2026 Emerald Lane - Inspection FormCity of Evan
Residential Sanitary Sewer Service
Compliance Inspection
Date I_
Name
PID Number
House Number
try;
Alternative Mailing Address
Owner, iccu ant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
C. No sump pump
4" to 6 "Transition:
White Copy: Property Owner
r f • 0 am
• Cfpm
Time
Street Name
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
Service Lateral Inspection Findings r `G , ,l umber of stacks
Roots 7.7 _� T `�
Poor PipeJoints i)
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition 1 _ it - �''�' i � +
Length of Service:
Record Number
Time
Phone
Inspector Signature
Obstruction
Unable to push past
feet
• %'0 am
Entered S L at -�-
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes
Pm
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
City of Evan
Residential Sanitary Sewer Service
Compliance Inspection
Date I_
Name
PID Number
House Number
try;
Alternative Mailing Address
Owner, iccu ant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
C. No sump pump
4" to 6 "Transition:
White Copy: Property Owner
r f • 0 am
• Cfpm
Time
Street Name
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
Service Lateral Inspection Findings r `G , ,l umber of stacks
Roots 7.7 _� T `�
Poor PipeJoints i)
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition 1 _ it - �''�' i � +
Length of Service:
Record Number
Time
Phone
Inspector Signature
Obstruction
Unable to push past
feet
• %'0 am
Entered S L at -�-
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes
Pm
Yellow Copy: City of Eagan Pink Copy: SEH