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4253 Sandstone Dr - Inspection FormSump pumps ( Foundation drains ' ,, Roof drains Residential Sanitary Sewer Service Compliance Inspection Date / Fe/ )(3 Nam PID Number House Number ._t Street Name Alternative Mailing Address • For, inforrrnation call 651:470.2788 Compliance O No foundation drain connection O No roof drain connection O Sump pit not connected to sanitary sewer Sump pump properly piped No sump pump 4" to 6" Transition: White Copy: Property Owner 7 ode I I I am Time_. • �t pm i Disk # Owner /Occupant Signature i ( 1' gy - 7 - Phone % -:.., �-� __ l' ✓'C 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 rmwmiw i Service Lateral Inspection Findings Number of stacks Entered S.L.at, Roots Poo Pipe /oints Mine Deposits --� ''' 2 /) "` } - / -7 ,) __ -:- -- r Sag/ ip Deflection i r' � � ��'! % r` ?� ' D maged Pipe -, l : ' = i ) _..` -.__ ' L /i J,�. % "'' Transition .r 7 Length of Service: Number Discharged Total Correctly Incorrectly Unknown Record Number am Time • 4' Pm Obstruction Unable to push past feet Notes r - / Inspector Signature Final Cleanout: No Access O No one in O Access to service lateral needed O Inspection refused Yellow Copy: City of Eagan Pink Copy: SEH Account # 260536 City of Eagan/City Dept at: Wayne Schwanz 3419 Coachman Pt Eagan MN 55122 Service At: Chad & Shawna Peterson 4253 Sandstone Di Eagan MN 55122 Service Date 09/15/10 PO # Camera inspection of sewer line. Description Of Service Camera inspection of sewer line. 1 Remit Io: 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 #2'7- 1025956 Job # 216834 Quantity DUNS #027314893 Ter ms: Due 10/15/2010 Please pay from this Invoice. Thank You Please Detach and Return with Remittance Check Enclosed [ ] Method of Payment Master Card [ ] Visa [ ] AmExp [ ] Discover [ ] Acct # Exp Date Name on Card Signature Unit Price $215.00 Amount Due Amount Paid Balance Due Date : Invoice # Date: Page # A72275 09/15/10 1 of 1 Extended Price Tx $215.00 $215.,00 Invoice # A72275 09/15/10 Account 260536 City of Eagan /City Dept at: $215.00 Residential San a Sewer Service Compliance nspection o Date f Name PID Number House Number 2105 Compliance o No foundation drain connection o No roof drain connection o Sump pit not connected to sanitary sewer o Sump Pump properly piped o No sump pump Time Service Lateral Inspection Findings Roots Poor Pipe Joints Mineral Deposits SaglPipe Deflection Damaged Pipe Transition 4" to 6" Transition: White Copy: Property Owner Disk # o am o pm Street Name Alternate Mailing A ddress Owner /Occupant Signature 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 Length of Service: Yellow Copy: City of Eagan Record Number e9i Obstruction Unable to push past feet Time Phone Inspector Signature For Information call 651.470.2788 Number of stacks Entered 5 L at No Access o No one in O Access to service lateral needed O Inspection refused Final Cleanout: o am o pm Number Discharged Sump Pumps Foundation Drains Roof Drains Total 1 4 L Correctly Incorrectly Unknown Notes k t Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551