3671 Windtree Cir - Inspection FormCity of Ca an
Residential Sanitary Sewer Service
Compliance Inspection
Date 05 / Time
Name .
z
�.�' i/
PID Number
House Number' m.T67 ! Street Name
Alternative Mailing Address
Compliance
Cl" No foundation drain connection
't..) No roof drain connection
/40 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
0 No sump pump
x1
s r
Owner /Occupant Signature
Service Lateral Inspection Findings
Sag /Pipe Deflection
Damaged Pipe
Transition . `
4" to 6" Transition:
White Copy: Property Owner
f 1r
• f g p'am
•.a 0 P
Disk #
0
O Flexible sump pump piping
Number of stacks
I TT
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Yellow Copy: City of Eagan
Record Number
--]
Length of Service: /37
f) •
Time /
•
Obstruction
Unable to push past
feet .
r
earn
o pry
For information call 651.470.2788
No Access
O No one in
O,. Access to service
lateral needed
O Inspection
refused
Entered St at
PoorPipeJoints
Mineral Deposits
7
Final Cleanout: 7 r
Pink Copy: SEH
Total
Notes
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
61
City of Ca an
Residential Sanitary Sewer Service
Compliance Inspection
Date 05 / Time
Name .
z
�.�' i/
PID Number
House Number' m.T67 ! Street Name
Alternative Mailing Address
Compliance
Cl" No foundation drain connection
't..) No roof drain connection
/40 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
0 No sump pump
x1
s r
Owner /Occupant Signature
Service Lateral Inspection Findings
Sag /Pipe Deflection
Damaged Pipe
Transition . `
4" to 6" Transition:
White Copy: Property Owner
f 1r
• f g p'am
•.a 0 P
Disk #
0
O Flexible sump pump piping
Number of stacks
I TT
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Yellow Copy: City of Eagan
Record Number
--]
Length of Service: /37
f) •
Time /
•
Obstruction
Unable to push past
feet .
r
earn
o pry
For information call 651.470.2788
No Access
O No one in
O,. Access to service
lateral needed
O Inspection
refused
Entered St at
PoorPipeJoints
Mineral Deposits
7
Final Cleanout: 7 r
Pink Copy: SEH