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2054 Carnelian Lane - Inspection Form! 3 City o Residential Sanitary Sewer Service Compliance Inspection Dated ix / / l 1 Time Name TT 72, PID Number House Number „<'°,7,,,),)-) 4 Street Name Alternative Mailing Address OwnerlOccupant Signature Compliance O No foundation drain connection O No roof drain connection O Sump pit not connected to sanitary sewer O Sump pump property piped O No sump pump / Disk #. rjj Service Lateral Inspection Findings 4" to 6" Transition: White Copy: Pro perty Owner • % am !O pm Non - Compliance O O O O O LLJ-W Length of Service: Yellow Copy: City of Eagan Clear water connections to sanitary sewer Service lateral defects Defective manholes Sump pump connected to sanitary sewer Flexible sump pump piping Record Number Time Number of stacks _ Entered S L at Obstruction Unable to push past feet Phone _ 6. .7 ^.�' > .._ Inspector Signature For information call 651.470.2788 Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection Damaged Pipe Transition Final Cleanout: • • __ O pm No Access 0 No one in C' 0 am Access to service _Laval need 0 inspection r efused Pink Copy: SEH C L) ri Number Discharged ote5 ,: ) 1 ! � t %L '-fir .,L -4-T ( , l '.) -: � ,,, , ._ ,. --' ' -_ ,L j Total Correctly Incorrectly Unknown Sump pumps Foundation drains Roof drains ! 3 City o Residential Sanitary Sewer Service Compliance Inspection Dated ix / / l 1 Time Name TT 72, PID Number House Number „<'°,7,,,),)-) 4 Street Name Alternative Mailing Address OwnerlOccupant Signature Compliance O No foundation drain connection O No roof drain connection O Sump pit not connected to sanitary sewer O Sump pump property piped O No sump pump / Disk #. rjj Service Lateral Inspection Findings 4" to 6" Transition: White Copy: Pro perty Owner • % am !O pm Non - Compliance O O O O O LLJ-W Length of Service: Yellow Copy: City of Eagan Clear water connections to sanitary sewer Service lateral defects Defective manholes Sump pump connected to sanitary sewer Flexible sump pump piping Record Number Time Number of stacks _ Entered S L at Obstruction Unable to push past feet Phone _ 6. .7 ^.�' > .._ Inspector Signature For information call 651.470.2788 Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection Damaged Pipe Transition Final Cleanout: • • __ O pm No Access 0 No one in C' 0 am Access to service _Laval need 0 inspection r efused Pink Copy: SEH C L) ri Account # 260536 City of Eagan/City Dept at: Wayne Schwanz 3419 Coachman Pt Eagan MN 55122 Service At: Jett Olsen 2054 Carnelian Ln Eagan MN 55122 Service Date 08/12/10 Camera inspection of sewer line. Pull & reset toilet. Description Of Service Camera inspection of sewer line Terms: Due 9/11/2010 PO # Invoice Benjamin Franklin Plumbing 1424 3rd St N Minneapolis MN 55411 612 -604 -4285 FAX: 612-822-5408 FID #27- 1025956 Job # 214763 Quantity DUNS #027314893 1 Please Detach and Return with Remittance 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 Minneapolis MN 55411 Invoice # A65393 Date: 08/12/10 Page # 1 of 1 Unit Pr ice Extended Price Tx $215.00 $215.00 Please pay front this Invoice. Thank You Amount Due Amount Paid Balance Due $215,00 Invoice # Date : A65393 08/12/10 Account # 260536 City of Eagan/City Dept at: $215,00 Residential Sanitary .ewer Se, ce Compliance Inspection City er Ewa Compliance No foundation drain connection %. No roof drain connection Sump pit not connected to sanitary sewer o Sump Pump properly piped Date 5 1 ! 1 10 No sump pump Transition 4" to 6" Transition: White Copy: Property Owner Time Name 3rc-c ri)A �^ PID Number �7 Rouse Number ✓ S El Alternate Mailing Address / Owner /Occupant Signature Service Lateral Inspection Findings am [: 0 pm Disk # 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 Street Name Number of stacks Length of Service: Sump Pumps Foundation Drains Roof Drains Total Correctly incorrectly Unknown � �r7C Record Number Obstruction Notes Time Unable to push past feet Phone C- Inspector Signature O am o pm For information call 651.470.2788 No Access O No one in o Access to service lateral needed O Inspection refused Entered S L. at ° L. 5 Roots �� 3 43 . C-3 ;,2 I# -7 0 Poor Pipe Joints J Mineral Deposits Sag /Pipe Deflection Damaged Pipe Final Cieanout: l c Yellow Copy: City of Eagan Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551