805 Eagan Oaks Lane - Inspection FormCity Eaa as
Residential Sanitary Sewer Service
Compliance Inspection
Date ✓? i //
,, ►s
Name
House Number
Alternative Mailing Address
4" to 6" Transition:
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 pump
White Copy: Property Owner
1 f • 0 , O am
Time rry _ • - 'pm
Disk #
PJD Number
Owner /Occupant Signature
Service Lateral Inspection Findings
- �— LL1 —CJ J
Street Name c ,,- i A+' f
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
Yellow Copy: City of Eagan
Record Number
jr "
0 am
•
Time • 0 pm
'Phone _ I.
Inspector Signature
For information :call 651.470.278$
Obstruction
Unable to push past
feet
Length of Service: Final Cleanout:
Notes . /t - A —}f
/47_
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
i
i.
1
Foundation drains
Roof drains
City Eaa as
Residential Sanitary Sewer Service
Compliance Inspection
Date ✓? i //
,, ►s
Name
House Number
Alternative Mailing Address
4" to 6" Transition:
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 pump
White Copy: Property Owner
1 f • 0 , O am
Time rry _ • - 'pm
Disk #
PJD Number
Owner /Occupant Signature
Service Lateral Inspection Findings
- �— LL1 —CJ J
Street Name c ,,- i A+' f
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
Yellow Copy: City of Eagan
Record Number
jr "
0 am
•
Time • 0 pm
'Phone _ I.
Inspector Signature
For information :call 651.470.278$
Obstruction
Unable to push past
feet
Length of Service: Final Cleanout:
Notes . /t - A —}f
/47_
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Account # 260536
City of Eagan/City Dept at:
Wayne Schwanz
3419 Coachman Pt.
Eagan MN 55122
Service Date 08/12/10 PO #
Camera inspection of sewer line. Pull & reset toilet.
Description Of Service
Camera inspection of sewer line
Check Enclosed [
Invoice
Benjamin Franklin Plumbing
1424 3rd St N
Minneapolis MN 55411
612 -604 -4285 FAX: 612 -822 -5408
FID#27- 1025956
Tob # 214989
Method of Payment
Master Card [ ] Visa [ ] AmExp [ ] Discover [ ]
Acct # Exp Date
Name on Card
Signature
Quantity
1
Please Detach and Return with Remittance
Remit To:
Benjamin Franklin Plumbing
1424 3r St N
Minneapolis MN 55411
Service At:
Amy Erickson
805 Eagan Oaks Ln
Eagan MN 55123
Unit Price Extended Price Tx
Amount Due
Amount Paid
Invoice #
Date:
Page #
A65391
08/12/10
1 of 1
$215.00 $215.00
Balance Due $215.00
DUNS #027314893
Terms: Due 9/11/2010 Please pay fiom this invoice, Thank You
Invoice # A65391
Date :
08/12/10
Account # 260536
City of Eagan /City Dept at:
$215.,00
Residential Sanitary Sewer Service
Compliance Inspection
Date c 6 / Pc)
Name
PID Number
House Number OS
Alternate Mailing Address
Compliance
O No roof drain connection
Owner/Occupant Signature
No foundation drain connection
Sump pit not connected to
sanitary sewer
Sump Pump properly piped
0 No sump pump
Time
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Disk #
o am
o pm
Street Name
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
//0
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet
Length of Service:
Time
Phone /1)-7) .7 C.•
inspector Signature
No Access
O No one in
o Access to service lateral
needed
O Inspection refused
Number of stacks j Entered St at — 1.
Final Cleanout: 1 I
O am
o pm
Number Discharged
Sump Pumps
Foundation Drains
Roof Drains
Total
( 7 /
Correctly Incorrectly Unknown
N otes
Pink Copy: Benjamin Franklin Plumbing
651-222-1551