2041 Bluestone Lane - Inspection Formtlt ofF
� It ai
Residential Sanitary Sewer Service
Compliance Inspection
Date,�l F/? 1
Name i
PID Number
House Number
Alternative M
/1.1.) 1 (14(3) Disk #
/?
ingAddress
Owner /Occupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
4" to 6 "Transition:
White Copy: Property Owner
� % O am
Time • pm
Street Name
� .
-477-11 l �
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
Poor Pipe Joints
Length of Service:
Yellow Copy: City of Eagan
Record Number
inspector S ignature
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks '1 Entered S. L. at
Roots
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe J)
Transition
Phone •r,
LLB —
• r 0 a
• O pm
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
Notes
Total
Sump pumps
; %
Foundation drains
{�,u
Il l
Roof drains
tlt ofF
� It ai
Residential Sanitary Sewer Service
Compliance Inspection
Date,�l F/? 1
Name i
PID Number
House Number
Alternative M
/1.1.) 1 (14(3) Disk #
/?
ingAddress
Owner /Occupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
4" to 6 "Transition:
White Copy: Property Owner
� % O am
Time • pm
Street Name
� .
-477-11 l �
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
Poor Pipe Joints
Length of Service:
Yellow Copy: City of Eagan
Record Number
inspector S ignature
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks '1 Entered S. L. at
Roots
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe J)
Transition
Phone •r,
LLB —
• r 0 a
• O pm
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH