4879 Knottingham Cir - Inspection Formof
Res dential Sanitary Sewer Service
Compliance Inspection
O
Date C., I f C7
✓ Disk #
Name z
PID Number
House Number
cl
Alternate Mailing Address
Owner /Occupant Signature
Compliance
1( No foundation drain connection
" No roof drain connection
Sump pit not connected to
sanitary sewer
Sump Pump properly piped
No sump pump
Damaged Pipe
Transition
White Copy: Property Owner
Time
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
)c) L(5
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
Sag /Pipe Deflection 1! ' ) OS' fi
t
J
6" Transition: / (-.
(J
K am
0 pm
Street Name
Number of stacks
Yellow Copy: City of Eagan
Record Number
For Information call 651.470.2788
Obstruction
Time
Phone
Unable to push past
feet.
Length of Service: )0 (
Inspector Signature
c7I &3
C
O am
o pm
No Access
O No one in
O Access to service lateral
needed
O Inspection refused
Entered S L at
7\ )
Final Cleanout:
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551
Number
Correctly
Discharged
Incorrectly
Unknown
Notes y} -,
I'i Lc, r
Total
Sum Pumps Sump p
11111
.i "
Foundation Drains
C
---
Roof Drains
El= ill
of
Res dential Sanitary Sewer Service
Compliance Inspection
O
Date C., I f C7
✓ Disk #
Name z
PID Number
House Number
cl
Alternate Mailing Address
Owner /Occupant Signature
Compliance
1( No foundation drain connection
" No roof drain connection
Sump pit not connected to
sanitary sewer
Sump Pump properly piped
No sump pump
Damaged Pipe
Transition
White Copy: Property Owner
Time
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
)c) L(5
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
Sag /Pipe Deflection 1! ' ) OS' fi
t
J
6" Transition: / (-.
(J
K am
0 pm
Street Name
Number of stacks
Yellow Copy: City of Eagan
Record Number
For Information call 651.470.2788
Obstruction
Time
Phone
Unable to push past
feet.
Length of Service: )0 (
Inspector Signature
c7I &3
C
O am
o pm
No Access
O No one in
O Access to service lateral
needed
O Inspection refused
Entered S L at
7\ )
Final Cleanout:
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551