2077 Copper Lane - Inspection FormCity of Piagn
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name 4 ° r /r ,rrDisk#
PID Number
House Number :'O2 7
) ri
r . r i�� rs!
/f
T pliance
I No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6" Transition:
White Copy: Property Owner
Time df 1 • • 2 p pm
Owner /Occupant Signature
Service Lateral Inspection Findings
Roots S; r--C"
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 I
Poor Pipe Joints _
Mineral Deposits C
Sag /Pipe Deflection
Damaged Pipe
Transition / „,,r- ( —) . 7;,”
f. w
Length` of Service:
Record Number
Street Name
i
Alternative Mailing Address
Time • . ..� - O pm
Phone 1,/} - 41,/}
{s ✓�s�#- -L .
i nspector Signature
For information call 651:4703788
Obstruction
Unable to push past
feet.
Entered S L, at `T'irr .°it:_.. (�)
Final Cleanout: ,,r
No Access
O No one in
am
O Access to service .
lateral needed
O Inspection
r efused
Notes (L
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number. Discharged
Correctly
Incorrectly
Unknown
Sump pumps
..._— ._.___m.._
_ —
Foundation drains
/
__- —
Roof drains'
_______
. ._.____
_ _
City of Piagn
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name 4 ° r /r ,rrDisk#
PID Number
House Number :'O2 7
) ri
r . r i�� rs!
/f
T pliance
I No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6" Transition:
White Copy: Property Owner
Time df 1 • • 2 p pm
Owner /Occupant Signature
Service Lateral Inspection Findings
Roots S; r--C"
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 I
Poor Pipe Joints _
Mineral Deposits C
Sag /Pipe Deflection
Damaged Pipe
Transition / „,,r- ( —) . 7;,”
f. w
Length` of Service:
Record Number
Street Name
i
Alternative Mailing Address
Time • . ..� - O pm
Phone 1,/} - 41,/}
{s ✓�s�#- -L .
i nspector Signature
For information call 651:4703788
Obstruction
Unable to push past
feet.
Entered S L, at `T'irr .°it:_.. (�)
Final Cleanout: ,,r
No Access
O No one in
am
O Access to service .
lateral needed
O Inspection
r efused
Notes (L
Yellow Copy: City of Eagan Pink Copy: SEH