4580 Lake Park Dr - Inspection Form4 City o1 ii
Residential Sanitary Sewer Service
Compliance Inspection
Date 0/ i if
Name l
IA
PID Number
House Number ° 5/ ./Street Name
Alternative Mailing Address
OwnerlOccupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
9 No roof drain connection
Sump pit not connected to
sanitary sewer
11
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6"Transition:
White Copy: Property Owner
` ;) !?• Disk #
o am
Time 1 • S pm
/i
Phone i; , ) i
1 1
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
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number b r
Time
Inspector Signature J 7) �
Obstruction
Unable to push past
feet
•
Final Cleanout:
o am
o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.L. at
Pink Copy: SEH
Total
Notes
4 - i
_ i' 'L
7
/ �wf
r�
1
i
'�
. l`� f G...
f 1 r I r l __
9
.._ . �
(` 2 -
" ' 7
--- —
_/
W:r
/V ._'
,—..
I
Number
Discharged
Correct)
Incorrectly
Unknown
Sump pumps
)
; /`
Foundation drains
Roof drains
.. /. - 7
--
4 City o1 ii
Residential Sanitary Sewer Service
Compliance Inspection
Date 0/ i if
Name l
IA
PID Number
House Number ° 5/ ./Street Name
Alternative Mailing Address
OwnerlOccupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
9 No roof drain connection
Sump pit not connected to
sanitary sewer
11
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6"Transition:
White Copy: Property Owner
` ;) !?• Disk #
o am
Time 1 • S pm
/i
Phone i; , ) i
1 1
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
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number b r
Time
Inspector Signature J 7) �
Obstruction
Unable to push past
feet
•
Final Cleanout:
o am
o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.L. at
Pink Copy: SEH