4807 Richard Lane - Inspection FormCity of p
Residential Sanitary Sewer Service
Compliance Inspection
Date /
s
Name , s f ! Lr 277
PID Number
House Number C � Street Name
Alternative Mailing Address
Disk #
[
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
cg I
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to b" Transition:
•',ilk 0 am
Time . I- • pm
Number of stacks
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
Length of Service:
White Copy: Property Owner Yellow Copy: City of Eagan
Record Number / — .�
ri Time
.9)
Phone t I
- j .__..
• Inspector Signature ter' / 1 l✓ � h y
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S,L,at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:.
• am
• Opm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
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Total
Sump pumps
/!
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Foundation drains
r
r
Roof dra s
l
City of p
Residential Sanitary Sewer Service
Compliance Inspection
Date /
s
Name , s f ! Lr 277
PID Number
House Number C � Street Name
Alternative Mailing Address
Disk #
[
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
cg I
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to b" Transition:
•',ilk 0 am
Time . I- • pm
Number of stacks
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
Length of Service:
White Copy: Property Owner Yellow Copy: City of Eagan
Record Number / — .�
ri Time
.9)
Phone t I
- j .__..
• Inspector Signature ter' / 1 l✓ � h y
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S,L,at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:.
• am
• Opm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH