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780 Elrene Ct - Inspection Form
4 ,0 111. Cay of hp Residential Sanitary Sewer Service Compliance Inspection Date Root Poor'ipeJ Miner Sag /PP Da Pipe Tr sition 1 r ! _ Time �"� • pm • Name,. 1 /©isk # PID Number House Number• Alternative Mailing Address 4" to 6�' fransit�o is White Copy: Property Owner Owner /Occupant Signature For information can 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 1- Street Name 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 Record Number Phone (2. F ; Entered S Lot ints ,...--v / eposits i < ' -.=--°' ;;, E' i i f,/ ? j /ice Deflection --7;f1 ! I i' �:.. / 1°7 . r w y- � , ." f y 4EVce( (.C:' ?77)5" d Notes Time inspector Signature Obstruction Unable to push past feet., • oam • o pm No Access O No one in Access to service lateral raegded, O Inspection refused Yellow Copy: City of Eagan Pink Copy: SEH Total Number Discharged Correctly Incorrectly Unknown Sump pumps Foundation drains Roof drains 4 ,0 111. Cay of hp Residential Sanitary Sewer Service Compliance Inspection Date Root Poor'ipeJ Miner Sag /PP Da Pipe Tr sition 1 r ! _ Time �"� • pm • Name,. 1 /©isk # PID Number House Number• Alternative Mailing Address 4" to 6�' fransit�o is White Copy: Property Owner Owner /Occupant Signature For information can 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 1- Street Name 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 Record Number Phone (2. F ; Entered S Lot ints ,...--v / eposits i < ' -.=--°' ;;, E' i i f,/ ? j /ice Deflection --7;f1 ! I i' �:.. / 1°7 . r w y- � , ." f y 4EVce( (.C:' ?77)5" d Notes Time inspector Signature Obstruction Unable to push past feet., • oam • o pm No Access O No one in Access to service lateral raegded, O Inspection refused Yellow Copy: City of Eagan Pink Copy: SEH Account # 260536 City of Eagan/City Dept at: Wayne Schwanz 3419 Coachman Pt Eagan MN 55122 Service Date 08/26/10 PO # .lob # 215748 Camera inspection of sewer line. Pull & reset toilet. Description Of Service Invoice Benjamin Franklin Plumbing 1424 3rd St N Minneapolis MN 55411 612 - 604 -4285 FAX: 612-822-5408 FID#27-1025956 Quantity Camera inspection of sewer line 1 $215.00 $215.00 DUNS #027314893 Terms: Due 9/25/2010 Please pay from this Invoice. T hank You Remit To: Benjamin Fr anklin 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 an Cat d Signature Service At: Mary Theisen 780 Elrene Ct Eagan MN 55123 Invoice # Date: Page # A65632 08/26/10 1 of 1 Unit Price Extended Price Tx Amount Due Amount Paid Balance Due $215.,00 Invoice # A65632 Date : 08/26/10 Account # 260536 City of Eagan /City Dept at: $215.00 Residential Sanitary Sewer Se ice Compliance Inspection Date ' ' / ? . Name PID Number Transition House Number -I `(';) Alternate Mailing Address Time r ti s _ Owner /Occupant Signature Compliance V' No foundation drain connection No roof drain connection O Sump pit not connected to sanitary sewer O Sump Pump properly piped No sump pump Service Lateral Inspection Findings Roots Poor Pipe Joints �� M Mineral Deposits ..: ,,, Sag /Pipe Deflection ' Damaged Pipe 4" to 6" Transition: White Copy: Property Owner 4 /, 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 Length of Service: Yellow Copy: City of Eagan Record Number Obstruction Unable to push past C; feet Phone Time Inspector Signature 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 Number of stacks Entered S L. at I r•= Final Cleanout: A 11 t Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551 Total Notes :.- ! c .• �a ', L.,- `-, , r ‘ _ , , p t --� '-. ,�,� ,� • , W t n ...a. - 1 ' , s , ,.,.... �'� :� 4. . , +,, 1 ,, ....{ Number Discharged Correctly Incorrectly Unknown Sump Pumps r� r, Foundation Drains r Roof Drains Residential Sanitary Sewer Se ice Compliance Inspection Date ' ' / ? . Name PID Number Transition House Number -I `(';) Alternate Mailing Address Time r ti s _ Owner /Occupant Signature Compliance V' No foundation drain connection No roof drain connection O Sump pit not connected to sanitary sewer O Sump Pump properly piped No sump pump Service Lateral Inspection Findings Roots Poor Pipe Joints �� M Mineral Deposits ..: ,,, Sag /Pipe Deflection ' Damaged Pipe 4" to 6" Transition: White Copy: Property Owner 4 /, 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 Length of Service: Yellow Copy: City of Eagan Record Number Obstruction Unable to push past C; feet Phone Time Inspector Signature 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 Number of stacks Entered S L. at I r•= Final Cleanout: A 11 t Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551