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811 Wescott Square - Inspection FormDate 4" to 6" Transition: (7 ?) Name PIO Number House Number _] ! / Street Name Alternative Mail} gjlddress : dwrierIOccupant Signature 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 Time Service Lateral Inspection Findings •• Pm a ] — W —CI_J Non - Compliance 0 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 Length of Service: City ollap Residential Sanitary Sewer Service : Compliance Inspection Record Number i t f� Time • Phone _ Inspector Signature For information call 65 Obstruction Unable to push past feet Entered S. L. at Roots Poor Pipe Joints Mineral Deposits -_ Sag /Pipe Deflection Damaged Pipe Transition Final Cleanout: o am o pm No Access 0 No one in Access to service lateral needed 0 Inspect ioD refused Notes Yellow Copy: City of E -� �fi l � r Pink Copy: SEH Total Number Discharged Correctly Incorrectly Unknown Sump pumps Foundation drains Roof drains Date 4" to 6" Transition: (7 ?) Name PIO Number House Number _] ! / Street Name Alternative Mail} gjlddress : dwrierIOccupant Signature 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 Time Service Lateral Inspection Findings •• Pm a ] — W —CI_J Non - Compliance 0 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 Length of Service: City ollap Residential Sanitary Sewer Service : Compliance Inspection Record Number i t f� Time • Phone _ Inspector Signature For information call 65 Obstruction Unable to push past feet Entered S. L. at Roots Poor Pipe Joints Mineral Deposits -_ Sag /Pipe Deflection Damaged Pipe Transition Final Cleanout: o am o pm No Access 0 No one in Access to service lateral needed 0 Inspect ioD refused Notes Yellow Copy: City of E -� �fi l � r Pink Copy: SEH Account # 260536 City of Eagan/City Dept at: Wayne Schwanz 3419 Coachman Pt. Eagan MN 55122 Camera inspection of sewer line. Pull & reset toilet. Terms: Due 9/10/2010 Remit To: Benjamin Franklin Plumbing 1424 3rd St N Minneapoils MN 55411 Inv ©ice Benjamin Franklin Plumbing 1424.31d St N Minneapolis MN 55411 612- 604 -4285 FAX: 612-822-5408 FID #27- 1025956 Service Date 08 /11 /10 PO # Job # 214832 Description Of Service Quantity Unit Price Extended Price Tx Camera inspectin of sewer line 1 $215.00 $215.00 DUNS #027314893 Check Enclosed [ ] Method of Payment Master Card [ ] Visa [ ] AmExp [ ] Discover [ ] Acct # Exp Date Name on Card Signature Service At: Joy & Bill Kotte 811 Westcott Sq Eagan MN 55123 Invoice # A65396 Date: 08/11/10 Page # 1 of 1 Balance Due $215.,00 Please pay from this Invoice, Thank You Please Detach and Return with Remittance Amount Due Amount Paid Invoice # A65396 Date : 08/11/10 Account # 260536 City of Eagan /City Dept at: $215,00 go ' 1 • Residential . Sanitary ewer Service.. hens Inspection • Date / i ! / r c Name PlD Number House Number L3 F 'f i , C. ( re Time owner /Occupant Signature Compliance 4 No foundation drain connection 4 d No roof drain connection o Sump pit not connected to sanitary sewer Sump Pump properly piped o No sump pump Service Lateral Inspection Findings Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection Damaged Pipe Transition l 4" to 6" Transition: White Copy: Property Owner Disk # 7 o am o pm 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 Street Name Yellow Copy: City of Eagan Record Number c7/ I 1 3 - Obstruction Length of Service: / r` Time Se Unable to push past feet Number of stacks Entered S L. at Final Cleanout: C O am o pm r M. E d r Phone 1 ° J 7- di Alternate lin e �> 7 ``i r/ Inspector Signature For Information call 651.470.2788 No Access o No one in O Access to service lateral needed o Inspection refused Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551 Total Notes Number Discharged Correctly Incorrectly Unknown Sump Pumps Foundation Drains r f, Roof Drains go ' 1 • Residential . Sanitary ewer Service.. hens Inspection • Date / i ! / r c Name PlD Number House Number L3 F 'f i , C. ( re Time owner /Occupant Signature Compliance 4 No foundation drain connection 4 d No roof drain connection o Sump pit not connected to sanitary sewer Sump Pump properly piped o No sump pump Service Lateral Inspection Findings Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection Damaged Pipe Transition l 4" to 6" Transition: White Copy: Property Owner Disk # 7 o am o pm 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 Street Name Yellow Copy: City of Eagan Record Number c7/ I 1 3 - Obstruction Length of Service: / r` Time Se Unable to push past feet Number of stacks Entered S L. at Final Cleanout: C O am o pm r M. E d r Phone 1 ° J 7- di Alternate lin e �> 7 ``i r/ Inspector Signature For Information call 651.470.2788 No Access o No one in O Access to service lateral needed o Inspection refused Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551