3444 Ivy Ct - Inspection Form..
Number
Correctly
Discharged:: : . •: .
Notes — (.
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ti 7 z
7,-
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Total
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains •
/ c. -247. .. ; ...
4 111 11 '
City fit liago
Residential Sanitary Sewer Service
Compliance Inspection
Date e'-'
N ame Z . J)'.--r Disk # M
PID Number
House Number
Alternative flailing Address
Na)
dwnerlOccupant Signature
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 surnp purnp
4" to 6"Transition:
White Copy: Property Owner
e am
Tim 7
e i s— 0 pm
Street Name
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
o am
Time • 0 Pm
Obstruction
Unable to push past
feet
Final Cleanout:
Pone
/UPI -
'?"1/ Inspector Signature
, ,
For information call 651.470.2788
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Account# 260536
Service Date 08/26/10
PO #
Camera inspection of sewer line. Pull & reset toilet
Description Of Service
Camera inspection of sewer line
Remit To:
Benjamin Franklin Plumbing
1424 3rd St N
Minneapoils 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:
Ellen Snustad
3444 Ivey Crt
Eagan MN 55123
Job # 215745
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 #
A65631
08/26/10
1 of 1
Unit Price Extended Price Tx
DUNS #027314893
Terms: Due 9/25/2010 Please pay from this Invoice. Thank You
Amount Due
Amount Paid
$215.00 $215.00
Balance Due $215,00
Invoice # A65631
Date :
08/26/10
Account # 260536
City of Eagan /City Dept at:
$215..00
Residential Sanitary Sewer Service
Compliance Inspectiort
p ity of Ea ait
0
0
Date S. lc p 1 t:"‘
Name E
PID Number
House Number 34 A
Alternate Mailing Address
Roots
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump Pump properly piped
No sump pump
Service Lateral Inspection Findings
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
,�,�� �;� w :•f Disk #
Owner /Occupant Signature
White Copy: Property Owner
Time
s'l t S ,
4" to 6" Transition:
I
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
L �>
Street Name
Number of stacks
Yellow Copy: City of Eagan
Record Number ( f 5 S
Obstruction
Length of Service: )4 r
Time
Phone
Unable to push past
feet
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
Entered S L at - re, , '�F.
Final Cleanout: )
Number Discharged
Sump Pumps
Foundation Drains
Roof Drains
Total
Correctly Incorrectly Unknown
Notes
Pink Copy: Benjamin Franklin Plumbing
651 - 222 -1551