4766 Cypress Pt - Inspection Form11 ,0 1111 City or km
Residential Sanitary Sewer Service
Compliance Inspection-
Date S /
Name 77 r 6!,* f T/ Z4 Disk #
PID Number.
House Number
Alternative Mailing Address
—Ys . .i..
For information call 651.470.2788
Copliance
No foundation drain connection
ip roof drain connection
. /S'irmp pit not connected to
sanitary sewer
0 Sump pump properly piped
;' No sump pump
Service Lateral Inspection Findings Number of stacks -4 Entered S L. at _ 17,, 6 ,
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition e / w'.•
4" to 6" Transition:
White Copy: Property Owner
r
• o am
Time _a..r' pm
OwnerlOccupant Signature
Street Name _1 r ,/
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
Yellow Copy: City of Eagan
Record Number J1'"
Length of Service: r
O am
•
Time • O pm
, �� 6-
Phone C /'
1I .. i
spector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: .
Pink Copy: SEH
Number Discharged
Notes
f
m.. C6ar1, t tr .J :i�,r.� 6 7:. --'' _:'-j /l g -
�,t.., � _
— i - 4,,46 7 : , cam f ,^
c , f r ^Y
r
i
Total
Correctly
Incorrectly
Unknown
Sump pumps
f _
� —
�_ �.Jm ��----
.- --,•-°,••.�...._
Foundation drains
Roof drains
11 ,0 1111 City or km
Residential Sanitary Sewer Service
Compliance Inspection-
Date S /
Name 77 r 6!,* f T/ Z4 Disk #
PID Number.
House Number
Alternative Mailing Address
—Ys . .i..
For information call 651.470.2788
Copliance
No foundation drain connection
ip roof drain connection
. /S'irmp pit not connected to
sanitary sewer
0 Sump pump properly piped
;' No sump pump
Service Lateral Inspection Findings Number of stacks -4 Entered S L. at _ 17,, 6 ,
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition e / w'.•
4" to 6" Transition:
White Copy: Property Owner
r
• o am
Time _a..r' pm
OwnerlOccupant Signature
Street Name _1 r ,/
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
Yellow Copy: City of Eagan
Record Number J1'"
Length of Service: r
O am
•
Time • O pm
, �� 6-
Phone C /'
1I .. i
spector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: .
Pink Copy: SEH