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3797 South Hills Cir - Inspection Form44111 Cit y or Ca afl Residential Sanitary Sewer Service Compliance Inspection Date al / /o Name n Disk # PID Number House Number' Alternative Mailing Address For information call 651.470.2788 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 pump Service Lateral Inspection Findings Roots Transition 4" to 6" Transition: White Copy: Property Owner �/• Time /,s e pam am Street Name 0wnerl0ccupant Signature Non - Compliance 0 0 O 0 0 Clear water connections to sanitary sewer. Service lateral defects Defective manholes Sump pump connected to sanitary sewer Flexible sump pump piping Number of stacks Length of Service: Yellow Copy: City of Fagan Record Number Time o am • • o pm - Inspector Signature Obstruction Unable to push past feet Entered S L at Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection Damaged Pipe r)AJ V 4- of Final Cleanout: _ / V • No Access O No one in Notes AL 1/ t ] 1 rI r" ./ice fr( A l Access to service lateral needed O Inspection refused i Jv G VV 1 Cl( Pink Copy: SEH Number Correctly Discharged lncorrectly Unknown Total Sump pumps Foundation drains Roof drains 44111 Cit y or Ca afl Residential Sanitary Sewer Service Compliance Inspection Date al / /o Name n Disk # PID Number House Number' Alternative Mailing Address For information call 651.470.2788 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 pump Service Lateral Inspection Findings Roots Transition 4" to 6" Transition: White Copy: Property Owner �/• Time /,s e pam am Street Name 0wnerl0ccupant Signature Non - Compliance 0 0 O 0 0 Clear water connections to sanitary sewer. Service lateral defects Defective manholes Sump pump connected to sanitary sewer Flexible sump pump piping Number of stacks Length of Service: Yellow Copy: City of Fagan Record Number Time o am • • o pm - Inspector Signature Obstruction Unable to push past feet Entered S L at Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection Damaged Pipe r)AJ V 4- of Final Cleanout: _ / V • No Access O No one in Notes AL 1/ t ] 1 rI r" ./ice fr( A l Access to service lateral needed O Inspection refused i Jv G VV 1 Cl( Pink Copy: SEH Account # 260536 City of Eagan/City Dept at: Wayne Schwanz 3419 Coachman Pt. Eagan MN 55122 Invoice Benjamin Franklin Plumbing 1424 3rd St N Minneapolis MN 55411 612 - 604 -4285 FAX: 612-822-5408 FID #27- 1025956 Service Date 08/11/10 PO # lob # 214850 Camera inspection of sewer line. Pull & reset toilet. Description Of Service Quantity Unit Price Extended Price Tx Camera inspection of sewer. line 1 $215.00 $215.00 DUNS #027314893 Ierms: Due 9/10/2010 Please pay from this Invoice„ Ihank You Remit To: Benjamin Franklin Plumbing 1424 3rd St N Minneapolis MN 55411 Please Detach and Return with Remittance Check Enclosed [ ] Method of Payment Master Card [ ] Visa [ ] AmExp [ ] Discover [ ] Acct # Exp Date Name on Card Signature Service At: Wallace Peterson 3797 South Hills Cit Eagan MN 55123 Amount Due Amount Paid Balance Due $215.00 Invoice # A65397 Date : Invoice # A65397 Date: 08/11/10 Page # 1 of 1 08/11/10 Account # 260536 City of Eagan /City Dept at: $215.00 City of Eagan Residential Sanitary Sewer Se r Compliance Inspection Date Name PID Number House Number Transition 3 - 79 - 7 White Copy: Property Owner Time - y Disk # Owner /Occupant Signature Compliance 0 No foundation drain connection o No roof drain connection 0\ Sump pit not connected to sanitary sewer Sump Pump properly piped No sump pump 5_ 5 4" to 6" Transition: 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 o am O pm Street Name Number of stacks Length of Service: Yellow Copy: City of Eagan Record Number 67 Alternate Mailing Address Obstruction Time i �S Phone Unable to push past 5 feet r Inspector Signature Entered S L at J C? Final Cleanout: -5 O am O pm For Information call 651.470.2788 No Access o No one in O Access to service lateral needed O Inspection refused Service Lateral Inspection Findings Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection Damaged Pipe Number Discharged Sump Pumps Foundation Drains Roof Drains Total Correctly Incorrectly Unknown Notes ( Cc..x r ti) _ c, ry,, A r > i C Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551