4071 Mica Tr - Inspection Form16 ' City of Ba a
Residential Sanitary Sewer Service
Compliance Inspection
Date. 1 L) ,
Name
PID Number
House Number
Alternative Mailing Address
Transition Z
4" to 6" Transition:
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
r�
r Y 7 -¢- -
711,..- (9g em
Time r � ,. pm
Disk #
Owner /Occupant Signature
Street Name ✓ / J�
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
/Pipe Deflection
Damaged Pipe i
' 1 '>r' �,..- �-7 '
7
Length of Service: C / ) I
Record Number
7
• -A am
Time r _ pm
I
Phone
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks f Entered S L at
Roots ' y� / -r'
Poor Pipe Joints
Mineral Deposits
Final Cleanout:
Yellow Copy City of Eagan, 1 / j / Pink Coy: SEH
,-
Number
Correctly
Discharged,
Incorrectly Unknown
N tes
F e , /1j� -_'� } a
c 1
V. �-� ) c
I Cp"' . .�i� 3
1
. r 1- -- - 1--- - - ~ ) . """
- p_ f)
�sI T/ I /
J 4 L, / 3
Total
Sump pumps
Foundation drains
Roof drains
16 ' City of Ba a
Residential Sanitary Sewer Service
Compliance Inspection
Date. 1 L) ,
Name
PID Number
House Number
Alternative Mailing Address
Transition Z
4" to 6" Transition:
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
r�
r Y 7 -¢- -
711,..- (9g em
Time r � ,. pm
Disk #
Owner /Occupant Signature
Street Name ✓ / J�
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
/Pipe Deflection
Damaged Pipe i
' 1 '>r' �,..- �-7 '
7
Length of Service: C / ) I
Record Number
7
• -A am
Time r _ pm
I
Phone
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks f Entered S L at
Roots ' y� / -r'
Poor Pipe Joints
Mineral Deposits
Final Cleanout:
Yellow Copy City of Eagan, 1 / j / Pink Coy: SEH
,-