1952 Carnelian Lane - Inspection Forms3g33
itstj Edaii
Residential Sanitary Sewer Service
Compliance Inspection
Date (9S / 476"/ 'r Time r'97 • • (( ' p pm
e
Name , ✓ i � n � Disk# [I]
PID Number � /
House Number �. A
Alternative Mailing Address
U wnerlQccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
Sag/Pipe Deflection
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
Damaged Pipe
Transition
4" to 6 "Transition:
T [II
White Copy: Property Owner
Length of Service:
Record Number
Street Name (' ! ii/eT7 / A
Time
Obstruction
Unable to push past
feet
te°
Phpne (4, •Z" Zf 2 G '
Inspector Signature
For information call 651.470.2788
Service Lateral Inspection Findings Number of stacks Entered S.L at
Roots
Poor Pipe Joints
Mineral Deposits
Final Cleanout:
Notes
3 r' A/c)
o am
O pm
No Access
O No one in
Access to service .
lateral needed
O Inspection
refused
p i
✓ t cy f 7 i / .0
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
3g33
itstj Edaii
Residential Sanitary Sewer Service
Compliance Inspection
Date (9S / 476"/ 'r Time r'97 • • (( ' p pm
e
Name , ✓ i � n � Disk# [I]
PID Number � /
House Number �. A
Alternative Mailing Address
U wnerlQccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
Sag/Pipe Deflection
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
Damaged Pipe
Transition
4" to 6 "Transition:
T [II
White Copy: Property Owner
Length of Service:
Record Number
Street Name (' ! ii/eT7 / A
Time
Obstruction
Unable to push past
feet
te°
Phpne (4, •Z" Zf 2 G '
Inspector Signature
For information call 651.470.2788
Service Lateral Inspection Findings Number of stacks Entered S.L at
Roots
Poor Pipe Joints
Mineral Deposits
Final Cleanout:
Notes
3 r' A/c)
o am
O pm
No Access
O No one in
Access to service .
lateral needed
O Inspection
refused
p i
✓ t cy f 7 i / .0
Yellow Copy: City of Eagan Pink Copy: SEH
Account # 260536
City of Eagan/City Dept at:
Wayne Schwanz
3419 Coachman Pt
Eagan MN 55122
Service At:
Kelvin Pulphus
1952 Carnelian Ln
Eagan MN 55122
Service Date 09/07/10
Camera inspection of sewer line. Pull & reset toilet.
Description Of Service
PO #
Camera inspection of sewer line
Remit To:
Benjamin Franklin Plumbing
1424 3rd St N
Minneapolis MN 55411
Invoice
Benjamin Franklin Plumbing
1424 3rd St N
Minneapolis MN 55411
612 -604 -4285 FAX: 612 -822 -5408
FID #27- 1025956
Job # 216170
Quantity
1
Please Detach and Return with Remittance
Check Enclosed [ ] Method of Payment
Master Card [ ] Visa [ ] AmExp [ ] Discover [ ]
Acct # Exp Date
Name on Card
Signature
Invoice #
Date:
Page #
A65618
09/07/10
1 of 1
Unit Price Extended Price Tx
Amount Due
Amount Paid
$215.00 $215.00
Balance Due $215,00
DUNS #02731489:3
Terms: Due 10/7/2010 Please pay from this Invoice. Thank You
Invoice #
Date :
A65618
09/07/10
Account # 260536
City of Eagan/City Dept at:
$215.00
Residential Sanitary' Sewer Service
CorriPtiance inspection
of Jaa
Date C l / /
Name
PID Number
House Number 1
Alternat Meiling Address
Compliance
0-, No foundation drain connection
o • No roof drain connection
Y Sump pit not connected to
sanitary sewer
Sump Pump properly piped
0 No sump pump
Time
Owner /Oc upanf Sign ure
For Information call 651.470.2788
Service Lateral Inspection Findings
Roots . 't
Poor Pipe Joints it
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
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
4" to 6" Transition: (• .,
Disk #
O am
O pm
Street Name
Number of stacks Entered S.L at
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet
/0
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: � 7
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551
Number
Correctly
Discharged
Incorrectly
Unknown
Notes
Total
Sump Pumps
r
Foundation Drains
f�
Roof Drains
---
Residential Sanitary' Sewer Service
CorriPtiance inspection
of Jaa
Date C l / /
Name
PID Number
House Number 1
Alternat Meiling Address
Compliance
0-, No foundation drain connection
o • No roof drain connection
Y Sump pit not connected to
sanitary sewer
Sump Pump properly piped
0 No sump pump
Time
Owner /Oc upanf Sign ure
For Information call 651.470.2788
Service Lateral Inspection Findings
Roots . 't
Poor Pipe Joints it
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
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
4" to 6" Transition: (• .,
Disk #
O am
O pm
Street Name
Number of stacks Entered S.L at
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet
/0
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: � 7
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551