673 Windtree Knoll - Inspection Formcity of o
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date ///1( 1 /r
Name r -,� ..fii'3
PID Number
House Number
Alternative Mailing Address
Time ."• c.";O prn
Disk #
Street Name
Owner/Occupant Signature
Compliance
p ' No foundation drain connection
A No roof drain connection
O Sump pit not connected to
sanitary sewer
y Sump pump properly piped
O No sump pump
Service Lateral inspection Findings
4" to 6" Transition:
White Copy: Property Owner
0
t'a
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
0
,er??—/"tom
Number • of stacks
Length of Service:
Yellow Copy: City of Eagan
7=
Obstruction
Unable to push past
feet
Record Number
am
A ri Time C- 7 � :�,� o pm
s _
Phone 6 -
f'�lnspectar Signature
For information calf 651.470.2788
Entered S L at TA"/"
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection 7..0 Mf r
Damaged Pipe
Transition (1-4,/ , °
Final Cleanout: , r
Pink Copy: SEH
Total
Notes
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
I
Foundation drains
Roof drains
city of o
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date ///1( 1 /r
Name r -,� ..fii'3
PID Number
House Number
Alternative Mailing Address
Time ."• c.";O prn
Disk #
Street Name
Owner/Occupant Signature
Compliance
p ' No foundation drain connection
A No roof drain connection
O Sump pit not connected to
sanitary sewer
y Sump pump properly piped
O No sump pump
Service Lateral inspection Findings
4" to 6" Transition:
White Copy: Property Owner
0
t'a
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
0
,er??—/"tom
Number • of stacks
Length of Service:
Yellow Copy: City of Eagan
7=
Obstruction
Unable to push past
feet
Record Number
am
A ri Time C- 7 � :�,� o pm
s _
Phone 6 -
f'�lnspectar Signature
For information calf 651.470.2788
Entered S L at TA"/"
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection 7..0 Mf r
Damaged Pipe
Transition (1-4,/ , °
Final Cleanout: , r
Pink Copy: SEH