4871 Richard Lane - Inspection Formit!oI' Fa
Residential Sanitary Sewer Service
Compliance Inspection
Date ; I ) /
Name ± A"1 V )774/ Disk #
PID Number
House Number r7 i Street Name
Alternativef ailing Address
For information call 651.470.2788
Compliance
O ,No foundation drain connection
q No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral inspection Findings
4" to 6 "Transition:
White Copy: Propel ty Owner
Time >/ i •
Owner/Occupant-Signature
0
O
O
O
0
am
pm
Non - Compliance
C
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 7 '"
Time
• am
• 0pm
Phone r o .1- -' 2—E ' g %q
Obstruction
Unable to push past
feet
Inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Entered S.L. at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
/Li 'n/y
Number
Correctly
Discharged
Incorrectly
Unknown
Notes
]
,' !�, - x °°--'
_-;:-.. -'- 2 7 - , 1 4 /1.... / P 4--.(... er' ,
4
1 _ ,{1.4—. .
~�#
, mac' %7 1 '+ °'
Total
Sump pumps
L -
� " /
,
Foundation drains
- -
Fla:
Roof drains
it!oI' Fa
Residential Sanitary Sewer Service
Compliance Inspection
Date ; I ) /
Name ± A"1 V )774/ Disk #
PID Number
House Number r7 i Street Name
Alternativef ailing Address
For information call 651.470.2788
Compliance
O ,No foundation drain connection
q No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral inspection Findings
4" to 6 "Transition:
White Copy: Propel ty Owner
Time >/ i •
Owner/Occupant-Signature
0
O
O
O
0
am
pm
Non - Compliance
C
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 7 '"
Time
• am
• 0pm
Phone r o .1- -' 2—E ' g %q
Obstruction
Unable to push past
feet
Inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Entered S.L. at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
/Li 'n/y