826 Ivy Lane - Inspection Form1 \
411, 1. . City of hop
Y � n
Residential Sanitary Sewer Service
Compliance Inspection
Dat 1)` 1 /e
Name .J �%'i : � � �%,",!',•' '''�1 Disk #
PID Number
1 -louse Number i;^ Street Name ) ) o
/
Alternative Mailing Address -
Phone
For information call 651.470.2788
Compliance
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
Roots
Poor Pipe joints
Mineral Deposits
4" to 6 "Transition:
Sag /Pipe Deflection
Damaged Pipe
Transition =•�;. ; ''F ° -�":�"
1
White Copy: Property Owner
1' am
Time ( f. � pm
OwnerlOccupant Signature
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
Number of stacks °'` Entered S L at
J
Length of Service:
Yellow Copy: - City of Eagan
Record Number
Obstruction
Unable to push past':
feet..
Notes
,�,.• �,d.. i.._- t am
Time • opm
a Final Cleanout:
Inspectdr Signature
fr
a r t_
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
d
,
Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
#
Foundation drains
Roof drains
1 \
411, 1. . City of hop
Y � n
Residential Sanitary Sewer Service
Compliance Inspection
Dat 1)` 1 /e
Name .J �%'i : � � �%,",!',•' '''�1 Disk #
PID Number
1 -louse Number i;^ Street Name ) ) o
/
Alternative Mailing Address -
Phone
For information call 651.470.2788
Compliance
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
Roots
Poor Pipe joints
Mineral Deposits
4" to 6 "Transition:
Sag /Pipe Deflection
Damaged Pipe
Transition =•�;. ; ''F ° -�":�"
1
White Copy: Property Owner
1' am
Time ( f. � pm
OwnerlOccupant Signature
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
Number of stacks °'` Entered S L at
J
Length of Service:
Yellow Copy: - City of Eagan
Record Number
Obstruction
Unable to push past':
feet..
Notes
,�,.• �,d.. i.._- t am
Time • opm
a Final Cleanout:
Inspectdr Signature
fr
a r t_
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
d
,
Pink Copy: SEH
Ftesidiential Sanitary Sewer Service
Compliance Inspection
Date e / 2 ,'c
Name
PID Number
House Number
Alter native Mailing Address
For information calI 651A70.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump purnp
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Miner al Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
,•••
• , gPam
Time /o • (27> 0 p
Owner/Occupant Signature
71-LL-LE
Street Name
Non
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
Number of stacks
/
17
9
Ak
4(/6/f,t1(
•
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phan 4 r7
<:
Inspector Signature
Obstruction
Unable to push past
feet
Entered 5 L at
Final Cleanout:
• O am
• o pm
No Access
No one in
Access to service
lateral needed
0 Inspection
refused
Pink Copy: SEH
Notes
Number. Discharged
Total
Correctly
Incorrectly
Unknown
• -.) ..
• /i
._..,' (......._ --i"
--L / - :;"/-,
. -.., A/ ,
Sump pumps
Foundation drains
Roof drains
-.
Ftesidiential Sanitary Sewer Service
Compliance Inspection
Date e / 2 ,'c
Name
PID Number
House Number
Alter native Mailing Address
For information calI 651A70.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump purnp
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Miner al Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
,•••
• , gPam
Time /o • (27> 0 p
Owner/Occupant Signature
71-LL-LE
Street Name
Non
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
Number of stacks
/
17
9
Ak
4(/6/f,t1(
•
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phan 4 r7
<:
Inspector Signature
Obstruction
Unable to push past
feet
Entered 5 L at
Final Cleanout:
• O am
• o pm
No Access
No one in
Access to service
lateral needed
0 Inspection
refused
Pink Copy: SEH