869 Ivy Lane - Inspection FormNot
Nurnber Dischared
Correctly
�.
f „.--2 T � � r'
i
Total
Incorrectly
Unknown
Sump pumps
( •,
_
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i
( iirl t 's
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'
Foundation drains
�
Roof drains
City of Fafta
Residential Sanitary Sewer Service
Compliance inspection
Dat
Name]) <i t. S .''; ,'`)1 ; Disk #x
PID Number
1 Street Name _ 1
House Number
Alternative Mailing Address
Compliance
No foundation drain connection
i 0
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Owner /Occupant Signature
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition ✓1
4" to 6 "Transition:
White Copy: Property Owner
Length of Service:
Record Number
i "' j
Phone •i; ..__J .,f -
Obstruction
Unable to push past
feet
Time 2
t �I
a
Inspector Signature
i
Lanai „ Cleanout:
am
pm
For information call 5511470.2788
No Access
O No one in
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! '� _' '°
O Access to service
lateral needed
O Inspection
refused
F'»= F
r f�
Yellow Copy: City of Eagan _ ? _. Pink opy: SEH
Sump pumps
(/ 1,___}
Foundation drains
Roof drains
(7...)
City ofan
Residential Sanitary Sewer Service
Compliance Inspection
Name, - LI /
PID Number
House Number -- Street Name
Alternative Mailing Address
Come liance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
! r Disk #
OwnerlOccu /ant Signature
For information call 651:470.2788
Service Lateral Inspection Findings
Roots
Poor. Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition ✓')✓
1'
4" to 6" Transition:
4r
Time _rya
am
pm
Non - Compliance
O Clear water connections to J Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks F Entered S.L.at.,
Total Correctly Incorrectly
J J ,
�
Length of Service: ( ,%
Number Discharged
Unknown
White Copy: Property Owner
Yellow Copy: City of Eagan
Record Number
Time la
Phone 4
Obstruction
j
!f r
inspector Signature
Final Cleanout:
o am
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
I
-, ' te- ° ' - r - 1 1
Note �+
r _ .
Pink
ropy SEH