1425 Rebecca Lane - Inspection Form46. Cm of tam
Residential Sanitary Sewer Service
Compliance Inspection
Date a 1 fo / /
r
Name / -' ?'A r r fa) Disk #
PID Number /
House Number / Z
Alternative MailingAddress
For information call 651.470.2788
Compliance
S /No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
X No sump pump
Service Lateral Inspection Findings
Roots
Poor Pi peJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition . ,� J
4" to 6" Transition:
White Copy: Property Owner
t
� • 0 am
Time s �, # lo--p m
r•
V
Street Name
OwnerlOccupgot Signature
Non - Compliance
O
O
O
0
0
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
3
Number of stacks
Yellow Copy: City of Eagan
0
471 41 "V
Length of Service: /o
Record Number
Phone (g / 1 /5 -( 7 - - 6
Ii
/Inspector Signature
Time s s cill'aprnm
Obstruction
Unable to push past
feet.
No Access
O No one in
EnteredS.L.at
F a,L Creanout: 3 -
. r,✓ f,.
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
{�
_ _. N °_.—
., ____
11111111111
MEN
Foundation drains
Roof drains
46. Cm of tam
Residential Sanitary Sewer Service
Compliance Inspection
Date a 1 fo / /
r
Name / -' ?'A r r fa) Disk #
PID Number /
House Number / Z
Alternative MailingAddress
For information call 651.470.2788
Compliance
S /No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
X No sump pump
Service Lateral Inspection Findings
Roots
Poor Pi peJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition . ,� J
4" to 6" Transition:
White Copy: Property Owner
t
� • 0 am
Time s �, # lo--p m
r•
V
Street Name
OwnerlOccupgot Signature
Non - Compliance
O
O
O
0
0
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
3
Number of stacks
Yellow Copy: City of Eagan
0
471 41 "V
Length of Service: /o
Record Number
Phone (g / 1 /5 -( 7 - - 6
Ii
/Inspector Signature
Time s s cill'aprnm
Obstruction
Unable to push past
feet.
No Access
O No one in
EnteredS.L.at
F a,L Creanout: 3 -
. r,✓ f,.
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH