4851 Richard Lane - Inspection FormDate ..; l
e c:•, l)
Name)
PID Number
House Number
—
Owner/Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Roots
4" to 6"Transition:
)
White Copy: Proper ty Owner
t"; 771 ?? am
Time ,/ .4`.:',10_ - p
Dis k #
)Street Name
4 City of Eappi
Residential Sanitary Sewer Service
Compliance Inspection
L
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
Alternative Mailing Address Phone )-1
, "
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S.L. at
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
0 am
•
• 0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number Discharged
Notes
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Total
Correctly
Incorrectly
Unknown
Sump pumps
,(
,_,
.,_,
);::"P
1 '
Foundation drains
Roof drains
,A\
Date ..; l
e c:•, l)
Name)
PID Number
House Number
—
Owner/Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Roots
4" to 6"Transition:
)
White Copy: Proper ty Owner
t"; 771 ?? am
Time ,/ .4`.:',10_ - p
Dis k #
)Street Name
4 City of Eappi
Residential Sanitary Sewer Service
Compliance Inspection
L
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
Alternative Mailing Address Phone )-1
, "
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S.L. at
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
0 am
•
• 0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH