927 Wild Rose Ct - Inspection FormEfty oftap
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name )
Y\„
PID Number
House Number
Alternative Mailirig Address
Transition
4" to 6" Transition:
White Copy: Property Owner
Time
Disk #
Street Name
OwnerlOccupant Signature
Compliance
O No foundation drain connection
No roof drain connection
e
f
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
/+ 6 am
•Pm
For information call 651.470/788
Non - Compliance
O Clear water connections to
sanitary sewer.
O Service lateral defects
O Defective manholes
O
O
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Sump pump connected to sanitary
sewer
Flexible sump pump piping
i
Number of stacks ,
Length of Service:
Yellow Copy: City of Eagan
Record Number
7
ime ti�o
Phone /.7 `"tt
Obstruction No Access
Unable to push past 0 No one in
feet
i /
Entered S,L,at. ��'= " ?f '�
/
•
Inspector Signature
am
o Pm
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
Total
Notes
c. %
/ `
fi:
-. ,
' _
i -
/' �I
�_
,
_ k
t -ry
; ,_
' '/ � i l ' , ' ° °r `.
9 l
1
%" r " i >
S - _. 1 i
f. A --
= 1
Number.
Discharged
Correctly
incorrectly
Unknown
Sum um s
Sump pumps
I
M
r
T
1 !
�
"
= 2
L
Foundation drains
J
Roof drains
Efty oftap
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name )
Y\„
PID Number
House Number
Alternative Mailirig Address
Transition
4" to 6" Transition:
White Copy: Property Owner
Time
Disk #
Street Name
OwnerlOccupant Signature
Compliance
O No foundation drain connection
No roof drain connection
e
f
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
/+ 6 am
•Pm
For information call 651.470/788
Non - Compliance
O Clear water connections to
sanitary sewer.
O Service lateral defects
O Defective manholes
O
O
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Sump pump connected to sanitary
sewer
Flexible sump pump piping
i
Number of stacks ,
Length of Service:
Yellow Copy: City of Eagan
Record Number
7
ime ti�o
Phone /.7 `"tt
Obstruction No Access
Unable to push past 0 No one in
feet
i /
Entered S,L,at. ��'= " ?f '�
/
•
Inspector Signature
am
o Pm
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH