4868 Windsor Ct - Inspection Form4 111. City of to
Residential Sanitary Sewer Service
Compliance Inspection
Date -- /
j
Name!' .'J r!a' • Disk #
MD Number
House Number Street Name
Alternative MailingA4dress
J:
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
,
• 4{ am
Time 7 • O p
Owner /Occupant Signature
Non - Compliance
O
O
O
O
O
1/2 r1
}
Number of stacks j
C
Length of Service: /i
Ci
Yellow Copy: City of Eagan
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Record Number
Time
Phone
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S_L.at
•
X41
b am
0 pm
Final Cleanout:
No Access
O No one in
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
ji
Transition
O Inspection
refused
Notes l
.�/ -' 02Y. C 6 (-
O Access to service
lateral needed
Pink Copy: SE
Total
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
:7)
MIMI
? pe //lir
MEI
Foundation drains
Roof drains
4 111. City of to
Residential Sanitary Sewer Service
Compliance Inspection
Date -- /
j
Name!' .'J r!a' • Disk #
MD Number
House Number Street Name
Alternative MailingA4dress
J:
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
,
• 4{ am
Time 7 • O p
Owner /Occupant Signature
Non - Compliance
O
O
O
O
O
1/2 r1
}
Number of stacks j
C
Length of Service: /i
Ci
Yellow Copy: City of Eagan
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Record Number
Time
Phone
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S_L.at
•
X41
b am
0 pm
Final Cleanout:
No Access
O No one in
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
ji
Transition
O Inspection
refused
Notes l
.�/ -' 02Y. C 6 (-
O Access to service
lateral needed
Pink Copy: SE
r _apt
Re
rental Sanitary Sewer Service
Oompliance Inspection
Date 66 .25- 1
Name
P1D Number
Time
r � .� /7/,_ S
House Number /-1 GS { , C r€ Street Name
White Copy: Property Owner
Owner /Occupant Signature
Disk it
am
S° o pm
Yellow Copy: City of Eagan
Record Number c 3 S I
Time
c Y
Alternate Mailing Address 'hone / - c> i 0't
Inspector Signature
o am
O pm
Compliance
No foundation drain connection
No roof drain connection
O )(Sump pit not connected to
sanitary sewer
o Sump Pump properly piped
o )(No sump pump
Non - Compliance
o Clear water connections to
sanitary sewer
o Service lateral defects
O Defective manholes
o Sump pump connected to
sanitary sewer
-able sump pump piping
Obstruction
Unable to push past
feet
No Access
o No one in
o Access to service lateral
needed
O Inspection refused
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
3 - '
Number of stacks
Length of Service:
Entered S. at
g i r Final Cleanout:
C f
For Information call 651.470.2788
Number Discharged
Sump Pumps
Foundation Drains
Roof Drains
Total
Correctly Incorrectly Unknown
N otes
Pink Copy: Benjamin Franklin Plumbing
651 -222 -1551