4065 Mica Tr - Inspection Form' City of Capp
Residential .Sanitary Sewer Service
Compliance Inspection
Date.. Irk 7 1 ;(i
Name J A . /".1, ' ]( _'.- 1.f1 /J Disk #
PID Number.
House Number )065 Street Name
Alternative Mailing Address
onpliance
I No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
White Copy: Property Owner
Time
Owner/Occupant Signature
am
Pm
) k t ;
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
Yellow Copy: City of Eagan
1
Record Number 1
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
( 74, l
ime ! -A a
Phone _ /Cr _ ✓ ' `.
Inspector Signature
For information call 65
Obstruction
Unable to push past
feet
Service Lateral inspection Fiings Numberof stacks _ _ Entered S.L.at
Roots
O am
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
�w1
L
' e i 1 � I
S C
Transition ; 1 (- - n r , , � ;
_�
4" to 6 "Transition: Length of Service: r - - Final Cleanout:/ '/ iT r
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
Total
!
Sump pumps
Foundation drains
r ' , f
Roof drains
' City of Capp
Residential .Sanitary Sewer Service
Compliance Inspection
Date.. Irk 7 1 ;(i
Name J A . /".1, ' ]( _'.- 1.f1 /J Disk #
PID Number.
House Number )065 Street Name
Alternative Mailing Address
onpliance
I No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
White Copy: Property Owner
Time
Owner/Occupant Signature
am
Pm
) k t ;
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
Yellow Copy: City of Eagan
1
Record Number 1
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
( 74, l
ime ! -A a
Phone _ /Cr _ ✓ ' `.
Inspector Signature
For information call 65
Obstruction
Unable to push past
feet
Service Lateral inspection Fiings Numberof stacks _ _ Entered S.L.at
Roots
O am
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
�w1
L
' e i 1 � I
S C
Transition ; 1 (- - n r , , � ;
_�
4" to 6 "Transition: Length of Service: r - - Final Cleanout:/ '/ iT r
Pink Copy: SEH