4236 Limestone Dr - Inspection FormCity fl1 F,af
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
PID Number
House Number : Street Name
Alternative Mailing Address
Owner /Occupant Signature
For information call 651.470.2788
o pliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
Service Lateral Inspection Findings Number of stack
Roots ,.<,. ) iT) ✓�
Poor Pipe Joints
Mineral Deposits
4" to 6 "Transition:
White Copy: Property Owner
am
Time pm
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
1
dar
Length of Service:
71 /
Record Number
Phone
Entered S L.at
p°`-Time
Inspector Signature
Obstruction
Un� ble to push past
Meet.
��-
{
Sag /Pipe Deflection .� p
Damaged Pipe !)
Transition - ,211
Final Cleanout:
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown"
Notes
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Total
Sump pumps
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Foundation drains
Roof drains
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City fl1 F,af
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
PID Number
House Number : Street Name
Alternative Mailing Address
Owner /Occupant Signature
For information call 651.470.2788
o pliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
Service Lateral Inspection Findings Number of stack
Roots ,.<,. ) iT) ✓�
Poor Pipe Joints
Mineral Deposits
4" to 6 "Transition:
White Copy: Property Owner
am
Time pm
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
1
dar
Length of Service:
71 /
Record Number
Phone
Entered S L.at
p°`-Time
Inspector Signature
Obstruction
Un� ble to push past
Meet.
��-
{
Sag /Pipe Deflection .� p
Damaged Pipe !)
Transition - ,211
Final Cleanout:
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Yellow Copy: City of Eagan Pink Copy: SEH