857 Ivy Lane - Inspection Form4111111
Qty al Ea u
Residential Sanitary Sewer Service
Compliance Inspection
Date
)
Name *° / — �
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
• sanitary sewer
Sump pump properly piped
O No sump pump
v
r �
4" to 6" Transition:
Owner)
White Copy: Property Owner
Time •C': p
Disk #
Street Name
ccupant Signature
Non - Compliance
Sag /Pipe Deflection _� - ) } - �'-
j
Length of Service:
Yellow Copy: City of Eagan
For information tall 651.470.2788
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
Number of stacks Entered S.L.at
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
1
F
Record Number
Obstruction
Unable to push past
feet
Damaged Pipe
Transition
O am
Time • 9 pm
Phone ' KT?
C r' ;.
inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: f
Pink Copy: SEH
1
Number
Correctly
Y
Discharged
Incorrectly Unknown
Y
Notes
(--'/ i � l --6 -1 3 "c`.� , � 4` °} a
z � ���
- l
f /-"--
Total
Sump pumps
Foundation drains
// Ci 1
} - n ,,
ill &- l c..� i i. ` ' = -. ,: 7 ^ ;
i-4"-- <7 , i r � , -` c
Roof drains
4111111
Qty al Ea u
Residential Sanitary Sewer Service
Compliance Inspection
Date
)
Name *° / — �
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
• sanitary sewer
Sump pump properly piped
O No sump pump
v
r �
4" to 6" Transition:
Owner)
White Copy: Property Owner
Time •C': p
Disk #
Street Name
ccupant Signature
Non - Compliance
Sag /Pipe Deflection _� - ) } - �'-
j
Length of Service:
Yellow Copy: City of Eagan
For information tall 651.470.2788
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
Number of stacks Entered S.L.at
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
1
F
Record Number
Obstruction
Unable to push past
feet
Damaged Pipe
Transition
O am
Time • 9 pm
Phone ' KT?
C r' ;.
inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: f
Pink Copy: SEH
1