834 Ivy Lane - Inspection FormCity off as
Residential Sanitary Sewer Service
Compliance Inspection
Date 2 /f1 1 / Time
f
Name /i/: /O Disk #
PID Number•
House Number .
Alternative Mailing Address
Owner/Occupant Signature
Compliance
o foundation drain connection
Cr No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
J
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection__
Damaged Pipe _
Transition Li
4" to 6 "Transition: /, //---1-
/.
White Copy: Proper ty Owner
Street Name
• loam
•,'.� p p
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks
I '
Length of Service:
Yellow Copy: City of Eagan
Phpne `>� f!
I a
Record Number
c
Obstruction
Unable to push past
feet
yr . 2
Time
r` e
inspector Signature
•
•
Entered S L. at .): ,'/C r
•
Final Cleanout:f
0)0
.pi'pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
7
Notes �
i r l't!r
/
]rs
y" Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
/`
-
W"_
Roof drains
LL�
7 ;,
__ •„�_ ..
�
"
City off as
Residential Sanitary Sewer Service
Compliance Inspection
Date 2 /f1 1 / Time
f
Name /i/: /O Disk #
PID Number•
House Number .
Alternative Mailing Address
Owner/Occupant Signature
Compliance
o foundation drain connection
Cr No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
J
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection__
Damaged Pipe _
Transition Li
4" to 6 "Transition: /, //---1-
/.
White Copy: Proper ty Owner
Street Name
• loam
•,'.� p p
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks
I '
Length of Service:
Yellow Copy: City of Eagan
Phpne `>� f!
I a
Record Number
c
Obstruction
Unable to push past
feet
yr . 2
Time
r` e
inspector Signature
•
•
Entered S L. at .): ,'/C r
•
Final Cleanout:f
0)0
.pi'pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
7
Notes �
i r l't!r
/
]rs
y" Pink Copy: SEH