809 Ivy Lane - Inspection Form41111
City ol Eapn
Residential Sanitary Sewer Service
Compliance Inspection
Date (29/ 29 /
Name
1
PID Number
A Disk #
House Number Street Name
Alternative Mailing Address
I
VvnerlOccupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
1 0 No roof drain connection
O Sump pit not connected to
sanitary sewer'
O Sump pump properly piped
tr sump pump
Service Lateral Inspection Findings
Sag/Pipe Deflection - 7
Damaged Pipe
(.
Transition . F`'` 5
4" to 6"Transition:
Time ///- Parfirn
/
Non-Compliance
0
0
White Copy: Property Owner
Vt.445
0
/ /
/
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Roots
Poor Pipe joints
Mineral Deposits
- ( )( t
Length of Service:
Yellow Copy: City of Eagan
1 r )-
-
IL" A r
; -
Record Number
Ci?
Time
Obstruction
Unable to push past
feet
Entered S L at
•
• t
am
0 pm
Phone
/
/1/
/ tn'spector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
Total
Notes ,, ,,,.:7,,:c
:,,,--
,,,.., ..
-,,, ,..,L...., ,
/17 1; .1:3 63 . - - ,.1: .7
/ (1 .61
-..
-'''''''"/ ,,,,,,".-'-'-'
(7 C'''
--'
.,/,',:
' 11 : % L
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
...,—.„..--..-
Foundation drains
Roof drains
..r.,::
.: ...,..,
-..-...,--'"... ..,....-...,..---.
41111
City ol Eapn
Residential Sanitary Sewer Service
Compliance Inspection
Date (29/ 29 /
Name
1
PID Number
A Disk #
House Number Street Name
Alternative Mailing Address
I
VvnerlOccupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
1 0 No roof drain connection
O Sump pit not connected to
sanitary sewer'
O Sump pump properly piped
tr sump pump
Service Lateral Inspection Findings
Sag/Pipe Deflection - 7
Damaged Pipe
(.
Transition . F`'` 5
4" to 6"Transition:
Time ///- Parfirn
/
Non-Compliance
0
0
White Copy: Property Owner
Vt.445
0
/ /
/
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Roots
Poor Pipe joints
Mineral Deposits
- ( )( t
Length of Service:
Yellow Copy: City of Eagan
1 r )-
-
IL" A r
; -
Record Number
Ci?
Time
Obstruction
Unable to push past
feet
Entered S L at
•
• t
am
0 pm
Phone
/
/1/
/ tn'spector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH