854 Ivy Lane - Inspection FormCity of Eaian
Residential Sanitary Sewer Service
Compliance Inspection
f5 I s
Date /
Name Al! , 7 /7 )
House Number
1
PID Number
Alternative Mailing Address
> a 111 f . i� F
Own/Occupant Signature
For inforrnation call 651.47 0.2788
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 F dings
Roots ]
Poor Pipe joints_
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition - -
4" to b" Transition:
White Copy: Pr operty Owner
ef
j Street Name
•. -�0%O am
Time��` • pm
/ Disk#
Non - Compliance
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 4 Entered S.L.at
L .
MIEN
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time 7
F
/7c
1
Phone f 1 .
Obstruction
Unable to push past
feet
i�-
•
•
O am
Pm
lnspectot"Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:,"
Pin1r Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
G-4 : i � i' V, � - :I/ , ' `' k .'(
_ ? ' -' /� ; ,- ; - 1 )
---',/.--1
� �' �" °, < �---,.
i
�' 1 )1_,,,,}4 .,, ,_' +i 3
rt e ,, ...� � 7 I / - ,�; L
Total
Sump P umps
! ,` _
� ) f"3
. /
I
. 7 -
Foundation drains
Roof drains
-- ,,---1-7>-.----1.-1-----,,',-7-5 '� , r
City of Eaian
Residential Sanitary Sewer Service
Compliance Inspection
f5 I s
Date /
Name Al! , 7 /7 )
House Number
1
PID Number
Alternative Mailing Address
> a 111 f . i� F
Own/Occupant Signature
For inforrnation call 651.47 0.2788
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 F dings
Roots ]
Poor Pipe joints_
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition - -
4" to b" Transition:
White Copy: Pr operty Owner
ef
j Street Name
•. -�0%O am
Time��` • pm
/ Disk#
Non - Compliance
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 4 Entered S.L.at
L .
MIEN
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time 7
F
/7c
1
Phone f 1 .
Obstruction
Unable to push past
feet
i�-
•
•
O am
Pm
lnspectot"Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:,"
Pin1r Copy: SEH