4265 Limestone Dr - Inspection FormSump pumps
Foundation drains
ry — "
Roof drains
r ..-
--
—
City a ' ha an
Residential Sanitary Sewer . Service
Compliance Inspection
Date 6 / / /'l / 7
Name
A. / ..; {C Disk#
PID Number
House Number
Alternative Mailing Address
(ices �• vi
Owner/Occupant Signature
Compliance
O' foundation drain connection
- No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6" Transition: /
White Copy: Property Owner
Time / e✓
Street Name
O
O
O
O
O
0
cOam
O pm
- A-51A
Non - Compliance
Clear water connections to
sanitary sewer.
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
/ e
Time •
c
Phone (d - t - t}
For information call 65
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks ( Entered S L at .11TAC, fJ
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition L / ( ''
" /4A - r-
Final Cleanout:
Notes
Inspector Signature
am
o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SE