1539 Sherwood Way - Inspection Formor a
Residentia z Sanitary Sewer Service
Compliance Inspection
Date 7 1 1 1! C
Name J „,cc L \n cc: , Su
PID Number
House Number J C 3?
Owner /Occupant Signature
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
Service Lateral Inspection Findings
Roots
Poor Pipe Joints a ¶ J ( 1 (
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe 9 0
Transition
White Copy: Property Owner
1 /o)
Time
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
Number of stacks 0
72 C
4” to 6" Transition: t� � Length of Service: //L
Yellow Copy: City of Eagan
Record Number :2 ` 3 } a
A r
Obstruction
Time
) ! -
Linable to push past
feet
Inspector Signature
Alternate Mailing Address Phone
For Information call 651.470.2788
No Access
O No one in
O Access to service lateral
needed
O inspection refused
Entered S L at � f‘ c a
O am
O pm
Final.Cleanout: (,
Number Discharged
Sump Pumps
Foundation Drains
Roof Drains
Total
Correctly Incorrectly Unknown
Notes
Pink Copy: Benjamin Franklin Plumbing
651 -222 -1551