4707 Hazeltine Lane - Inspection Form161. City f to ap
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date OS / 1 Time 0? p pro
Name
House Number
1
4" to 6 "Transition:
PID Number
e/.7 c 7
Alternative Mailing Address
c
O Sump pump properly piped
COY No sump pump
White Copy: Property Owner
OwnerlOccupant Signature
For information call 651.470.2788
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Disk #
Street Name
Non - Compliance
0
O
O
0
0
U
0
Length of Service:
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
flexible sump pump piping
Yellow Copy: City of Eagan
Record Number
Phone 4/) 77
�7 J
Inspector Signature
Number of stacks 1 Entered 5 Lat
lay ACS) 7'/�7 -- "
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition - ? A..+ Agf r' C � / f 7
dam
Time • • c' c= p pm
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
>
Final Cleanout: , I
Pink Copy: SEH
Notes _ ,, ✓ {., 4
C ,r/? - " a
� ,.. d _ .s'#.J� �°''�'' LS �,,
i t _ - i6 ,
-` 7 ., �
�
r ,t_.r A-7
" 7
•�'�,���! .
-�° ! �.
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
—
__. ..._.,..�,....._.
` °.
Foundation drains
Roof drains
ry �
161. City f to ap
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date OS / 1 Time 0? p pro
Name
House Number
1
4" to 6 "Transition:
PID Number
e/.7 c 7
Alternative Mailing Address
c
O Sump pump properly piped
COY No sump pump
White Copy: Property Owner
OwnerlOccupant Signature
For information call 651.470.2788
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Disk #
Street Name
Non - Compliance
0
O
O
0
0
U
0
Length of Service:
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
flexible sump pump piping
Yellow Copy: City of Eagan
Record Number
Phone 4/) 77
�7 J
Inspector Signature
Number of stacks 1 Entered 5 Lat
lay ACS) 7'/�7 -- "
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition - ? A..+ Agf r' C � / f 7
dam
Time • • c' c= p pm
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
>
Final Cleanout: , I
Pink Copy: SEH