4604 1_2 Penkwe Way - Inspection FormCity of Eagan
Residential Sanitary Sewer Service
Compliance Inspection
Date /`a' f Time
Name /.r i! f !•j/ Disk #
' 1f
PID Number
House Number
Alternative Mailing Address
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
t No sump pump
Mineral Deposits
Sag /Pipe Deflection ZS -- /iS --
Damaged Pipe
Transitions
4" to 6" Transition:
White Copy: Property Owner
4 Street Name
OwnerlOccupant Signature
I
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone / , �/ 42
Time / 1 • F, Pro
Obstruction
Unable to push past
feet
For information call 651.470.2788
`1" /"
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S,L at %W C n
Final Cleanout: / / ' /C/,rv��.
Pink Copy: SEH
Total
Number
Correctly
Disch.
Incorrectly
ged
Unknown
Notes � 1,, -'ice _:� -, t!" ;7 .
-`-J 61F,' (?0 j7 i,-i't -
" - , jam t; C
ciU:_"�q 9
Sump pumps
W —�w6
Foundation drains
N/
/
Roof drains
_
aw...__._ — __
City of Eagan
Residential Sanitary Sewer Service
Compliance Inspection
Date /`a' f Time
Name /.r i! f !•j/ Disk #
' 1f
PID Number
House Number
Alternative Mailing Address
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
t No sump pump
Mineral Deposits
Sag /Pipe Deflection ZS -- /iS --
Damaged Pipe
Transitions
4" to 6" Transition:
White Copy: Property Owner
4 Street Name
OwnerlOccupant Signature
I
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone / , �/ 42
Time / 1 • F, Pro
Obstruction
Unable to push past
feet
For information call 651.470.2788
`1" /"
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S,L at %W C n
Final Cleanout: / / ' /C/,rv��.
Pink Copy: SEH