800 Ivy Lane - Inspection FormR Sanitary Sewer Service
Inspection
Date (' L / 2
Name / .: <47 Disk #
PID Number
1 -louse Number lei_ Street Name 7/4!!
Alternative Mailing Address
OwnerlOccupant Signature
For information tail 65 i 470.2788
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints j ( °�
Mineral Deposits b J t ' c f') Lt ? L( 4 ' '
Sag /Pipe Deflection
Damaged Pipe
Transition (V A >c ((-IL, .06c- If
1
4" to 6" Transition: Ai r
i �
Sump pumps
Foundation drains
Roof drains
Total
0 a
Time /7 D1_';" cypm
• 1 - -�
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
r fN
Number of stacks t Entered S L. at )I>
Length of Service: /j
Number Discharged
Correctly
Incorrectly
Unknown
White Copy: Property Owner Yellow Copy: City of Eagan
Record Number
Phone
{ r
Time
C7) S
u !'
{ ,1rrspector Signature
Obstruction
Unable to push past
feet
o am
�pm
a3
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
-r- "7 !t[ f 7
Final Cleanout: i
N --c, ,A, U - -- 1. ,5 . :% f ' i'f%:;_
L
L. t /ier(
t ▪ i
Pink Copy: SEH