889 Ivy Lane - Inspection Form4 City of Fa H
Residential Sanitary Sewer Service
Compliance inspection
Date
Name (/
I. 9
Time
isk ##
P10 Number
House Number 1 �J <1 Street Name
Alternative ailing Addr Address
r
v/ ' •
./ � i f
'' ..
dwnerlccupant Signature
Compliance
4 No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
)4 No sump pump
Transition
4" to 6" Transition:
White Copy: Property Owner
Service Lateral Inspection Findings
0
0
0
0
0
am
Pm
Phone ("%.2 ) ),'"4
, Z
Non- Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Roots
Length of Service:
Yellow Copy: City of Eagan
I
Record Number
D} J �1Time •
q 4
Obstruction
Unable to push past
feet
p am
/T pm
Inspector Signature
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
Q Inspection
refused
Entered S L. at
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
1 �
Final Cleanout: r,
Pink Copy: SEH
To Dal
N otes
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
f
-M
Foundation drains
(`„/
Roof drains
'tip
4 City of Fa H
Residential Sanitary Sewer Service
Compliance inspection
Date
Name (/
I. 9
Time
isk ##
P10 Number
House Number 1 �J <1 Street Name
Alternative ailing Addr Address
r
v/ ' •
./ � i f
'' ..
dwnerlccupant Signature
Compliance
4 No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
)4 No sump pump
Transition
4" to 6" Transition:
White Copy: Property Owner
Service Lateral Inspection Findings
0
0
0
0
0
am
Pm
Phone ("%.2 ) ),'"4
, Z
Non- Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Roots
Length of Service:
Yellow Copy: City of Eagan
I
Record Number
D} J �1Time •
q 4
Obstruction
Unable to push past
feet
p am
/T pm
Inspector Signature
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
Q Inspection
refused
Entered S L. at
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
1 �
Final Cleanout: r,
Pink Copy: SEH