4789 London Lane - Inspection Form41. City 1 Ea
Y � 1
Residential Sanitary Sewer Service
Compliance Inspection
jj
Date I'7 l 1 r )
Name
PID Number
House Number
Alternative Mailing Address
r
For information call 651.47 0.2788
Compliance
O. No foundation drain connection
No roof drain connection
/ L )
O' Sump pit riot connected to
sanitary sewer
Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
j •cgO am
Time 1 1 . c pm
Disk #
1
Street Name
3 4 }}
Owner /Occupant Signature
m-
-_ /
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective rnanholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered 5.L _at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone
Time
inspector Signature
Obstruction
Unable to push past
feet
O am
•
• - - -o p
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Notes
,(., - ' %
__� -'
i f f
_
� 1 % % -'� ` - t
1. � - a
G I G�/— e c : ,�.
/ / /f
,,rr� �y�� S \ --
--
. a
✓7C✓ (
/
�)�"'- -t
..
/
Number
Discharged
Total
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
41. City 1 Ea
Y � 1
Residential Sanitary Sewer Service
Compliance Inspection
jj
Date I'7 l 1 r )
Name
PID Number
House Number
Alternative Mailing Address
r
For information call 651.47 0.2788
Compliance
O. No foundation drain connection
No roof drain connection
/ L )
O' Sump pit riot connected to
sanitary sewer
Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
j •cgO am
Time 1 1 . c pm
Disk #
1
Street Name
3 4 }}
Owner /Occupant Signature
m-
-_ /
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective rnanholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered 5.L _at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone
Time
inspector Signature
Obstruction
Unable to push past
feet
O am
•
• - - -o p
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH