4058 Mica Tr - Inspection Forms4
City [Papa
Residential Sanitary Sewer Service
Compliance Inspection
7,
Date (%
Name (L. ,
Alternative Mailing Address
Mineral Deposits
4" to 6 "Transition:
PID Number
House Number % ) Street Name
Compliance
No foundation drain connection
No roof drain connection
i
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Property Owner
i 3(Oam
Tune • pm
7
Owner /Occupant Signature
Service Lateral Inspection Findings
f1
R oots .•`' -4--- -r
i
Poor Pipe Joints
Sag /Pipe Deflection
Damaged Pipe
Transition
Si/ I 473
For information: call 651.470 2788
Non - Compliance
O Clear water connections to
sanitar 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 <
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
f
Obstruction
Unable to push past
feet
Final Cleanout:
Notes
— oam
Time I • f pm
� � 2
Phone � T.1
'Inspector Sig ature
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Pink Copy: SEH
Number. Discharged
Correctly Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
6 j
4
City [Papa
Residential Sanitary Sewer Service
Compliance Inspection
7,
Date (%
Name (L. ,
Alternative Mailing Address
Mineral Deposits
4" to 6 "Transition:
PID Number
House Number % ) Street Name
Compliance
No foundation drain connection
No roof drain connection
i
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Property Owner
i 3(Oam
Tune • pm
7
Owner /Occupant Signature
Service Lateral Inspection Findings
f1
R oots .•`' -4--- -r
i
Poor Pipe Joints
Sag /Pipe Deflection
Damaged Pipe
Transition
Si/ I 473
For information: call 651.470 2788
Non - Compliance
O Clear water connections to
sanitar 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 <
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
f
Obstruction
Unable to push past
feet
Final Cleanout:
Notes
— oam
Time I • f pm
� � 2
Phone � T.1
'Inspector Sig ature
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Pink Copy: SEH
4
City [Papa
Residential Sanitary Sewer Service
Compliance Inspection
7,
Date (%
Name (L. ,
Alternative Mailing Address
Mineral Deposits
4" to 6 "Transition:
PID Number
House Number % ) Street Name
Compliance
No foundation drain connection
No roof drain connection
i
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Property Owner
i 3(Oam
Tune • pm
7
Owner /Occupant Signature
Service Lateral Inspection Findings
f1
R oots .•`' -4--- -r
i
Poor Pipe Joints
Sag /Pipe Deflection
Damaged Pipe
Transition
Si/ I 473
For information: call 651.470 2788
Non - Compliance
O Clear water connections to
sanitar 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 <
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
f
Obstruction
Unable to push past
feet
Final Cleanout:
Notes
— oam
Time I • f pm
� � 2
Phone � T.1
'Inspector Sig ature
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Pink Copy: SEH
Number. Discharged
Correctly Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
6 j
4
City [Papa
Residential Sanitary Sewer Service
Compliance Inspection
7,
Date (%
Name (L. ,
Alternative Mailing Address
Mineral Deposits
4" to 6 "Transition:
PID Number
House Number % ) Street Name
Compliance
No foundation drain connection
No roof drain connection
i
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Property Owner
i 3(Oam
Tune • pm
7
Owner /Occupant Signature
Service Lateral Inspection Findings
f1
R oots .•`' -4--- -r
i
Poor Pipe Joints
Sag /Pipe Deflection
Damaged Pipe
Transition
Si/ I 473
For information: call 651.470 2788
Non - Compliance
O Clear water connections to
sanitar 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 <
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
f
Obstruction
Unable to push past
feet
Final Cleanout:
Notes
— oam
Time I • f pm
� � 2
Phone � T.1
'Inspector Sig ature
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Pink Copy: SEH