810 Ivy Lane - Inspection FormCity of tapaa
1tesider tial Sanitary Sewer Service
Compliance Inspection
Dat 1�? 1 )79. / Time /( /s_�
Disk #
Alternative Mailing
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
Transition
4" to 6" Transition:
n
White Copy: Property Ower
\tom a U � ,-r
OwnerlOcaipant Signature ,-i
r
am
Pm
Service Lateral Inspection Findings . Number of stacks
Length of Service:
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
Yellow Copy: pity of Eagan
Record Number
HD Number
House Number / _..� _ C_ )Street Name ) )I V ) s - a.-
Address Phone (? 5) �
inspector Signature
For information call, 651:470.2788
Obstruction
Unable to push past
feet
Entered S.1_ at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
.'� Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged arged
Incorrectly Unknown
Notes
Not
t i � ^ .. r. �1 , ...,=C--.,
,•
- -- `' ` - ''� ' " iii V ``
i l i l �
.-
I ; � I � .- �. ff
,, i , , may -^
- ,:ail
;1 ° ' r . -, ,- : / l � J
Total
Sump pumps
__
Foundation drains
Roof drains
C......____---'
City of tapaa
1tesider tial Sanitary Sewer Service
Compliance Inspection
Dat 1�? 1 )79. / Time /( /s_�
Disk #
Alternative Mailing
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
Transition
4" to 6" Transition:
n
White Copy: Property Ower
\tom a U � ,-r
OwnerlOcaipant Signature ,-i
r
am
Pm
Service Lateral Inspection Findings . Number of stacks
Length of Service:
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
Yellow Copy: pity of Eagan
Record Number
HD Number
House Number / _..� _ C_ )Street Name ) )I V ) s - a.-
Address Phone (? 5) �
inspector Signature
For information call, 651:470.2788
Obstruction
Unable to push past
feet
Entered S.1_ at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
.'� Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Notes
Number Discharged
Unknow
� r`� c__.
"f --7-_..7 -° `� a � �
i
' ` T '
'
ca 4-...,-. - -.,/. - .�j - �-
Total
Correctly
Incorrectly
Sump pumps
j
Foundation drains
Roof drains
,
;>
City 4 F i au
Residential Sanitary Sewer Service
Compliance Inspection
Date! 1 1 /`�. / Time o pm
n f �
Name" — . 0 ✓ l Disk #
PID Number
House Number
Alternative MailingAddress
For information,' call 651.470:2788
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings Number of stacks
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition ,
4" to 6 "Transition:
White Copy: Property Owner
Street Name
OwnerlOccupant Signature ,/V
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
Length of Service:
Phone '? 2 T)- ICJ �°r" ..c6775
Yellow Copy: City of Fagan
Record Number
---. am
Time O pm
Obstruction
Unable to push past
feet
Signature
Entered S L at --� �'��i
Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Pink Copy: SEH