923 Wild Rose Ct - Inspection FormCity of F, "dtai[
Residential Sanitary Sewer Service
Compliance Inspection
• r2 , O am
Date �-` :r 1 f /G! Time ' r. • , ` P o pm
Name ,3//
Y-4
PID Number.
House Number
Compliance
d No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
PO' No sump pump
4" to b "Transition:
Sump pumps
Foundation drains
Roof drains
White Copy: Proper ty Owner
Disk #
OwnerlOccupant Signature
Total
ti.
Street Name
Cor rectly
F Ld-[?J]
/ 7
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Q_. Flexible sump pump piping
Service Lateral Inspection Findings
Roots
Poor Pipejoints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe r j
Transition - ,sr /.'41.; / ' i
Length of Service:
Number Discharged
Incorrectly
Unknown
Record Number
Alternative Mailing Address �. - - --
For information: call 651A70.2788
Obstruction
Unable to push past
feet
Number of stacks / Entered S L at
/
Notes
1 � : , / °y am •
Time f iY • e _O Pm
;Inspector Signature
Final Cleanout:1
/XD`s;
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH