4230 Jasper Dr - Inspection FormCity of
Residential Sanitary Sewer Service
Compliance Inspection
Date 6 ,'/ / / /x
Name / 4/"Fzt/ ;` 7/X. //r'i42 i,Disk #
PID Number
House Number
Alternative Mailing Address
Compliance
No foundation drain connection
t No roof drain connection
O Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
Roots
Poor Pipe joints
Mineral Deposits &L _ , -
Sag/Pipe Deflection ( Z7 < C ' f
Damaged Pipe
'Transition
4" to 6 "Transition:
White Copy: Property Owner
i z or am
Time evil O pm
J Street Name
OwnerlOccupant Signature
(' °t�� r ..
1
l
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
0
For. information ;call 651.470.2788
Obstruction
Unable to push past
feet,
Service Lateral Inspection Findings Number of stacks Entered S.L.at i } t{.2i!
�J s
o
/ %
Phone
') 3, s
9
inspector Signature
Notes -
`i ;° t ter
!s?Jf'rsL �`
Time t • //Li
r�j am
0 pm
No Access
O No one in
Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
4+�
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
V
11, 1\10 ;i
E
d" [
t E :
l{
Foundation drains
Roof drains
,----.1---
----- _
__ --
_ ._
City of
Residential Sanitary Sewer Service
Compliance Inspection
Date 6 ,'/ / / /x
Name / 4/"Fzt/ ;` 7/X. //r'i42 i,Disk #
PID Number
House Number
Alternative Mailing Address
Compliance
No foundation drain connection
t No roof drain connection
O Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
Roots
Poor Pipe joints
Mineral Deposits &L _ , -
Sag/Pipe Deflection ( Z7 < C ' f
Damaged Pipe
'Transition
4" to 6 "Transition:
White Copy: Property Owner
i z or am
Time evil O pm
J Street Name
OwnerlOccupant Signature
(' °t�� r ..
1
l
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
0
For. information ;call 651.470.2788
Obstruction
Unable to push past
feet,
Service Lateral Inspection Findings Number of stacks Entered S.L.at i } t{.2i!
�J s
o
/ %
Phone
') 3, s
9
inspector Signature
Notes -
`i ;° t ter
!s?Jf'rsL �`
Time t • //Li
r�j am
0 pm
No Access
O No one in
Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
4+�
Pink Copy: SEH