4857 Windsor Ct - Inspection Formas a
•
R_esidential Sanita r Sewer Ser
Co fiance o pe do
Date 1 17 I \ C) Time
Narne
PID Number
House Number
Alternate Mailing Address
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
o Sump Pump properly piped
No sump pump
Service Lateral Inspection Findings
daft 1 Il k 'IL
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
r=1,, .x.,1 \.(-
Owner /Occupant Signature
4" too Transition: 04
White Copy: Property Owner
Disk #
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
04 C4
o am
o pm
Street Name
Number of stacks
Yellow Copy: City of Eagan
Record Number c i c . \ r }
Time
Obstruction
r C"
Ph
For Information call 651.470.2788
Unable to push past
feet
4'
Inspector Signature
O am
O pm
No Access
O No one in
o Access to service lateral
needed
O Inspection refused
Entered S L at
Length of Service: -C - Final Cleanout: (3 c �--
Pink Copy: Benjamin Franklin Plumbing
651 - 222 -1551
iz
Total
Notes
`" Sc "
'c -- C 1'e c a., ,-^,
Number
Discharged
Correctly
Incorrectly
Unknown
Sump Pumps
0
Foundation Drains
%�
Roof Drains
as a
•
R_esidential Sanita r Sewer Ser
Co fiance o pe do
Date 1 17 I \ C) Time
Narne
PID Number
House Number
Alternate Mailing Address
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
o Sump Pump properly piped
No sump pump
Service Lateral Inspection Findings
daft 1 Il k 'IL
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
r=1,, .x.,1 \.(-
Owner /Occupant Signature
4" too Transition: 04
White Copy: Property Owner
Disk #
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
04 C4
o am
o pm
Street Name
Number of stacks
Yellow Copy: City of Eagan
Record Number c i c . \ r }
Time
Obstruction
r C"
Ph
For Information call 651.470.2788
Unable to push past
feet
4'
Inspector Signature
O am
O pm
No Access
O No one in
o Access to service lateral
needed
O Inspection refused
Entered S L at
Length of Service: -C - Final Cleanout: (3 c �--
Pink Copy: Benjamin Franklin Plumbing
651 - 222 -1551
iz