4567 Lake Park Dr - Inspection Form41 ' City of F,a a
Residential Sanitary Sewer Service
Compliance Inspection
i 19' ( r (
Date
o i
Name i .! f ?� ^ " Disk #
PID Number.
House Number ,- Street Name
t f
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
di Sump pump properly piped
� O No sump pump
Service Lateral Inspection Findings Number of stacks
4" to 6" Transition:
White Copy: PropertysOwner
! • 9, am
I-7( Time • q pm
OwnerlOccupant Signature
-CD
Length of Service:
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
Yellow Copy: City of Eagan
Record Number
Time
—
Alternative Mailing Address Phone 7
Obstruction
Unable to push past
feet
Entered S.L. at
Final Cleanout:
• kFa
• 0pm
Inspector Signature :
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
j
. y ' "" ,� ( _ , T T -- 7C._,'
- 1 � . 4 / � �>
) ; r 7 ! i 1
� ^ f �"�.'� i ,-. i' , , - ,
1
Total
Sump pumps
Foundation drains
Roof drains
-,
41 ' City of F,a a
Residential Sanitary Sewer Service
Compliance Inspection
i 19' ( r (
Date
o i
Name i .! f ?� ^ " Disk #
PID Number.
House Number ,- Street Name
t f
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
di Sump pump properly piped
� O No sump pump
Service Lateral Inspection Findings Number of stacks
4" to 6" Transition:
White Copy: PropertysOwner
! • 9, am
I-7( Time • q pm
OwnerlOccupant Signature
-CD
Length of Service:
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
Yellow Copy: City of Eagan
Record Number
Time
—
Alternative Mailing Address Phone 7
Obstruction
Unable to push past
feet
Entered S.L. at
Final Cleanout:
• kFa
• 0pm
Inspector Signature :
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH