2049 Carnelian Lane - Inspection FormsCity of Ca a
(Residential Sanitary Sewer Service
Compliance Inspection
Date M 1 0,-P
Name L V/r ] Disk #
PID Number
House Number OqY Street Name
Alternative Mailing Address
Owner /O ccu d nt Signature
For information call 651 .470.2788
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
Service Lateral inspection Findings
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Roots
4" to 6" Transition:
Sump pumps
Foundation drains
Roof drains
White Copy: Pr opex ty Ownet
Total
Time am
� pm
Non-Compliance
O
O
O
O
O
Number Discharged
Correctly
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stac Ertl eyed S L at
Length of Service:
lncorrectly
LLJ - LLJ
xtv
Unknown
Record Number
L ' v
Phone "�
- Obstruction
Unable to push past
feet
Notes , /L /r
"C� r
a: - C� P
t/
a c
1
Time
; ,1 1, 7 6 /
'/ / Inspector Signature
/./
Final Cleanout:
,S lurs 2i
• Fpm
Nct Access
No one in
0 am
O Access to service
Lateral needed
O Inspection
refused
ff
Yellow Copy: City of Eagan Pink Copy: SEH
Resi enttai Sanitary Sewer Ser
Compliance I pectio
City of E &.
Date( L O 1/0
Name 1� rG.
PID Number
House Number
;70 00 Q1
Compliance
!o No foundation drain connection
.10 No roof drain connection
O _ 5 mp_pit...not- connected to
_saaitaseuuer --
-4- Sump - ump_properl*.piped
No sump pump
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition C i 0
White Copy: Property Owner
Time
Alternate Mailing Address
1 r • ! -
k 1 fl ;'fir
Owner /Occupant Signatu
Service Lateral Inspection Findings
Roots
Disk #
For Information cal! 651.470.2788
4" to 6" Transition: .
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
o am
o pm
Number of stacks Entered S L at
,
_g3
Length of Service: 9 0�
Yellow Copy: City of Eagan
Record Number c / 9 / Scic
Obstruction
Street Name C r
Unable to push past
feet.
Time
Phone
Inspector Signature
o am
o pm
No Access
o No one in
O Access to service lateral
needed
o Inspection refused
Final Cleanout: 3 34
Notes
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump Pumps
Foundation Drains
Drains
G I Roof
Resi enttai Sanitary Sewer Ser
Compliance I pectio
City of E &.
Date( L O 1/0
Name 1� rG.
PID Number
House Number
;70 00 Q1
Compliance
!o No foundation drain connection
.10 No roof drain connection
O _ 5 mp_pit...not- connected to
_saaitaseuuer --
-4- Sump - ump_properl*.piped
No sump pump
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition C i 0
White Copy: Property Owner
Time
Alternate Mailing Address
1 r • ! -
k 1 fl ;'fir
Owner /Occupant Signatu
Service Lateral Inspection Findings
Roots
Disk #
For Information cal! 651.470.2788
4" to 6" Transition: .
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
o am
o pm
Number of stacks Entered S L at
,
_g3
Length of Service: 9 0�
Yellow Copy: City of Eagan
Record Number c / 9 / Scic
Obstruction
Street Name C r
Unable to push past
feet.
Time
Phone
Inspector Signature
o am
o pm
No Access
o No one in
O Access to service lateral
needed
o Inspection refused
Final Cleanout: 3 34
Notes
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551