3452 Ivy Ct - Inspection Form4 City of hp
Residential Sanitary Sewer Service
Compliance Inspection
} tJ : 7' am
Date
/ 1 Time Pm
Name /.d r ✓:"1 Disk ##
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
No roof drain connection
'O Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition ,
4" to 6 "Transition:
White Copy: Property Owner
Street Name
Owner /Occupant Signature
MOM
Yellow Copy: City,of Eagan
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
For information caII 651.470.2788
Number of stacks I Entered S.L at
Roots
Length of Service: j _, Final Cleanout:
Record Number 1
Obstruction
Unable to push past
feet
r,
Et Tim
r
/.
t m
, L • o a ,
• pm
Phone ' a �<?:"��
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown;
Notes
. .' . :5 }'.- 'C "' :.. ;r _ ,-- .. -
L ''t 7 7 ,
P�� C 't .J c�t ,t
Total
Sump pumps
,-
Foundation drains
Roof drains
F
4 City of hp
Residential Sanitary Sewer Service
Compliance Inspection
} tJ : 7' am
Date
/ 1 Time Pm
Name /.d r ✓:"1 Disk ##
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
No roof drain connection
'O Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition ,
4" to 6 "Transition:
White Copy: Property Owner
Street Name
Owner /Occupant Signature
MOM
Yellow Copy: City,of Eagan
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
For information caII 651.470.2788
Number of stacks I Entered S.L at
Roots
Length of Service: j _, Final Cleanout:
Record Number 1
Obstruction
Unable to push past
feet
r,
Et Tim
r
/.
t m
, L • o a ,
• pm
Phone ' a �<?:"��
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH