4874 Windsor Ct - Inspection Form• Residential Banner Sewer Ser
Compliance Inspection
Eapt
Date I ' /
Name
PID Number
House Number
Alternate Mailing Address
1
For information call 651.470.2788
Compliance
O.
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump Pump properly piped
No sump pump
Owner /Occupant Signature
Service Lateral Inspection Findings
4" to 6" Transition:
Total
White Copy: Property Owner
Time
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
Number of stacks c2 Entered S.L. at C /
Roots
Poor Pipe Joints
j r
Mineral Deposits
O am
O pm
Street Name
Length of Service:
Number Discharged
Sump Pumps
Foundation Drains
Roof Drains
Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number f
Obstruction
Unable to push past
feet
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
Time
Phone
Inspector Signature
o am
o pm
No Access
O No one in
O Access to service lateral
needed
O Inspection refused
Final Cleanout: 3 r
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551