2139 Sapphire Lane - Inspection FormCity o11'a as
Residential Sanitary Sewer Service
Compliance Inspection
Date °- I /'')
Name I �` ,d✓d �[ ! �:� #
PID Number
House Number Street Name
e, Owner /Occupont Signature
Compliance
to No foundation drain connection
1 0.,No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
OA No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
T i m e / • ��/ o pm
Alternative Mailing Address
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Pho (&) 2te/ /C
Obstruction
Unable to push past
feet
Number of stacks / Entered S at ,
/ clam
Time I r � • /� O pm
in ector Signature
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
/ 9 _✓ ..
Final Cle nowt: / ` y :�
Pink Copy: SEH
Number
Correctly
Discharged
Notes =✓ �
' . �7j1, ,i,-°
Total
Incorrectly
Unknown
Sump pumps
- -
— ~°
Foundation drains
--
Roof drains
i y
_ __...__._..__.
___
___.._...___.
City o11'a as
Residential Sanitary Sewer Service
Compliance Inspection
Date °- I /'')
Name I �` ,d✓d �[ ! �:� #
PID Number
House Number Street Name
e, Owner /Occupont Signature
Compliance
to No foundation drain connection
1 0.,No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
OA No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
T i m e / • ��/ o pm
Alternative Mailing Address
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Pho (&) 2te/ /C
Obstruction
Unable to push past
feet
Number of stacks / Entered S at ,
/ clam
Time I r � • /� O pm
in ector Signature
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
/ 9 _✓ ..
Final Cle nowt: / ` y :�
Pink Copy: SEH