2054 Marble Lane - Inspection Form41111- City of ag]
Residential Sanitary Sewer Service
Compliance Inspection
_ ' i'
1 {� %1 �
Date ,�
Name /11) .,�
,
PID Number
House Number
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
4" to 6" Transition:
White Copy: Property Owner
• jt ,
Time `7 •
Disk #
4 Street Name
OwnerlOccupant Signature
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
• No sump pump
Transition I I
Non - Compliance
O
O
O
O
O
( /
am
Pm
Length of Service:
Yellow Copy: City of Eagan
Alternative MailingAddress
Record Number '
Clear water connections to
sanitary sewer.
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
• Oam
7 Times • f pm
L
Phone 7" _ r
Inspector Signature
For information call 65 1.470.2788
Obstruction
Unable to push past
feet.
Service Lateral inspection Findings Number of stacks.---, Entered S.L.at,, - - - - , ts ! %) ° - ___ ( ..- 4- -....- ! — - �-,, /
,
•
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
otes
¢
2� } ` ' —
- f
'71 -?`� `
.;-
y_ >.
,
f
`
...
r , 7 .
Total
Sump pump
%< t ,'_
Foundation drains
° „I
er
.
Roof drains
41111- City of ag]
Residential Sanitary Sewer Service
Compliance Inspection
_ ' i'
1 {� %1 �
Date ,�
Name /11) .,�
,
PID Number
House Number
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
4" to 6" Transition:
White Copy: Property Owner
• jt ,
Time `7 •
Disk #
4 Street Name
OwnerlOccupant Signature
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
• No sump pump
Transition I I
Non - Compliance
O
O
O
O
O
( /
am
Pm
Length of Service:
Yellow Copy: City of Eagan
Alternative MailingAddress
Record Number '
Clear water connections to
sanitary sewer.
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
• Oam
7 Times • f pm
L
Phone 7" _ r
Inspector Signature
For information call 65 1.470.2788
Obstruction
Unable to push past
feet.
Service Lateral inspection Findings Number of stacks.---, Entered S.L.at,, - - - - , ts ! %) ° - ___ ( ..- 4- -....- ! — - �-,, /
,
•
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
4 , 1 ' City o a an
Residential Sanitary Sewer Service
Compliance Inspection
/)
Date / h ) 2
Name 2V
PID Number
House Number
Alternative Mailing Address
L- - Street Name
\ CA \ _3 r ;' ..
Owner /Occupant Signature
Compliance
O No foundation drain connection
( No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral inspection Findings
Roots 6-:)
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
Roof drains
f f!`1
White Copy: Proper ty Owner
Total
‘,,arT
Time ` • pm
Disk #
f „5
` F
i
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
Number of stacks'
)
Record Number
Time
inspector S
Obstruction
Unable to push past
feet,
Entered S Lat
Sump pumps
Foundation drains
Nunsber Discharged
Incorrectly
•
• r /. 0 am
-7 • pm
Phone 2 ) _a �� e✓ 3 � L
Notes
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
is ; J t
? -1 Final Cleanout:
Length of Service: �__�._� ✓� <
/
1 .1
Yellow Copy: City of Eagan Pink Copy: SEH