2043 Copper Lane - Inspection Formtits t1' Fia it
Residential Sanitary Sewer Service
Compliance Inspection
House Number
Date/27J / T I % L
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Name F ,ZL`ZI <J,
PID Number' -
Alternative Mailing Address
J • C ) r
Time • o pm
isk #
Street Name
OwnerlOccupant Signature
Compliance
o No foundation drain connection
I rby No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots - =
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
0
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Poor Pipe Joints
Mineral Deposits e- /9 -
Sag/Pipe Deflection_
Damaged Pipe
Transition
4" to 6" Transition
Length of Service:
/ ''
Sump pumps
Foundation drains
Roof drains
White Copy: Property Owner
d � �
t 0, 7v , /,101/
Total
Correctly
7
Number of stacks
Incorrectly
1
f r`4 , / /4
Unknown
Record Number ¢
Time // : ---
Phone _ -' 1, 67 ail
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i
i ! inspector Signature
Obstruction
Unable to push past
feet
Entered S L at , r
Notes
Final Cleanout: j
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
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Yellow Copy: City of Eagan
69 1 147 -_
Pink Copy: SEH