4242 Limestone Dr - Inspection FormCit,y a
Resident San Sewer Service
Compliance Inspection
Date ova 1, Z. 9 1 /a
5
Name t / ; / Disk #
r
PID Number
Rouse Number
Alternative Mailing Address
For information call :651.470.278
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
iCP No sump pump
/ 1
6 -fir' , <� - ✓r'_._.e
Owner /Occupant Signature
i J
4" to 6" Transition:
White Copy: Property Owner
Time OP • t9 76 0 Pm
77 Street Name �!' "� f i�' ✓
P one 7 f7 I 7 " r ('
f .
W ! ,inspector Signature
,
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:
1 r ,rf`72 e t?
Yellow Copy: City of Eagan
Record Number S /
' am
Time ( v' ` pm
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks ( Entered S. L at ; j r.�t't
Roots r r C
O
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout: ti V4'
Pink Copy: SEH
Total
Notes , - 4� a z;/v
/ -r -Cry ,
" ! 0 .�! rr r f � " f ?�tt' .;zie
a
ve -/
. : e
- , r 's - �T`': ^?
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
.._ _.._.s- ,.,.
- -- ---°Y
_
Foundation drains
Roof drains
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e „_r-
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Cit,y a
Resident San Sewer Service
Compliance Inspection
Date ova 1, Z. 9 1 /a
5
Name t / ; / Disk #
r
PID Number
Rouse Number
Alternative Mailing Address
For information call :651.470.278
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
iCP No sump pump
/ 1
6 -fir' , <� - ✓r'_._.e
Owner /Occupant Signature
i J
4" to 6" Transition:
White Copy: Property Owner
Time OP • t9 76 0 Pm
77 Street Name �!' "� f i�' ✓
P one 7 f7 I 7 " r ('
f .
W ! ,inspector Signature
,
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:
1 r ,rf`72 e t?
Yellow Copy: City of Eagan
Record Number S /
' am
Time ( v' ` pm
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks ( Entered S. L at ; j r.�t't
Roots r r C
O
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout: ti V4'
Pink Copy: SEH