825 Ivy Lane - Inspection FormsResidential Sanitary Sewer Service
Compliance Inspection
/y 1
Name V �.
PID Number
Roots
Roof drains
E
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Owner /Occupant Signature
Compliance
O No foundation drain connection
1 No roof drain connection
f
Sump pit not connected to
sanitar y sewer
Sump pump properly piped
O No sump pump
4" to 6" Transition:
Service Lateral Inspection Findings
White Copy: Property Owner
1 ,.C" am
Time J /e . pm
Disk#
House Number Street Name —
Alternative Mailing Address --- - --
For information call 651470 2788
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
Number of stacks 1 _ Entered S . at
Length of Service:
Sump pumps
Foundation drains
Total
Number Discharged
Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
Time
Phone _
Inspector Signature
Obstruction
Unable to push past
feet
N ote
s Final Cleanout:
3
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Residential Sanitary Sewer Service
Compliance Inspection
/y 1
Name V �.
PID Number
Roots
Roof drains
E
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Owner /Occupant Signature
Compliance
O No foundation drain connection
1 No roof drain connection
f
Sump pit not connected to
sanitar y sewer
Sump pump properly piped
O No sump pump
4" to 6" Transition:
Service Lateral Inspection Findings
White Copy: Property Owner
1 ,.C" am
Time J /e . pm
Disk#
House Number Street Name —
Alternative Mailing Address --- - --
For information call 651470 2788
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
Number of stacks 1 _ Entered S . at
Length of Service:
Sump pumps
Foundation drains
Total
Number Discharged
Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
Time
Phone _
Inspector Signature
Obstruction
Unable to push past
feet
N ote
s Final Cleanout:
3
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH