S rv\L 00A-Ce Aoot'S At
Length of Service:
Yellow Copy: City of Eagan
Record Number
F5- • 0am
Time • q pm
Phone
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
Entered SL. at C'
O Access to service
lateral needed
O Inspection
refused
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition (///
r
Pink Copy: SEH