4364 Copper Pt - Inspection FormCity of F,Sa o
Residential Sanitary Sewer Service
Compliance Inspection
Datei7):IC �✓
Name 4 #I C; 1 - 1
HD' Number
House Number __ <7 Street Name
Alternative Mailing Address
•
Time 4,- •
14 1 J
Owner /Occupant Signature
Compliance
f
X0. No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
o am
• pm
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
•
White Copy: Propetty Owner
LLJ -[J J
1
For information. call 651.4701788
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:
Record Number
Time
,- 1�
P h p n e m �_a� - -- .
ff ,I
i i .!Inspector Signature
Obstruction
Linable to push past
feet
I . r J
•� o
• o m
Final Cleanout:
No Access
O No one in
Number of stacks / Entered S L at J1/16-
(2'
O Access to service
lateral needed
O Inspection
r efused
Notes e .. f S / c
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number Discharged
Correctly
_iiMIN
--MEE
Incorrectly Unknown
Sump pumps
//0 ..-
Foundation drains
7a----
Roof drains
City of F,Sa o
Residential Sanitary Sewer Service
Compliance Inspection
Datei7):IC �✓
Name 4 #I C; 1 - 1
HD' Number
House Number __ <7 Street Name
Alternative Mailing Address
•
Time 4,- •
14 1 J
Owner /Occupant Signature
Compliance
f
X0. No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
o am
• pm
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
•
White Copy: Propetty Owner
LLJ -[J J
1
For information. call 651.4701788
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:
Record Number
Time
,- 1�
P h p n e m �_a� - -- .
ff ,I
i i .!Inspector Signature
Obstruction
Linable to push past
feet
I . r J
•� o
• o m
Final Cleanout:
No Access
O No one in
Number of stacks / Entered S L at J1/16-
(2'
O Access to service
lateral needed
O Inspection
r efused
Notes e .. f S / c
Yellow Copy: City of Eagan Pink Copy: SEH