2026 Bluestone Lane - Inspection Form4 of ha p
Residential Sanitary Sewer Service
Compliance Inspection
Date I eV I / 1 - 4-)
Name &"•77 'ft/ t` 4J' Disk #
PID Number
House Number
Compliance
Owner/Occupant Signature
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
F. Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots % 3 ..''
}
Time V/ • L} c Pm
d
G
Street Name r Z./K
Record Number
Time 7
• / Ed am
• ` 7 O Pm
Alternative Mailing Address Phone re .. />) Z -OW/
For information call 65 1.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
0 % Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks
rs pector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
Entered S.L.at J c• 'it C 0 ,
O Access to service
lateral needed
O Inspection
refused
PoorPipeJoints
Mineral Deposits ! ° -j, . ;el j Jl
Sag /Pipe Deflection
Damaged Pipe G 2O -..0 - -- 6 Z',
Transition ' t 1 ` ^�l C �P-' ` t r 1 C'. 47,0 r >>
I /
" ✓ „ o •
.5
4" to 6 " Transition:
White Copy: Property Owner
Length of Service: 3�
Yellow Copy: City of Eagan
:>.
�a
I
Final Cleanout:
Pink Copy: SE H
Number
Correctly
Discharged .
Incorrectly Unknown
Notes L. Li ' r - 1/( <:,..7
. . 7 ,f 4
�< ')
Total
Sump pumps
Foundation drains
. r MEM
Roof drains
4 of ha p
Residential Sanitary Sewer Service
Compliance Inspection
Date I eV I / 1 - 4-)
Name &"•77 'ft/ t` 4J' Disk #
PID Number
House Number
Compliance
Owner/Occupant Signature
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
F. Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots % 3 ..''
}
Time V/ • L} c Pm
d
G
Street Name r Z./K
Record Number
Time 7
• / Ed am
• ` 7 O Pm
Alternative Mailing Address Phone re .. />) Z -OW/
For information call 65 1.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
0 % Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks
rs pector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
Entered S.L.at J c• 'it C 0 ,
O Access to service
lateral needed
O Inspection
refused
PoorPipeJoints
Mineral Deposits ! ° -j, . ;el j Jl
Sag /Pipe Deflection
Damaged Pipe G 2O -..0 - -- 6 Z',
Transition ' t 1 ` ^�l C �P-' ` t r 1 C'. 47,0 r >>
I /
" ✓ „ o •
.5
4" to 6 " Transition:
White Copy: Property Owner
Length of Service: 3�
Yellow Copy: City of Eagan
:>.
�a
I
Final Cleanout:
Pink Copy: SE H