2037 Bluestone Lane - Inspection FormResidential Sanitary Sewer Service
City O 1apii Compliance Inspection
Date CY1 7 /
Name 6 / /4741 7 Disk #
PID Number
House Number
Alternative Mailing Address
For information call 651.470.2788
Compliance
2or
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pip , o
Transition /4- , i v e fi - q 7 d�
4" to 6" Transition:
White Copy: Property Owner
Owner/Occupant Signature
Ai t
Time f/ff O p pm
Street Name 72 }/
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
,Oam
Q pm
o I
Time a
Phone _ 77 r,''e
Inspector Signature
Obstruction
Unable to push past
feet
•
s
arlYC
No Access
O No one in
O Inspection
refused
Final Cleanout: j""
O Access to service
lateral needed
Notes 'i i ]
cat,
6 /5
ierf
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
d
Foundation drains
- -- w----r
Roof drains
)
°-- - -_ - -- - _..-
.._..._._-- �.__.�.
- - _.
Residential Sanitary Sewer Service
City O 1apii Compliance Inspection
Date CY1 7 /
Name 6 / /4741 7 Disk #
PID Number
House Number
Alternative Mailing Address
For information call 651.470.2788
Compliance
2or
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pip , o
Transition /4- , i v e fi - q 7 d�
4" to 6" Transition:
White Copy: Property Owner
Owner/Occupant Signature
Ai t
Time f/ff O p pm
Street Name 72 }/
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
,Oam
Q pm
o I
Time a
Phone _ 77 r,''e
Inspector Signature
Obstruction
Unable to push past
feet
•
s
arlYC
No Access
O No one in
O Inspection
refused
Final Cleanout: j""
O Access to service
lateral needed
Notes 'i i ]
cat,
6 /5
ierf
Pink Copy: SEH