3731 South Hills Way - Inspection FormsCity of EaRao
Residential Sanitary Sewer Service
Compliance Inspection
Date °27.
1 /6 / /
iVamek6771, Z 0.4 CY,1 e Disk #
PID Number
House Number _? / Street Name
Alternative Mailing Address
/
•
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time r]/ . C?
Owner /Occupant Signature
'am
d pm
LL]-
Length of Service:
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
if hone
i 1
For information call 651.47
Obstruction
Unable to push past
feet
Number of stacks Entered 5.1.. at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan / J 9.
Record Number
p am
Time 0 O pm
nspector Signature
Final Cleanout:
No Access
O No one in
,,,,t( Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Notes _ tes : 0
J 4
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Number
Correctly
Discharged
incorrectly
Unknown
Total
Sump pumps
f.:....,_.,._.._..
....a ----
_
_
. A.,--
Foundation drains
Roof drains
City of EaRao
Residential Sanitary Sewer Service
Compliance Inspection
Date °27.
1 /6 / /
iVamek6771, Z 0.4 CY,1 e Disk #
PID Number
House Number _? / Street Name
Alternative Mailing Address
/
•
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time r]/ . C?
Owner /Occupant Signature
'am
d pm
LL]-
Length of Service:
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
if hone
i 1
For information call 651.47
Obstruction
Unable to push past
feet
Number of stacks Entered 5.1.. at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan / J 9.
Record Number
p am
Time 0 O pm
nspector Signature
Final Cleanout:
No Access
O No one in
,,,,t( Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Account # 260536
Service Date 08/16/10
Camera inspection of sewer line. Pull & reset toilet.
Description Of Service
Terms: Due 9/15/2010
PO #
Camera inspection of sewer line
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
F1D #27- 1025956
City of Eagan/City Dept at:
Wayne Schwan?
3419 Coachman Pt
Eagan MN 55122
Service At:
Michael & Jean (Merle
3731 S Hills Way
Eagan MN 55123
Job # 215180
Quantity
DUNS #027314893
1
Please Detach and Return with Remittance
Check Enclosed [ ]
Master Card [ ] Visa [ ] AmExp [ ]
Acct #
Name on Card
Method of Payment
Discover [ ]
Exp Date
Signature
Unit Price
$215.00
Please pay ft om this Invoice, Thank You
Amount Due
Amount Paid
Balance Due
Invoice #
Date:
Page #
A64165
08/16/10
1 of 1
Extended Price Tx
$215.00
$215.00
Invoice # A64165
Date :
08/16/10
Account # 260536
City of Eagan /City Dept at:
$215.00
Residential Sanitary Sewer Service
Compliance Inspection
City of Eagn
Date / ((, / I 0 Time •
Name ear
PID Number
House Number
Alternate Mailing Address Phone
owne'''r /Occupant Signature
White Copy: Property Owner
Disk #
O am
o pm
Street Name
Compliance
ire No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump Pump properly piped
No sump pump
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
Obstruction
Unable to push past
feet.
No Access
O No one in
o Access to service lateral
needed
o Inspection refused
Service Lateral Inspection Findings
Roots
Poor Pipe Joints 5-3
i
Mineral Deposits 7 0
Sag /Pipe Deflection 7b , 6 t
Damaged Pipe
Transition
4" to 6" Transition:
Number of stacks Entered S L. at m . `� S
Length of Service:
Final Cleanout:
For Information call 651.470.2788
Yellow Copy: City of Eagan
Record Number 0 C
Time
Inspector Signature
O am
•
• o pm
L— -/
Pink Copy: Benjamin Franklin Plumbing
651 - 222 -1551
Total
Notes
i
yy
Number
Discharged
Correctly
Incorrectly
Unknown
Sump Pumps
Foundation Drains
Roof Drains .
Residential Sanitary Sewer Service
Compliance Inspection
City of Eagn
Date / ((, / I 0 Time •
Name ear
PID Number
House Number
Alternate Mailing Address Phone
owne'''r /Occupant Signature
White Copy: Property Owner
Disk #
O am
o pm
Street Name
Compliance
ire No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump Pump properly piped
No sump pump
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
Obstruction
Unable to push past
feet.
No Access
O No one in
o Access to service lateral
needed
o Inspection refused
Service Lateral Inspection Findings
Roots
Poor Pipe Joints 5-3
i
Mineral Deposits 7 0
Sag /Pipe Deflection 7b , 6 t
Damaged Pipe
Transition
4" to 6" Transition:
Number of stacks Entered S L. at m . `� S
Length of Service:
Final Cleanout:
For Information call 651.470.2788
Yellow Copy: City of Eagan
Record Number 0 C
Time
Inspector Signature
O am
•
• o pm
L— -/
Pink Copy: Benjamin Franklin Plumbing
651 - 222 -1551