3486 Trails End Rd - Inspection Formsr
City of.Ea as
Residential Sanitary Sewer Service
Compliance Inspection
/
Date/ / 1
Name ,
PID Number
House Number
Alternative Mailing Addr ess
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
PoorlPipeJotnts
MinAl eposits
Sag /Pipe Deflection
Drnage Pipe
Transition
4" to 6" Transition:
OwnerlOccupant Signature
White Copy: Property Owner
Time ?
t s
am
pm
°k°111- LLB -[1]
;Street Name 1
For information call 65
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
Service Lateral Inspection Findings
Roots
)
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
lime
Phone °f
Obstruction
Unable to push past
feet
Inspector Signature
0 am
•
• Q pm
T77�
No Access
O No one in
! i Access to service
lateraln�
O Inspect oh
refused
Final Cleanout:
Pink Copy: SEH
Number. D
Discharged
Notes
Total C
Incorrectly U
Unknown
Sump pumps
Foundation drains
Roof drains
City of.Ea as
Residential Sanitary Sewer Service
Compliance Inspection
/
Date/ / 1
Name ,
PID Number
House Number
Alternative Mailing Addr ess
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
PoorlPipeJotnts
MinAl eposits
Sag /Pipe Deflection
Drnage Pipe
Transition
4" to 6" Transition:
OwnerlOccupant Signature
White Copy: Property Owner
Time ?
t s
am
pm
°k°111- LLB -[1]
;Street Name 1
For information call 65
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
Service Lateral Inspection Findings
Roots
)
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
lime
Phone °f
Obstruction
Unable to push past
feet
Inspector Signature
0 am
•
• Q pm
T77�
No Access
O No one in
! i Access to service
lateraln�
O Inspect oh
refused
Final Cleanout:
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.
Remit To:
Benjamin Franklin Plumbing
1424 3rd St N
Minneapolis MN 55411
Invoice
Benjamin Franklin Plumbing
1424 3rd St N
Minneapolis MN 55411
612- 604 -4285 FAX: 612-822-5408
FID #2 7- 1025956
Service Date 09/08/10 PO # Job # 216294
Service At:
Judith Kane
3486 Trails End Rd
Eagan MN 55123
Description Of Service Quantity Unit Price Extended Price Tx
Camera inspection of sewer line 1 $215.00 $215.00
DUNS #02731489.3
Ter ms: Due 10/8/2010 Please pay from this Invoice. Thank You
Please Detach and Return with Remittance
Check Enclosed [] Method of Payment
Master Card [ ] Visa [ ] AmExp [ ] Discover [ ]
Acct # Exp Date
Name on Card
Signature
Amount Due
Amount Paid
Invoice # A71915
Date: 09/08/10
Page # l of 1
Balance Due $215•,00
Invoice #
Date :
A71915
09/08/10
Account# 260536
City of Eagan /City Dept at:
$215,00
Residential Sanitary Sewer Service
Compliance Inspection
of apt
Date 1 ``4 I I
Name
AID Number
House Number 3.
Alternate Mailing Address
Compliance
Owner /Occupant Signature
No foundation drain connection
No roof drain connection
o Sump pit not connected to
sanitary sewer
Sump Pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Time
Disk #
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
For Information call 651.470.2788
Number of stacks Entered S L at 1
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet
Time
Phone
rr)
inspector Signature
o am
o pm
No Access
o No one in
o Access to service lateral
needed
o Inspection refused
Final Cleanout:
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551