2061 Bluestone Dr E - Inspection FormCity 01' Ea a..
Residential Sanitary Sewer Service
Compliance Inspection
i"" jj 1
Date �'777. / ' / f (
Name . " 1./
PO Number
House Number
Alternative MailingAddress
1
i
For information cal! 651;470.2788
Compliance
No sump pump
Mineral Deposits
r9
'
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Service Lateral Inspection Findings
Roots
Poor Pipe Joints /
r ;ASa,g /Pipe Deflection
Damaged Pipe
Transition ; ( ?1
4" to 6" Transition:
White Copy: Property Owner
1 i am
Time / • p
Disk #
Street Name
ccupant Signature
t _
L Th
, / 7 1 '�
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
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
." r
Phone r" - �,
% :
Obstruction No Access
Unable to push past 0 No one in
feet
L r
Entered S L at /_,>t_
Time
inspector Signature
pm
�Ew
O inspection
refused
O Access to service .
lateral needed
i rival Cleanout: ��'�
- cam: "',
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
Total
Sump pumps
,.. -.
Foundation drains
Roof drains
'
---. C , 1re -` J 5/0 ii)
City 01' Ea a..
Residential Sanitary Sewer Service
Compliance Inspection
i"" jj 1
Date �'777. / ' / f (
Name . " 1./
PO Number
House Number
Alternative MailingAddress
1
i
For information cal! 651;470.2788
Compliance
No sump pump
Mineral Deposits
r9
'
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Service Lateral Inspection Findings
Roots
Poor Pipe Joints /
r ;ASa,g /Pipe Deflection
Damaged Pipe
Transition ; ( ?1
4" to 6" Transition:
White Copy: Property Owner
1 i am
Time / • p
Disk #
Street Name
ccupant Signature
t _
L Th
, / 7 1 '�
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
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
." r
Phone r" - �,
% :
Obstruction No Access
Unable to push past 0 No one in
feet
L r
Entered S L at /_,>t_
Time
inspector Signature
pm
�Ew
O inspection
refused
O Access to service .
lateral needed
i rival Cleanout: ��'�
- cam: "',
Pink Copy: SEH