3490 Wolfberry Ct - Inspection FormCity Iii' Ia
Residential Sanitary Sewer Service
Compliance Ins pect on
Dat� 1 1r l
Name r 1 Disk#
PID Number
House Number '<-
L
Alternative Mailing Address
,1
mod / 7,11
For information call 651.470.2188
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits 1
-') C? ' ?r 1
Sag /Pipe Deflection % `� " "7 ; = `
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
/ , Street Name i
Owner /Occupant Signature
/ 7
-• .. = .. fC' am
Time • ppp}}r pm
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 S L at
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time e• •
pm
Notes
inspector Signature
Obstruction
Unable to push past
feet
? 7 •
Final Cleanout:
) am
"--Th - . ::_, "�'J
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
1
)
Pink Copy: SEH
Number::
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
i
Y
ii
Foundation drains
, .
Roof drains
City Iii' Ia
Residential Sanitary Sewer Service
Compliance Ins pect on
Dat� 1 1r l
Name r 1 Disk#
PID Number
House Number '<-
L
Alternative Mailing Address
,1
mod / 7,11
For information call 651.470.2188
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits 1
-') C? ' ?r 1
Sag /Pipe Deflection % `� " "7 ; = `
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
/ , Street Name i
Owner /Occupant Signature
/ 7
-• .. = .. fC' am
Time • ppp}}r pm
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 S L at
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time e• •
pm
Notes
inspector Signature
Obstruction
Unable to push past
feet
? 7 •
Final Cleanout:
) am
"--Th - . ::_, "�'J
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
1
)
Pink Copy: SEH