2029 Zircon Lane - Inspection FormsCity of Era as
Residential Sanitary Sewer Service
Compliance Inspection
Dated /
Name
Com Hance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor Pipe Joints
4" to b "Transition:
White Copy: Property Owner
Time Lill
PID Number
House Number 6I Street Name
Alternative Mailing Address
Owner /Occupant Signature
am
pm
.1
Service Lateral Inspection Findings / . , Number of stacks
r �� / . 1
Roots 'Y. ;.-" ) i , i
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
n
Transition • -[1
Phone fi7 `��.,
inspector Signature
For information call 651.470.2788
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
Record Number
Time
a m p m
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.l-.
r:
i 1
Length of Service: ' / Final Cleanout: 7 }`
Yellow Copy: City of Eagan
7?
Pink Copy: SEH
'NurNber.
Correctly
Discharged .. -
Notes
_ n
Total
lncorr ectly
Unknown
Sump pumps
i
Foundation drains
l7
Roof drains
7
.. I �� I
City of Era as
Residential Sanitary Sewer Service
Compliance Inspection
Dated /
Name
Com Hance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor Pipe Joints
4" to b "Transition:
White Copy: Property Owner
Time Lill
PID Number
House Number 6I Street Name
Alternative Mailing Address
Owner /Occupant Signature
am
pm
.1
Service Lateral Inspection Findings / . , Number of stacks
r �� / . 1
Roots 'Y. ;.-" ) i , i
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
n
Transition • -[1
Phone fi7 `��.,
inspector Signature
For information call 651.470.2788
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
Record Number
Time
a m p m
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.l-.
r:
i 1
Length of Service: ' / Final Cleanout: 7 }`
Yellow Copy: City of Eagan
7?
Pink Copy: SEH
City of Era as
Residential Sanitary Sewer Service
Compliance Inspection
Dated /
Name
Com Hance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor Pipe Joints
4" to b "Transition:
White Copy: Property Owner
Time Lill
PID Number
House Number f� Street Name
Alternative Mailing Address
Owner /Occupant Signature
am
pm
.1
Service Lateral Inspection Findings / . , Number of stacks
r �� / . 1
Roots 'Y. ;.-" ) i , i
r I�u
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
) j>
Transition • -f� [ --
Phone ,�,
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
Yellow Copy: City of Eagan
Record Number
inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S.l-.
Time
r:
a m
p m
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Length of Service: ' / Final Cleanout: 7 }`
7?
Pink Copy: SEH
'NurNber.
Correctly
Discharged .. -
Notes
_ n
Total
lncorr ectly
Unknown
Sump pumps
i
Foundation drains
l7
Roof drains
7
.. I �� I
City of Era as
Residential Sanitary Sewer Service
Compliance Inspection
Dated /
Name
Com Hance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor Pipe Joints
4" to b "Transition:
White Copy: Property Owner
Time Lill
PID Number
House Number f� Street Name
Alternative Mailing Address
Owner /Occupant Signature
am
pm
.1
Service Lateral Inspection Findings / . , Number of stacks
r �� / . 1
Roots 'Y. ;.-" ) i , i
r I�u
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
) j>
Transition • -f� [ --
Phone ,�,
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
Yellow Copy: City of Eagan
Record Number
inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S.l-.
Time
r:
a m
p m
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Length of Service: ' / Final Cleanout: 7 }`
7?
Pink Copy: SEH