4871 Knottingham Cir - Inspection FormBallad Sanitary Sewer Service
Compliance Ins,pection
it s0 Ea wa
Date , I l
Name
PID Number
House Number
Alternate Mailing Address
(//-
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
�2
Owner /Occupant Signature
For Information call 651.470.2788
Compliance
o No foundation drain connection
o No roof drain connection
c Sump pit not connected to
/ \. sanitary sewer
o Sump Pump properly piped
ONo sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time
/ r brt.&-
}
Disk #
o am
' Or 9 p
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
s
Street Name
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
n
Time
Phone
Unable to push past
feet
Inspector Signature
Entered S L at
C r
Final Cleanout:
o am
o pm
No Access
a No one in
o Access to service lateral
needed
o Inspection refused
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551
N umber
Correctly
Discharged
Incorrectly Unknown
Notes
Total
Sump Pumps
M--
Foundation brains
El
Roof Drains
---
Ballad Sanitary Sewer Service
Compliance Ins,pection
it s0 Ea wa
Date , I l
Name
PID Number
House Number
Alternate Mailing Address
(//-
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
�2
Owner /Occupant Signature
For Information call 651.470.2788
Compliance
o No foundation drain connection
o No roof drain connection
c Sump pit not connected to
/ \. sanitary sewer
o Sump Pump properly piped
ONo sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time
/ r brt.&-
}
Disk #
o am
' Or 9 p
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
s
Street Name
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
n
Time
Phone
Unable to push past
feet
Inspector Signature
Entered S L at
C r
Final Cleanout:
o am
o pm
No Access
a No one in
o Access to service lateral
needed
o Inspection refused
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551