4236 Moonstone Dr - Inspection Form411
City of hp
Residential Sanitary Sewer Service
Compliance Inspection
�i
Date
Name
1 1 �r�� 1 Disk #
PID Number
House Number rStreet Name
Alternative Mailing Address
Time
'Owner /Ocupant Signature
For information call 65
Com pliance
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: Z
White Copy: Property Owner
r • ,7?- , O am
_ I Pm
i
7
Service Late9.1 Inspection Findings Number of stacks
Roots
f J �
Phone
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
Length of Service: � - � - r
Yellow Copy: City of Eagan
Record Number
ime
�.)
Inspector Signature
ft
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Entered S..L.at
c
"7
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout: /
Pink Copy: SEH
Number
Correctly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
(_J
411
City of hp
Residential Sanitary Sewer Service
Compliance Inspection
�i
Date
Name
1 1 �r�� 1 Disk #
PID Number
House Number rStreet Name
Alternative Mailing Address
Time
'Owner /Ocupant Signature
For information call 65
Com pliance
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: Z
White Copy: Property Owner
r • ,7?- , O am
_ I Pm
i
7
Service Late9.1 Inspection Findings Number of stacks
Roots
f J �
Phone
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
Length of Service: � - � - r
Yellow Copy: City of Eagan
Record Number
ime
�.)
Inspector Signature
ft
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Entered S..L.at
c
"7
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout: /
Pink Copy: SEH