893 Ivy Lane - Inspection FormCity of Eaao
Residential Sanitary Sewer Service
Compliance Inspection
Date �� t
/ f Time( J �` i s
. /1 , ,
O pm
Name ) � l f r' %� " Disk #
PID Number
House Number `/ _: Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
t1
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Owner /Occupant Signature
Service Lateral Inspection Findings
Roots
Poor Pi pe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
rf
C
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
1
Number of stacks I Entered S.L.at'¢<'1c" I
Length of Service: f -"7 l - Fina Cleanout:
Yellow Copy: City of Eagan
Record Number 1
Et Time --
p am
• o pm
.,
Phone 1 ` °7 - ._7 �/
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
� � % ! ' %
y3
I I i ll '-) ,'
c _-
3
:
i�''�; "!
- /--", � I�
�' - / 4 i - �,
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
City of Eaao
Residential Sanitary Sewer Service
Compliance Inspection
Date �� t
/ f Time( J �` i s
. /1 , ,
O pm
Name ) � l f r' %� " Disk #
PID Number
House Number `/ _: Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
t1
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Owner /Occupant Signature
Service Lateral Inspection Findings
Roots
Poor Pi pe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
rf
C
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
1
Number of stacks I Entered S.L.at'¢<'1c" I
Length of Service: f -"7 l - Fina Cleanout:
Yellow Copy: City of Eagan
Record Number 1
Et Time --
p am
• o pm
.,
Phone 1 ` °7 - ._7 �/
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH