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3440 Ivy Ct - Inspection FormAccount# 260536 City of Eagan/City Dept at: Wayne Schwanz 3419 Coachman Pt Eagan MN 55122 Service At: Kathy Paden 3440 Ivy Ct Eagan MN 55123 Service Date 09/10/10 PO # Camera inspection of sewer line, Pull & reset toilet. Description Of Service Camera inspection of sewer line DUNS #02'7314893 Ter ms: Due 10/10/2010 Please pay from this Invoice Ihank You Check Enclosed [ ] Method of Payment Master Card [ ] Visa [ ] AmExp [ ] Discover [ ] Acct # Exp Date Name on Card Signatur e Remit Io: Benjamin Franklin Plumbing 1424 3rd St N Minneapolis MN 55411 Invoice Benjamin Franklin Plumbing 1424 3rd St N Minneapolis MN 55411 612 -604 -4285 FAX: 612-822-5408 FID #27- 1025956 Job # 216535 Quantity 1 Please Detach and Return with Remittance Unit Price Extended Price Tx Amount Due Amount Paid $215.00 $215.00 Balance Due $215.D0 Invoice # A71511 Date : Invoice # Date: Page # A71511 09/10/10 1 of 1 09/10/10 Account# 260536 City of Eagan /City Dept at: $215.00 Residential Sanitary Sewer Service Compliance Inspection . \ ,{ Date r _1 /O !. Name House Number • White Copy: Property Owner Time Owner /Occupant Signature Disk # PID Number o am O pm Street Name Yellow Copy: City of Eagan Record Number O :am Time 0 pm Alternate Mailing Address ,Phone. Inspector Signature Compliance No:foundation drain connection Nf No roof drain connection O Sump pit not connected to sanitary sewer o Sump Pump properly piped No sump pump 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 Obstruction Unable to push past feet =No Access o No one in O Access to service lateral needed .. o Inspection refused Service Lateral Inspection Findings Roots PoorPipe .Joints ".. Mineral Deposits Sag /Pipe Deflection Damaged Pipe Transition 4" to 6" Transition: Number of stacks Entered S .. at Length of Service: Final Cleanout_, -/ For Information call 651.478.2788 Total Number Discharged Sump Pumps Foundation Drains Roof Drains Correctly Incorrectly Unknown Dotes Pink Copy.: Benjamin Franklin Plumbing 651- 222 -1 551 Cit of Ca a y � s Residential Sanitary Sewer Service Compliance Inspection Date / ›. 1 f { ° Name :5 RID Number I-louse Number Alter native Mailing Address i1 's1 Poor Pipe joints Mineral Deposits 4" to 6" Transition: OwnerlOccupant 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 sump pump Service Lat cal Inspection Findings I ..s.'.:.:.. Roots White Copy: Property Owner •� Time • Disk # .;Street Name am Pm Non - Compliance O Clear water connections sanitary sewer O Service lateral defects O Defective manholes O Sump pump connected to sanitary sewer O Flexible sump pump piping Record Number Length of Service: Yellow Copy: City of Eagan Time =Phone ,) Obstruction Unable to push past feet Numb ,r of stacks ...Entered S at Transition k o am • • O pm "2 -2 Inspector Signature For information call 651.470.2788 Final Cleanout: No Access No one in !1 0 Aces C61sivic e lateral needed 0 Inspection refused i i i Sag/Pipe Deflection -7 7,.s 7 . '7/3/2/ ?4,, �� y l e..-..) Damaged Pipe 64 Y; . • --.7.: t ,1 ; / ; -. ': ) Pink Copy: SEH Number Correctly Discharged Incorrectly Unknown Notes Total Sump pumps Foundation drains IIIII --- Roof drains Cit of Ca a y � s Residential Sanitary Sewer Service Compliance Inspection Date / ›. 1 f { ° Name :5 RID Number I-louse Number Alter native Mailing Address i1 's1 Poor Pipe joints Mineral Deposits 4" to 6" Transition: OwnerlOccupant 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 sump pump Service Lat cal Inspection Findings I ..s.'.:.:.. Roots White Copy: Property Owner •� Time • Disk # .;Street Name am Pm Non - Compliance O Clear water connections sanitary sewer O Service lateral defects O Defective manholes O Sump pump connected to sanitary sewer O Flexible sump pump piping Record Number Length of Service: Yellow Copy: City of Eagan Time =Phone ,) Obstruction Unable to push past feet Numb ,r of stacks ...Entered S at Transition k o am • • O pm "2 -2 Inspector Signature For information call 651.470.2788 Final Cleanout: No Access No one in !1 0 Aces C61sivic e lateral needed 0 Inspection refused i i i Sag/Pipe Deflection -7 7,.s 7 . '7/3/2/ ?4,, �� y l e..-..) Damaged Pipe 64 Y; . • --.7.: t ,1 ; / ; -. ': ) Pink Copy: SEH