4831 Richard Lane - Inspection FormCity of !Oil
Residential Sanitary Sewer Service
Compliance Inspection
Date k t' 4
Name Disk #
�' � f � ��� �.—�
PID Number
House Number i° �7 Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
' sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Time
Owner /Occupant Signature
Service Lateral Inspection Findings
Non - Compliance
O
O
O
O
O
am
Pm
m
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
,> _ .
Record Number
Phone
r i Time
O am
•
• O pin
Inspector Signature t
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered St at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Notes
No Access
O No one in
■
. -'
O Access to service
lateral needed
O Inspection
refused
I /
Pink Copy: SEH
4
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
,s
�,° j
c_
f o _
i / 1,
; � %
/' ? l
o °•
W; ;''s4'
Foundation drains
Roof drains
�
\.
City of !Oil
Residential Sanitary Sewer Service
Compliance Inspection
Date k t' 4
Name Disk #
�' � f � ��� �.—�
PID Number
House Number i° �7 Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
' sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Time
Owner /Occupant Signature
Service Lateral Inspection Findings
Non - Compliance
O
O
O
O
O
am
Pm
m
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
,> _ .
Record Number
Phone
r i Time
O am
•
• O pin
Inspector Signature t
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered St at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Notes
No Access
O No one in
■
. -'
O Access to service
lateral needed
O Inspection
refused
I /
Pink Copy: SEH
4