2073 Emerald Lane - Inspection Form41111. City or Ca p
Residential Sanitary Sewer Service
Compliance Inspection
Date /, /6 / /c)
Name / ?1',11 1 (AV Disk #
PID Number
House Number 277 Street Name .✓Ili�
Alternative Mailing Address
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Proper Owner
} am
Time f • pm
Ownerl0ccupant Signature
0
0
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
Time /0 am
� � L�-pm
ire
r inspector Signature
For information calk 651.470.2788
4" to 6 "Transition: C, / Kr, Length of Service: d o
Obstruction
Unable to push past
feet
Entered S . at S'7y -54 --
Service Lateral Inspection Findi s Number of stacks
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection 1i�'rt G //° - • 1 . /,
Damaged Pipe
Transition
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
A
Pink Copy: SEH
Total
Notes
Number Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Y
— __---- •- -
•r -.�. `._
_ _
Foundation drains
----- d_
_
Roof drains
___. ,...__
_..__- .--- -°-•
-- M
41111. City or Ca p
Residential Sanitary Sewer Service
Compliance Inspection
Date /, /6 / /c)
Name / ?1',11 1 (AV Disk #
PID Number
House Number 277 Street Name .✓Ili�
Alternative Mailing Address
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Proper Owner
} am
Time f • pm
Ownerl0ccupant Signature
0
0
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
Time /0 am
� � L�-pm
ire
r inspector Signature
For information calk 651.470.2788
4" to 6 "Transition: C, / Kr, Length of Service: d o
Obstruction
Unable to push past
feet
Entered S . at S'7y -54 --
Service Lateral Inspection Findi s Number of stacks
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection 1i�'rt G //° - • 1 . /,
Damaged Pipe
Transition
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
A
Pink Copy: SEH