4259 Moonstone Dr - Inspection Formtill of Lion
Residential Sanitary Sewer Service
Compliance Inspection
Date 0 1 .i 1
Name /4 „y / /t/ / ( Disk #
Time s r JC' C3 'am
PiD Number
House Number. Street Name
Alternative Mailing Addr ess
Compliance
O tl o foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
+0 No sump pump
r!, /, =.
Own erIOccupant Signature
Service Lateral Inspection Findings
Roots 27° / /
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
White Copy: Property Owner
i
4" to 6" Transition: / a // W ,77 Length of Ser vice:
Phone
5
Time
Obstruction
Unable to push past
feet
t,r
J
!
r
Record Number _!_ ---
r3 : 0 a
k
ins gctor Signature
For information call 651
No Access
O No one in
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 Entered St at � (
Final Cleanout: J
Notes "Z7
A (Vc-trlif, /5/ii
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number Discha
ged
Correctly
incorrectly
Unknown
Sump pumps
—_ ��_
Foundation drains
/�
._
-- - -"
Roof drains
,f
�
_._.._. -
_._-�..T_ ___ - --
till of Lion
Residential Sanitary Sewer Service
Compliance Inspection
Date 0 1 .i 1
Name /4 „y / /t/ / ( Disk #
Time s r JC' C3 'am
PiD Number
House Number. Street Name
Alternative Mailing Addr ess
Compliance
O tl o foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
+0 No sump pump
r!, /, =.
Own erIOccupant Signature
Service Lateral Inspection Findings
Roots 27° / /
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
White Copy: Property Owner
i
4" to 6" Transition: / a // W ,77 Length of Ser vice:
Phone
5
Time
Obstruction
Unable to push past
feet
t,r
J
!
r
Record Number _!_ ---
r3 : 0 a
k
ins gctor Signature
For information call 651
No Access
O No one in
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 Entered St at � (
Final Cleanout: J
Notes "Z7
A (Vc-trlif, /5/ii
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH