2089 Copper Lane - Inspection FormCity o';,a
Res dentiai Sanitary Seinrer Service
Compliance Inspection
Date!`,' i / /
Name ) //>
•
PID Number
House Number'
Alternative Mailing Address
Compliance
d 'No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Sag /Pipe Deflection
4" to 6 "Transition:
Sump pumps
Foundation drains
Roof drains
White Copy: Ptoperty Owner
00 ,4-am
Time / </ ; O pm
Disk #
Street Name
Owner /Occupant Signature
For information call 651.470.2788
Service Lateral Inspection Findings
Roots
Poor Pipet oints
Mineral Deposits
Damaged Pipe
Transition 4. �� �'=�" �f,,.�-
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 / Entered S L. at J / - (7,<5-7
Number Discharged
Correctly
Length of Service:
LL1 Lid
Incorrectly
Unknown
Yellow Copy: City of Eagan
Record Number
J `
f f0 a
Time! �� o O pm
Phone ,./ez).
%
Obstruction
Unable to push past
feet
Inspector Signature
Final CI anout: r f
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH