2049 Jade Lane - Inspection Form4 116. City or Ea n
Residential Sanitary Sewer Service
Compliance Inspection
r'y �
Date, s
Name
PID Number
House Number
Alternative Mailing Address
For information call 651.470.2788
Compliance
2- / Owner /Occupant Signature
No foundation drain connection
No roof drain connection
1
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
�-. • - 'ram
Time , fr • ` `o p
r
Disk i4
./' Street Name
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
Service Lateral Inspection Findings Numberlof stacks
7 ..-- .:7- .2:, Roots,
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition'
4" to 6" Transition:
White Copy: Property Owner
i�.
Length of Service:
Yellow Copy: City of Eagan
/i
Record Number
Phone '� a
Obstruction
Unable to push past
feet
Entered S L,at
•
Time •
Inspector Signature
;!- ?
. _ 0 P
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
Total
Sump pumps
Foundation drains
Roof drains
4 116. City or Ea n
Residential Sanitary Sewer Service
Compliance Inspection
r'y �
Date, s
Name
PID Number
House Number
Alternative Mailing Address
For information call 651.470.2788
Compliance
2- / Owner /Occupant Signature
No foundation drain connection
No roof drain connection
1
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
�-. • - 'ram
Time , fr • ` `o p
r
Disk i4
./' Street Name
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
Service Lateral Inspection Findings Numberlof stacks
7 ..-- .:7- .2:, Roots,
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition'
4" to 6" Transition:
White Copy: Property Owner
i�.
Length of Service:
Yellow Copy: City of Eagan
/i
Record Number
Phone '� a
Obstruction
Unable to push past
feet
Entered S L,at
•
Time •
Inspector Signature
;!- ?
. _ 0 P
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Pink Copy: SEH