2033 Zircon Lane - Inspection Form4. 1 . 1111. City of Nan
Residential Sanitary Sewer Service
Compliance Inspection
Date 0 c1 ( A
f
Name !fn / /7/: V/r I --J 'V Disk #
PID Number
House Number Street Name 2 /
Alternative Mailing Address
i
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
4" to 6" Transition:
White Copy: Property Owner
• ieam
Tirrie / • r' O pm
OwnerlOccupant Signature
Non - Compliance
O
O
O
O
0
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
Pho}
Time
r / 44 n t
,/ Inss ector Signature nature p g
For information call 65 1.470.2788
Obstruction
Unable to push past
feet
Notes �.
:Ja
Final Cleanout:
O am
•
• O pm
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L. at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4 it ,
ec OD it
; 52i" , t.ZA." ./
Pink Copy: SEH
a
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
4. 1 . 1111. City of Nan
Residential Sanitary Sewer Service
Compliance Inspection
Date 0 c1 ( A
f
Name !fn / /7/: V/r I --J 'V Disk #
PID Number
House Number Street Name 2 /
Alternative Mailing Address
i
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
4" to 6" Transition:
White Copy: Property Owner
• ieam
Tirrie / • r' O pm
OwnerlOccupant Signature
Non - Compliance
O
O
O
O
0
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
Pho}
Time
r / 44 n t
,/ Inss ector Signature nature p g
For information call 65 1.470.2788
Obstruction
Unable to push past
feet
Notes �.
:Ja
Final Cleanout:
O am
•
• O pm
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L. at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4 it ,
ec OD it
; 52i" , t.ZA." ./
Pink Copy: SEH
a
0 6 1 qD
City 01440
Residential Sanitary Sewer Service
Compliance Inspection
Date% 1- 1 ,),
Name j , r 7 °/ ! Disk #
PID Number
,)
House Number. t ✓ _` Street Name
Alternative MailingAddress
- "� Owner /Occupant Signature
Compliance
1
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
i No sump pump
Poor Pipe joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition .,° r i f':
4" to 6" Transition:
White Copy: Property Owner
Time 1 is
am
Pm
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
Service Lateral Inspection Finding 7! Number of stacks ir
f Z
› r- (. 3 . i` , ."% iv) i f I) l I -
Y _ '- j , - .. ' cam
Length of Service: e--" ic1(... Final Cleanout: / `; <-
Yellow Copy: City of Eagan
Record Number !
Phone
4 .
_ I' %.;; .;/". � c i � ..�
Time :Y i •
•
am
O pm
Obstruction
Un ,to push past
feet
inspector Signature
O Access to service.
lateral needed
; ) 0 Inspection
refused •
No Access
O No one in
Entered S L at
Pink Copy: SEH
Total
Notes
ve1 iS,
' 7
Number
Discharged
.
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
0 6 1 qD
City 01440
Residential Sanitary Sewer Service
Compliance Inspection
Date% 1- 1 ,),
Name j , r 7 °/ ! Disk #
PID Number
,)
House Number. t ✓ _` Street Name
Alternative MailingAddress
- "� Owner /Occupant Signature
Compliance
1
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
i No sump pump
Poor Pipe joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition .,° r i f':
4" to 6" Transition:
White Copy: Property Owner
Time 1 is
am
Pm
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
Service Lateral Inspection Finding 7! Number of stacks ir
f Z
› r- (. 3 . i` , ."% iv) i f I) l I -
Y _ '- j , - .. ' cam
Length of Service: e--" ic1(... Final Cleanout: / `; <-
Yellow Copy: City of Eagan
Record Number !
Phone
4 .
_ I' %.;; .;/". � c i � ..�
Time :Y i •
•
am
O pm
Obstruction
Un ,to push past
feet
inspector Signature
O Access to service.
lateral needed
; ) 0 Inspection
refused •
No Access
O No one in
Entered S L at
Pink Copy: SEH