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3474 Trails End Rd - Inspection FormAccount # 260536 City of Eagan/City Dept at: Wayne Schwanz 3419 Coachman Pt. Eagan MN 55122 Service Date 09/22/10 PO # Camera inspection of sewer line. Pull & reset toilet. Description Of Service Camera inspection of sewer line Remit To: Benjamin Franklin Plumbing 1424 3rd St N Minneapoils MN 55411 Invoice Benjamin Franklin Plumbing 1424 3rd St N Minneapolis MN 55411 612 -604 -4285 FAX: 612 -822 -5408 FID#27-1025956 Job # 217148 1 Check Enclosed [ ] Method of Payment Master Card [ ] Visa [ ] AnrExp [ ] Discover [ ] Acct # Exp Date Name on Card Signature Quantity Please Detach and Return with Remittance Service At: Nancy Namur 3474 Trails End Rd Eagan MN 55123 Unit Price Extended Price Tx DUNS #027314893 Terms: Due 10/22/2010 Please pay from this Invoice., Thank You Amount Due Amount Paid Date : Invoice # Date: Page # Invoice # A72298 09/22/10 1 of 1 $215.00 $215.00 Balance Due $215.00 A72298 09/22/10 Account# 260536 City of Eagan /City Dept at: $215.00 - Res dent al Sanitary Sewer Services - icompliance Inspection - try :nen Date 9 ic i 1 t' Name 11 .,c, (1 4 ., RD Number House Number / sump pump Transition 3 LI 1 Lk Alternate Mailing Address Owner/Occupant Signature Compliance No foundation drain connection No roof drain connection o Sump pit not connected to sanitary sewer o Sump Pump properly piped Time Service Lateral Inspection Findings Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection t c ) \ 5 Damaged Pipe 4" to 6" Transition:8O White Copy: Property Owner ) (5- am • l5 - 0 pm Disk # 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 Street Name Yellow Copy: City of Eagan Record Number 0 1 Obstruction Time Phone For Information call 651.470.2788 Unable to push past feet Number of stacks Entered S L Inspector Signature No Access o No one in O Access to service lateral needed O Inspection refused O am o pm Length of Service: '" Final Cleanout:c20 23 1 < ' Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551 Total N otes Number Discharged Correctly Incorrectly Unknown Sump Pumps Foundation Drains r Roof Drains 0 - Res dent al Sanitary Sewer Services - icompliance Inspection - try :nen Date 9 ic i 1 t' Name 11 .,c, (1 4 ., RD Number House Number / sump pump Transition 3 LI 1 Lk Alternate Mailing Address Owner/Occupant Signature Compliance No foundation drain connection No roof drain connection o Sump pit not connected to sanitary sewer o Sump Pump properly piped Time Service Lateral Inspection Findings Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection t c ) \ 5 Damaged Pipe 4" to 6" Transition:8O White Copy: Property Owner ) (5- am • l5 - 0 pm Disk # 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 Street Name Yellow Copy: City of Eagan Record Number 0 1 Obstruction Time Phone For Information call 651.470.2788 Unable to push past feet Number of stacks Entered S L Inspector Signature No Access o No one in O Access to service lateral needed O Inspection refused O am o pm Length of Service: '" Final Cleanout:c20 23 1 < ' Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551 Name ,P0 City ill fhp,an Residential Sanitary Sewer Service Compliance inspection Datet--- 4 I I Time '; pm • am Alternative Nailing Address Disk # RD Number , 4 Pk 3 House Number 714 Street Name t 1"" 1 ,i A a OwnerlOccupant Signature For information call 651.470.2788 Compliance 0 No foundation drain connection 0 No roof drain connection 0 Sump pit not connected to sanitary sewer 0 Sump pump properly piped 0 No sump pump Service Lateral Inspection Findings Roots \b Poor Pipel ints ' Mir eposits / - Non 0 Clear water connections to sanitary sewer 0 Service lateral defects 0 Defective manholes 0 Sump pump connected to sanitary sewer o Flexible sump pump piping Number of stacks 7 d'1 Sag/P1 ie Deflection ri) 4-0 Da Pipe Transition 4" to 6" Transition: White Copy: Property Ownei ) Length of Service: Yellow Copy: City of Eagan Record Number A/ er 7V r7 Phone Obstruction Unable to push past feet Entered S L at / ) Time • 0 am • 0 pm Inspector Signature „ No Access 0 No one in 0 Access to service lateral needed 0 Inspection refused a Final Cleanout: Pink Copy: SE H Number Correctly Discharged Incorrectly Unknown Notes Total Sump pumps ill Foundation drains MIN Roof drains Name ,P0 City ill fhp,an Residential Sanitary Sewer Service Compliance inspection Datet--- 4 I I Time '; pm • am Alternative Nailing Address Disk # RD Number , 4 Pk 3 House Number 714 Street Name t 1"" 1 ,i A a OwnerlOccupant Signature For information call 651.470.2788 Compliance 0 No foundation drain connection 0 No roof drain connection 0 Sump pit not connected to sanitary sewer 0 Sump pump properly piped 0 No sump pump Service Lateral Inspection Findings Roots \b Poor Pipel ints ' Mir eposits / - Non 0 Clear water connections to sanitary sewer 0 Service lateral defects 0 Defective manholes 0 Sump pump connected to sanitary sewer o Flexible sump pump piping Number of stacks 7 d'1 Sag/P1 ie Deflection ri) 4-0 Da Pipe Transition 4" to 6" Transition: White Copy: Property Ownei ) Length of Service: Yellow Copy: City of Eagan Record Number A/ er 7V r7 Phone Obstruction Unable to push past feet Entered S L at / ) Time • 0 am • 0 pm Inspector Signature „ No Access 0 No one in 0 Access to service lateral needed 0 Inspection refused a Final Cleanout: Pink Copy: SE H