4543 Lake Park Dr - Inspection Form4 City of FAVII
Residential Sanitary Sewer Service
Compliance Inspection
Date /1 1/
Name
No roof drain connection
O Sump pit not connected to
sanitary sewer
0 1 Sump pump properly piped
No sump pump
4" to 6" Transition:
White Copy: Property Owner
am
Timed • pm
PID Number
House Number ' Name
Alternative Mailing Address Phone
Disk #
Owner /Occupant Signature
Compliance
O No foundation drain connection
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:
Yellow Copy: City of Eagan
Record Number
Time
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
• O pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number Discharged
Notes
l
Total
Correctly
Incorrectly
Unknown
Sump pumps
/
Foundation drains
L: it
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,:J .l'
Roof drains
w
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4 City of FAVII
Residential Sanitary Sewer Service
Compliance Inspection
Date /1 1/
Name
No roof drain connection
O Sump pit not connected to
sanitary sewer
0 1 Sump pump properly piped
No sump pump
4" to 6" Transition:
White Copy: Property Owner
am
Timed • pm
PID Number
House Number ' Name
Alternative Mailing Address Phone
Disk #
Owner /Occupant Signature
Compliance
O No foundation drain connection
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:
Yellow Copy: City of Eagan
Record Number
Time
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
• O pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH