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808 Ivy Lane - Inspection FormCity of o Residential Sanitary Sewer Service Compliance Inspection Date / I(7 • l ` Nam PID Number I -louse Number. Alternative Mailing Address !'„,f j _;�OwnerlOccupant Signature For information call 651.470.2788 Non - Compliance No foundation drain connection 0 Clear water connections to Compliance 0 O No roof drain connection O Sump pit not connected to sanitary sewer O Sump pump properly piped O No sump pump Transition 4" to 6" Transition: White Copy: Proper ty Owner r% Service Lateral Inspection Findings Roots Poor Pipe joints Mineral Deposits Sag /Pipe Deflection am Time / • o pm Disk # Street Name � -CL1 1 sanitary sewer O Service lateral defects O Defective manholes O Sump pump connected to sanitary sewer O Flexible sump pump piping Number of stacks f �y Damaged Pipe Length of Service: Yellow Copy: City of Eagan Record Number 7 _ Notes Time Obstruction Unable to push past feet Entered S L at Inspector Signature Final Cleanout: o am • • o pm Phone r�'_ -___� - �.!> No Access 0 No one in Access to service lateral rje ed r 0 Inspeeti - ' refused Pink Copy: SEH Number Correctly Discharged Incorrectly Unknown Total Sump pumps Foundation drains Roof drains City of o Residential Sanitary Sewer Service Compliance Inspection Date / I(7 • l ` Nam PID Number I -louse Number. Alternative Mailing Address !'„,f j _;�OwnerlOccupant Signature For information call 651.470.2788 Non - Compliance No foundation drain connection 0 Clear water connections to Compliance 0 O No roof drain connection O Sump pit not connected to sanitary sewer O Sump pump properly piped O No sump pump Transition 4" to 6" Transition: White Copy: Proper ty Owner r% Service Lateral Inspection Findings Roots Poor Pipe joints Mineral Deposits Sag /Pipe Deflection am Time / • o pm Disk # Street Name � -CL1 1 sanitary sewer O Service lateral defects O Defective manholes O Sump pump connected to sanitary sewer O Flexible sump pump piping Number of stacks f �y Damaged Pipe Length of Service: Yellow Copy: City of Eagan Record Number 7 _ Notes Time Obstruction Unable to push past feet Entered S L at Inspector Signature Final Cleanout: o am • • o pm Phone r�'_ -___� - �.!> No Access 0 No one in Access to service lateral rje ed r 0 Inspeeti - ' refused Pink Copy: SEH Account # 260536 City of Eagan/City Dept at: Wayne Schwarz 3419 Coachman Pt. Eagan MN 55122 Service At: Corinne Young 808 Ivy Ln Eagan MN 55123 Service Date 08/09/10 Description Of Service PO # Camera inspection of sewer line. Pull & reset toilet. Camera inspection of sewer line Remit I o: Benjamin Franklin Plumbing 1424 3rd St N Minneapoils MN 55411 Invoice Benjamin. Franklin Plumbing 1424 3rd St N Minneapolis MN 55411 612 - 604 -4285 FAX: 612-822-5408 FID #27- 1025956 Job # 214668 Quantity 1 Please Detach and Return with Remittance Check Enclosed [ ] Method of Payment Master Card [ ] Visa [ ] AmExp [ ] Discover [ ] Acct # Exp Date Name on Card Signature Amount Due Amount Paid Invoice # Date: Page # A22802 08/09/10 1of1 Unit Price Extended Price Tx $215.00 $215.00 Balance Due $215,00 DUNS #027314893 Terms: Due 9/8/2010 Please pay from this Invoice. Thank You Invoice # A22802 Date : 08/09/10 Account # 2605361 City of Eagan /City Dept at: $215 Residential Sanitary Sewer Service Compliance Inspection n j Cif of a an Date = / Name PID Number House Number No roof drain connection Transition , 1 White Copy: Property Owner r Owner Occuparif Compliance ,o\ No foundation drain connection i,. 1Q O Sump pit not connected to sanitary sewer o� Sump Pump properly piped 0 No sump pump Time Service Lateral Inspection Findings Roots Poor Pipe Joints Mineral Deposits SaglPipe Deflection Damaged Pipe 4" to 6" Transition: 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 O am o pm Street Name Alternate Mailing Address Phone C- ' � For Information can 651.470.2788 Number of stacks Length of Service: Yellow Copy: City of Fagan Record Number Obstruction - Unable to push past feet. Time Inspector Signature Entered S L at • o am o pm No Access o No one in o Access to service lateral needed o Inspection refused Final Cleanout: , Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551 Total N otes Number Discharged Correctly Incorrectly Unknown Sump Pumps (_/--) =I Foundation Drains i' , _ - Roof Drains � ( Residential Sanitary Sewer Service Compliance Inspection n j Cif of a an Date = / Name PID Number House Number No roof drain connection Transition , 1 White Copy: Property Owner r Owner Occuparif Compliance ,o\ No foundation drain connection i,. 1Q O Sump pit not connected to sanitary sewer o� Sump Pump properly piped 0 No sump pump Time Service Lateral Inspection Findings Roots Poor Pipe Joints Mineral Deposits SaglPipe Deflection Damaged Pipe 4" to 6" Transition: 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 O am o pm Street Name Alternate Mailing Address Phone C- ' � For Information can 651.470.2788 Number of stacks Length of Service: Yellow Copy: City of Fagan Record Number Obstruction - Unable to push past feet. Time Inspector Signature Entered S L at • o am o pm No Access o No one in o Access to service lateral needed o Inspection refused Final Cleanout: , Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551