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801 Ivy Lane - Inspection Forms• City of Era an Residential Sanitary Sewer Service Compliance Inspection • CF" O am Date �� ! ! 1 Time • pm Disk # Fri Name 's _r PID Number House Number - / Street Name r 1/ O Alternative Mailing Address For information call 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 Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection Damaged Pipe Transition 4" to 6 "Transition: White Copy: Proper ty Owners Owner /Occupant Signature Non - Compliance C11 O Clear water connections to Unable to push past sanitary sewer feet O Service lateral defects O Defective rnanholes O Sump pump connected to sanitary sewer O Flexible sump pump piping Number of stacks Length of Service: Yellow Copy: City of Eagan Record Number i Time • • Phone - . -.u Inspector Signature Obstruction Final Cleanout: No one in "O Acr'egs o ser civ e lateral needed o am 0 pm 0 Inspection refused Entered S.L..at Pink Copy: SEH Notes Number Discharged Total Correctly Incorrectly Unknown Sump pumps Foundation drains Roof drains • City of Era an Residential Sanitary Sewer Service Compliance Inspection • CF" O am Date �� ! ! 1 Time • pm Disk # Fri Name 's _r PID Number House Number - / Street Name r 1/ O Alternative Mailing Address For information call 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 Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection Damaged Pipe Transition 4" to 6 "Transition: White Copy: Proper ty Owners Owner /Occupant Signature Non - Compliance C11 O Clear water connections to Unable to push past sanitary sewer feet O Service lateral defects O Defective rnanholes O Sump pump connected to sanitary sewer O Flexible sump pump piping Number of stacks Length of Service: Yellow Copy: City of Eagan Record Number i Time • • Phone - . -.u Inspector Signature Obstruction Final Cleanout: No one in "O Acr'egs o ser civ e lateral needed o am 0 pm 0 Inspection refused Entered S.L..at Pink Copy: SEH 410 City oi Lapo Residential Sanitary Sewer Service Compliance Inspection //) Date/ k .„/ ) Name PID Number Disk#011—L1J—LL 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 4" to 6" Transition: White Copy: Property Owner Time arn • 9 P House Number Street Name Alternative Mailing Addpe 'Owner/Occupant Signature Non 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 Record Number Set vice Lateral Inspection Findings Number of stacks Entered S L at Notes 0 am • Time • prn L,.// Phone /-„-- --/ — • • Inspector Signature For information call 2788 Obstruction Unable to push past feet • ,, Roots / / , 1 .,-.:,----" ..-- - ../ 1 . . i .,• Po •Pipoints ,/ ,,,, : E.. -.....,.. 7 ir _ ,. :. ., .••• ; . ) , / ....-.(- / I Mine (Deposits -1.=- ;.- i).- i ..---"'' :_ _.`,.'..- . .:,.---' SaglPipt Deflection 4.1',:2/..1?.-4 .1, - );')/-: Zli - re -1 ' L' // / 1 e." --, Damaged‘Pipe --+ --7/ //),-"- c: //-1- ,.2.-- --, 7;' Transition ) i /) -, - - /-' , .- - f: - ..,._.- . i (-) , ,/./.; it , / ()-----7r 7) , - .., - ,-- (S ,-;—,_ /),-2/)).:-g ,/) <7? i i ,,-. ,,, ,,,,, fit I Length of Service: Final Cleanout: No Access q No one in latera n eded Access to service efl 0 Ins refused Yellow Copy: City of Eagan Pink Copy: SEH Number Correctly Discharged. Incorrectly Unknown Total Sump pumps Foundation drains Roof drains 410 City oi Lapo Residential Sanitary Sewer Service Compliance Inspection //) Date/ k .„/ ) Name PID Number Disk#011—L1J—LL 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 4" to 6" Transition: White Copy: Property Owner Time arn • 9 P House Number Street Name Alternative Mailing Addpe 'Owner/Occupant Signature Non 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 Record Number Set vice Lateral Inspection Findings Number of stacks Entered S L at Notes 0 am • Time • prn L,.// Phone /-„-- --/ — • • Inspector Signature For information call 2788 Obstruction Unable to push past feet • ,, Roots / / , 1 .,-.:,----" ..-- - ../ 1 . . i .,• Po •Pipoints ,/ ,,,, : E.. -.....,.. 7 ir _ ,. :. ., .••• ; . ) , / ....-.(- / I Mine (Deposits -1.=- ;.- i).- i ..---"'' :_ _.`,.'..- . .:,.---' SaglPipt Deflection 4.1',:2/..1?.-4 .1, - );')/-: Zli - re -1 ' L' // / 1 e." --, Damaged‘Pipe --+ --7/ //),-"- c: //-1- ,.2.-- --, 7;' Transition ) i /) -, - - /-' , .- - f: - ..,._.- . i (-) , ,/./.; it , / ()-----7r 7) , - .., - ,-- (S ,-;—,_ /),-2/)).:-g ,/) <7? i i ,,-. ,,, ,,,,, fit I Length of Service: Final Cleanout: No Access q No one in latera n eded Access to service efl 0 Ins refused Yellow Copy: City of Eagan Pink Copy: SEH of esi ential Sanitary Sewer Service Compliance Inspection Date f 1 ;i / L) Name PID Number House Number � s Alternate MailingAAddress Phone For Information call 651.470.2788 ompliance No foundation drain connection No roof drain connection o Sump pit not connected to sanitary sewer o j,._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 # Owner /Occ6pant Signature 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 Number of stacks Length of Service: Yellow Copy: City of Eagan Record Number Obstruction Unable to push past feet Time Inspector Signature Entered S.L. at ft-1 0 No Access o No one in o Access to service lateral needed o Inspection refused Final Cleanout: 3 .„ o am O pm Number Discharged Surnp Pumps Foundation Drains Roof Drains Total Y t Correctly incorrectly Unknown Notes Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551 Account # 260536 Service Date 09/28/10 PO # Camera inspection of sewer line. Pull & reset toilet. Description Of Service Camera inspection of sewer line Remit Io: 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#27-1025956 City of Eagan/City Dept at: Wayne Schwanz 3419 Coachman Pt Eagan MN 55122 Service At: George Toby 801 Ivy Ln Eagan MN 55123 Job # 217376 Quantity 1 Please Detach and Return with Remittance Check Enclosed [ ] Method of Payment Master Card [ ] Visa [ ] AmExp [ ] Discover [ ] Acct # Exp Date Name on Card Signature Invoice # Date: Page # A67225 09/28/10 1 of 1 Unit Price Extended Price Tx DUNS #027314893 Terms: Due 10/28/2010 Please pay from this Invoice.. Thank You Amount Due Amount Paid $215.00 $215.00 Balance Due $215.00 Invoice # A67225 Date : 09/28/10 Account # 260536 City of Eagan /City Dept at: $215.,00