4299 Jasper Dr - Inspection FormCity f Capp
p
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name r 1
PID Number
House Number
Alternative Mailing gAddress
Transition
4" to 6 "Transition:
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Property Owner
Time
Disk #
/
Street Name
Owner/Occupant Signature
am
Pm
Non- Compliance
Service Lateral Ir}s Findings Number of stacks
Roots
Record Number
rn
Time • p
Phone
For information calf 65 1.470.2788
Obstruction
Inspector Signature
O Clear water connections to Unable to push past
sanitary sewer feet,
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Entered S. L at
Length of Service:
Number Discharged
Sump pumps
Foundation drains
Roof drains
Total
Correctly Incorrectly Unknown
J
7
.771
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe 1 /
1
Final Cleanout:
Nots
fl 7)'(2 tom , " �'/ , `' t ,f �," d ` , )
?
f i r f 3 /} 1.
v=3/
Yellow Copy: City of Eagan Pink Copy: SEH