1575 Sherwood Ct - Inspection Form4111
LIty oi • a o
Residential Sanitary Sewer Service
Compliance Inspection
Date (2 Y/ ` / , {61
Name ,e Z CZ - °e Disk #
Alternative Mailing Address
r
Compliance
F r
No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Proper Owner
f • ro g
Time • • ° gram
0
f
I
Owner /Occupant Signature
Q
PID Number
House Number Street Name
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
Record Number - k i-
Phone r' s i e yS7$
0 d am
Time f l • 3 £ �V pm
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Number of stacks / Entered S L.at
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition i Ni J f �a A If / 4 • tr= 1 '^ ✓ ,1 /i_f �, / /i L' : ��i� . Z1
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout: ✓ ]�
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes --,. t r'A-c> f ` ,
� , . 7 - 2
�' i " ` Z "\'/< 0C .. t._h D
0 vvice.: ; �� 0,- ri (-4-4,- ,f_=-.7.7 t''' ,c, y
1(
y eatozV K ,.9,-,-.u.,
AIf .
Total
Sump pumps
Foundation drains
14e
Roof drains
7
MEI
4111
LIty oi • a o
Residential Sanitary Sewer Service
Compliance Inspection
Date (2 Y/ ` / , {61
Name ,e Z CZ - °e Disk #
Alternative Mailing Address
r
Compliance
F r
No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Proper Owner
f • ro g
Time • • ° gram
0
f
I
Owner /Occupant Signature
Q
PID Number
House Number Street Name
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
Record Number - k i-
Phone r' s i e yS7$
0 d am
Time f l • 3 £ �V pm
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Number of stacks / Entered S L.at
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition i Ni J f �a A If / 4 • tr= 1 '^ ✓ ,1 /i_f �, / /i L' : ��i� . Z1
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout: ✓ ]�
Pink Copy: SEH