2017 Jade Lane - Inspection Form41 , 1 1 111 'city or Ea an
Residential Sanitary Sewer Service
Compliance Inspection
Date (..VS -1 2 2/ Ye)
Name _77 E Pv$ -),4 Disk # I ,1
HD Number
House Number 2'01
Alternative Mailing Address
Compliance
No foundation drain connection
r No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
'No sump pump
Service Lateral Inspection Findings
Roots 6
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
4" to 6" Transition:
White Copy: Property Owner
ern
Time / : p pm
Owner /Occupant Signature
O
0
O
O
O
Street Name
Non - Compliance
Damaged Pipe
Transition L; t"^.f (/ }°
z
Liv
For information call 451.470:2788
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks / Entered S L. at
Length of Service:
Yellow Copy: City of Eagan
Record Number
_ '
Time 07 •
Phone ,'" l 11�� tG7
- inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
l vw
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Note s C' . ? c.; ; - � -, t
?. d { z,„
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
:y°
,," ° ~ -_°
- _--
--�
Foundation drains
(,,.
Roof drains
----- --
-- -- ---
.
41 , 1 1 111 'city or Ea an
Residential Sanitary Sewer Service
Compliance Inspection
Date (..VS -1 2 2/ Ye)
Name _77 E Pv$ -),4 Disk # I ,1
HD Number
House Number 2'01
Alternative Mailing Address
Compliance
No foundation drain connection
r No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
'No sump pump
Service Lateral Inspection Findings
Roots 6
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
4" to 6" Transition:
White Copy: Property Owner
ern
Time / : p pm
Owner /Occupant Signature
O
0
O
O
O
Street Name
Non - Compliance
Damaged Pipe
Transition L; t"^.f (/ }°
z
Liv
For information call 451.470:2788
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks / Entered S L. at
Length of Service:
Yellow Copy: City of Eagan
Record Number
_ '
Time 07 •
Phone ,'" l 11�� tG7
- inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
l vw
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH