1573 Sherwood Way - Inspection Form/ - 1,7?
Date /i / 1 / / /
4
Alternative Mailing Address
r
\j--/ .a
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
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
(17e: I' am
Time / • ,c3 pm
Owner /Occupant Signature
Non-Compliance
O Clear water connections to
sanitary sewer
O Ser vice 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
Number of stacks Entered S L at
City OF Ea Ii
Residential Sanitary Sewer Service
Compliance Inspection
Record Number
Obstruction
Unable to push past
feet
Name / n r �- / lr : Disk # Time
PID Number
ii
House Number 1 Z "`) Street Name �, 1 #�' ..r y �.
Phone r_ " . ) .. _..._
o am
•
• o pm
Inspector Signature
Final Cleanout:
No Access
O No one in
For information call 651:470:2788
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEM
Number Discharged
Notes
, .-
2 T ', - - --/1
�> c' �i= '~ % - ' ' � j
.:_, '7 I 1 i ' 1 "7 _. _- r' 3 x41 ci �'-% r
Total
Correctly
incorrectly
Unknowry
Sump pumps
1
,,-
,('
✓ )
/} I
' 6 ✓
I
Foundation drains
Roof drains
f
/ - 1,7?
Date /i / 1 / / /
4
Alternative Mailing Address
r
\j--/ .a
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
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
(17e: I' am
Time / • ,c3 pm
Owner /Occupant Signature
Non-Compliance
O Clear water connections to
sanitary sewer
O Ser vice 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
Number of stacks Entered S L at
City OF Ea Ii
Residential Sanitary Sewer Service
Compliance Inspection
Record Number
Obstruction
Unable to push past
feet
Name / n r �- / lr : Disk # Time
PID Number
ii
House Number 1 Z "`) Street Name �, 1 #�' ..r y �.
Phone r_ " . ) .. _..._
o am
•
• o pm
Inspector Signature
Final Cleanout:
No Access
O No one in
For information call 651:470:2788
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEM