2085 Marble Lane - Inspection FormCity of Capri
aii
Residential Sanitary Sewer Service
Compliance Inspection
Date l / / /
Name 1- ,j '/"/Zit.'` '
PID Number
House Number .(191"- Street Name
Alternative MailingAddress
Owner /Occupant Signature
No sump pump
4" to 6 "Transition:
Compliance
O,No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
A
Service Lateral Inspection Findings
- t
White Copy: Property Owner
. • p am
Times • r�rr =� pm
Disk #
For information call 651.470.2788 '.
0
7
1
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
Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time o pm
Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
Entered S . at
p ro
O Access to service
lateral needed
O Inspection
refused
�.J
Final Cleanout:
Pink Copy: SEH
'
T
Notes _
- e-
- v
; i`; .- ^
Number
Discharged
Correctly
Incorrectly
Unknownh
Sump pumps
Foundation drains
- --. - --
Roof _drains
--~- b
City of Capri
aii
Residential Sanitary Sewer Service
Compliance Inspection
Date l / / /
Name 1- ,j '/"/Zit.'` '
PID Number
House Number .(191"- Street Name
Alternative MailingAddress
Owner /Occupant Signature
No sump pump
4" to 6 "Transition:
Compliance
O,No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
A
Service Lateral Inspection Findings
- t
White Copy: Property Owner
. • p am
Times • r�rr =� pm
Disk #
For information call 651.470.2788 '.
0
7
1
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
Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time o pm
Inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
Entered S . at
p ro
O Access to service
lateral needed
O Inspection
refused
�.J
Final Cleanout:
Pink Copy: SEH
-1
Number
Correctly
Discharged
incorrectly Unknown
N otes --1,V� 4 ,./ r r'(;) y
Z- /7 — fl O' ✓ r6 ( . rte , ; '. (
iG7f Grid z _ �.ts, t .
L c; r:.!`-- 'o VUv '.7 6,` r r
5
Total
Sump pumps
,• `; P
a.- • °. ~`W'
°° - . _
Foundation drains
Roof drains
City of tap
Residential Sanitary Sewer Service
Compliance Inspection
Date {/ 2 1 2✓ / /c/
Name Disk #
PID Number
House Number
Alternative Mailing Address
0
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
iJ No sump pump
Service Lateral Inspection Findings
Roots - 5-07
4" to 6 "Transition: j
White Copy: Piopetty Owner
Street Name ✓'r rte'` 2 -
�! \ .�:,��JC...
Owner /Occupant Signature
• ce-am
Time ./././ • J/ o pm
0
21-E2 [du]
Non - Compliance
O Clear water connections to
sanitary sewer
O Ser vice 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 _ _
/ • �y am
Time / s O pm
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks _ / Entered S.L at A'./1C .y :
Poor Pipe Joints
Mineral Deposits �.^ _
Sag /Pipe Deflection ,,,J: -5 0
Damaged Pipe
Transition
pi`s ��- ,.r�iy,•
Pink Copy: SEH