844 Ivy Lane - Inspection FormResidentfal Sanitary Sewer Service .
Compliance Inspection
Date / 2 / 1 0
Name
PID Number
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Or Sump Pump properly piped
O No sump pump
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
White Copy: Property Owner
Time
Service Lateral Inspection Findings
Disk #
House Number .d- Street Name��t
Iternate Mailing Address
Owner /Occupant 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
3 45' 119 . -„ CC,
O am
O pm
Yellow Copy: City of Eagan
Record Number a 2 / 2101 C)
Obstruction
Unable to push past
feet.
3 r `�"' Length of Service: /4
4" to 6" Transition: '�.�L g �
Time
inspector Signature
o am
O pm
Phone
No Access
o No one in
O Access to service lateral
needed
O Inspection refused
Number of stacks c Entered S L at - VD '\.J 5
Final Cleanout: 30, 33
Pink Copy: Benjamin Franklin Plumbing
651 -222 -1551
Total
Notes f
j
!^ 7 7 . L -cam _, l,,.c c3/4"
II
0%, -f-ii,
Number
Discharged
Correctly
Incorrectly
Unknown
Sump Pumps
Drains
cb
Roof Drains
Residentfal Sanitary Sewer Service .
Compliance Inspection
Date / 2 / 1 0
Name
PID Number
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Or Sump Pump properly piped
O No sump pump
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
White Copy: Property Owner
Time
Service Lateral Inspection Findings
Disk #
House Number .d- Street Name��t
Iternate Mailing Address
Owner /Occupant 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
3 45' 119 . -„ CC,
O am
O pm
Yellow Copy: City of Eagan
Record Number a 2 / 2101 C)
Obstruction
Unable to push past
feet.
3 r `�"' Length of Service: /4
4" to 6" Transition: '�.�L g �
Time
inspector Signature
o am
O pm
Phone
No Access
o No one in
O Access to service lateral
needed
O Inspection refused
Number of stacks c Entered S L at - VD '\.J 5
Final Cleanout: 30, 33
Pink Copy: Benjamin Franklin Plumbing
651 -222 -1551
1 I q
• City OE
0
Residential Sanitary Sewer Service
Compliance Inspection
Date /1
Name �_
4" to 6" Transition:
White Copy: Proper ty Owner
f ° Disk #
S-
•
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Time
PID Number
House Number L L Street Name
Owner /Occupant Signature
0 am
Pm
Non - Compliance
O
O
O
O
O
r
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Fagan
Recor Number
Time
Phone '
1/
1
Inspect Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
® — O pm
No Access
O No one in
•
For information call 651:470.2788
Access to service
latera�l 1.eedq,
O Inspect-60
refused
Service Lateral Inspection Findings Number of stacks Entered S.L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Cu3
Number
Correctly
Discharged
Incorrectly Unknown
Notes
i
i j %
t
- vil'i i? . = '% f� ,--.>" (
�? t
Total
Sump pumps
Foundation drains
Roof drains
1 I q
• City OE
0
Residential Sanitary Sewer Service
Compliance Inspection
Date /1
Name �_
4" to 6" Transition:
White Copy: Proper ty Owner
f ° Disk #
S-
•
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Time
PID Number
House Number L L Street Name
Owner /Occupant Signature
0 am
Pm
Non - Compliance
O
O
O
O
O
r
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Fagan
Recor Number
Time
Phone '
1/
1
Inspect Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
® — O pm
No Access
O No one in
•
For information call 651:470.2788
Access to service
latera�l 1.eedq,
O Inspect-60
refused
Service Lateral Inspection Findings Number of stacks Entered S.L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Cu3