4621 Stonecliffe Dr - Inspection FormCity o[ 'apt
Residential Sanitary Sewer Service
Compliance Inspection
f s�
Date 2°I_ s / f -
1
Name 1 fi Disk#
MD Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Sag /Pipe Deflection
Damaged Pipe
3 r
Transition il .
4" to 6" Transition:
White Copy: Property Owner
OwnerlOccupant Signature
i C / //� 00 am
Time Ii /o pm
l3
Street Name
f•�
Length of Service:
■111•1.
Yellow Copy: City of Eagan
Record Number
r 1,- -7 -- -- am
T ime It t. o pm
Phone
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
r r..�
r Inspectorlignature
Obstruction
Unable to push past
feet .
r
1
r
•
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S.L.at;:"
Roots
Poor Pipe Joints
Mineral Deposits
Final Cleanout:
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
Total
Sump pumps
Foundation drains
/ 1J
Roof drains
r
City o[ 'apt
Residential Sanitary Sewer Service
Compliance Inspection
f s�
Date 2°I_ s / f -
1
Name 1 fi Disk#
MD Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Sag /Pipe Deflection
Damaged Pipe
3 r
Transition il .
4" to 6" Transition:
White Copy: Property Owner
OwnerlOccupant Signature
i C / //� 00 am
Time Ii /o pm
l3
Street Name
f•�
Length of Service:
■111•1.
Yellow Copy: City of Eagan
Record Number
r 1,- -7 -- -- am
T ime It t. o pm
Phone
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
r r..�
r Inspectorlignature
Obstruction
Unable to push past
feet .
r
1
r
•
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S.L.at;:"
Roots
Poor Pipe Joints
Mineral Deposits
Final Cleanout:
Pink Copy: SEH