814 Ivy Lane - Inspection FormCity of Capri
Residential Sanitary Sewer Service
Compliance Inspection
,F r
Date ()F/ /: i /d Time G
Name 4/ 7 / Disk #
PID Number
House Number Street Name
Alternative Mailing Address t
I>�
Roots
1 J
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition LI
4" to 6 "Transition:
i ' Owner /Occupant Signature
j 3
For information ca.II 651:47
Compliance
D No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
,r f No sump pump
Service Lateral Inspection Findings Number of stacks Entered S . at "
White Copy: Propei ty Owner
t •%;• : r i
sp'am
O pm
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
LLJ- LLkJ
r
Length of Service:
Yellow Copy: City of Eagan
„„ Record Number r`
Time Li / •
Phone
inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
Final Cleanout:
a:am
O pm
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged . N otes ---1:)(2o fi f./ � 1 � .: -r -
Total
Incorrectly
Unknown
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c , 1 ,cr,.A° ; ;e^,_ / / - •e' ; � s � : / "'
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/,'� ;�', :�.'A t.• r. t C
. > 3
Sump pumps
Foundation drains
r-,.-_� _r__
- _
_ i s
Roof drains
City of Capri
Residential Sanitary Sewer Service
Compliance Inspection
,F r
Date ()F/ /: i /d Time G
Name 4/ 7 / Disk #
PID Number
House Number Street Name
Alternative Mailing Address t
I>�
Roots
1 J
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition LI
4" to 6 "Transition:
i ' Owner /Occupant Signature
j 3
For information ca.II 651:47
Compliance
D No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
,r f No sump pump
Service Lateral Inspection Findings Number of stacks Entered S . at "
White Copy: Propei ty Owner
t •%;• : r i
sp'am
O pm
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
LLJ- LLkJ
r
Length of Service:
Yellow Copy: City of Eagan
„„ Record Number r`
Time Li / •
Phone
inspector Signature
Obstruction No Access
Unable to push past 0 No one in
feet
Final Cleanout:
a:am
O pm
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Sump pumps
—
- _
_.-
Foundation drains
-
° --
,_w. •- - __
Roof drains
r y
w_____
City of Cagan
Residential Sanitary Sewer Service
Compliance Inspection
Date dt1 / > ! .'
Name 4 >� n 4 /) Disk #
House Number
Alternative Viailing Address r
• A5
Time i2 7 • ,' "✓ o pm
'�
N Owner /Occupant Signature
I `E
-LE -[1J
Record Number c
PID Number
g lity Street Name
p am
Time L • Ws r o pm
i(
l lnspWtor Signature
For information call 651:470.2788
Compliance
.6' No foundation drain connection
1p No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
14 (No sump pump
Service Lateral Inspection Findings Number of stacks 8 Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition., r i r • 1 ( 7
4" to 6" Transition:
Total
Yellow Copy: City of Eagan
White Copy: Property Owner
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:
Number Discharged
Correctly Incorrectly Unknown
Obstruction
Unable to push past
feet
Notes
rr i
I
^' 440 g
y .
n1J Jir c
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
r
r
G f ✓ Hof ter
Pink Copy: SEH