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2082 Carnelian Lane - Inspection FormResidential Sanitary Sewer Service City of hp Compliance Inspection Date f" S/ 27 / /o Name J /A',/ 4/'//9",4. Disk # Number PID Numbe House Number 4" to 6 "Transition: Alternative Mailing Address Phone (3: Z ' "2— l l 7, White Copy: Property Owner • O am Time 75 • 0 .P, p OwnerlOccupant 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 Street Name ( ! e 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 Entered S L. at Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection Damaged Pipe Transition Length of Service: Yellow Copy: City of Eagan Record Number Time / f ._.inspector Signature Obstruction Unable to push past feet Final Cleanout: O am • • o pm No Access O No one in Access to service lateral needed O Inspection refused Pink Copy: SEH Number Cor Discharged Incorrectly Unknown Notes /1 , ! u /e- n - / 41 `,K Total Sump pumps - Foundation drains Roof drains L J IA; r p , Residential Sanitary Sewer Service City of hp Compliance Inspection Date f" S/ 27 / /o Name J /A',/ 4/'//9",4. Disk # Number PID Numbe House Number 4" to 6 "Transition: Alternative Mailing Address Phone (3: Z ' "2— l l 7, White Copy: Property Owner • O am Time 75 • 0 .P, p OwnerlOccupant 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 Street Name ( ! e 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 Entered S L. at Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection Damaged Pipe Transition Length of Service: Yellow Copy: City of Eagan Record Number Time / f ._.inspector Signature Obstruction Unable to push past feet Final Cleanout: O am • • o pm No Access O No one in Access to service lateral needed O Inspection refused Pink Copy: SEH Account # 260536 City of Eagan/City Dept at: Wayne Schwanz 3419 Coachman Pt Eagan MN 55122 Service Date 08 /13 /10 PO # Job # 215016 Camera inspection of sewer line. Description Of Service Quantity Unit Price Extended Price Tx Camera inspection of sewer line 1 $215.00 $215.00 DUNS #027314893 Terms: Due 9/12/2010 Please pay from this Invoice, Ihank You Check Enclosed [ ] Method of Payment Master Card [ ] Visa [ ] AmExp [ ] Discover [ ] Acct # Exp Date Name on Card Signature Remit To: Benjamin Franklin Plumbing 1424 3rd St N Minneapoils MN 55411 Invoice Benjamin Franklin Plumbing 1424 3rd St N Minneapolis MN 55411 612 -604 -4285 FAX: 612-822-5408 FID #27- 1025956 Please Detach and Return with Remittance Service At: Kim Wilharber 2082 Carnelian Ln Eagan MIN 55122 Amount Due Amount Paid Invoice # A65389 Date: 08/13/10 Page # 1 of 1 Balance Due $215.00 Invoice # Date : A65389 08/13/10 Account # 260536 City of Eagan /City Dept at: $215.00 Resicienttal Sanity Compliance Cif or Eafta Sewer Service rt pection. Date / I la 1 \ , Name PID Number House Number Alternate Mailing Address Time r .�,. LL - Owner /Occupant Signature Compliance No foundation drain connection / No roof drain connection r C Sump pit not connected to sanitary sewer Sump Pump properly piped 0 No sump pump Service Lateral Inspection Findings Roots 7 . Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection Damaged Pipe Transition ,2f 7 4" to 6" Transition: White Copy: Property Owner 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 iI 1 Disk # O am o pm Street Name For Information call 651.470.2788 Number of stacks Length of Service: Yellow Copy: City of Eagan Record Number Obstruction Time Phone Unable to push past feet EnteredS 7cr. Inspector Signature o am O pm No Access o No one in o Access to service lateral needed O Inspection refused Final Cleanout: Total Number Discharged Sump Pumps Foundation Drains Roof Drains ( Correctly ncorrectly Unknown Notes Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551