873 Ivy Lane - Inspection FormSump pumps
Foundation drains
Roof drains
1111111111 Cityo Eaq,aa
Residential Sanitary Sewer Service
Compliance Inspection
Date 0, / / ( 1 .- 6;
Name 1: (..; /I Disk #
PID Number
House Number rk Street Name
Alternative Mailing Addr ess
Owner/Occupant Signature
Compliance
6 No foundation drain connection
W No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
i xo No sump pump
4" to 6" Transition:
White Copy: Proper ty Owner
A/ A
T ' am
ime • v 0 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
Length of Service:
Number Discharged
Total Correctly Inca( r ectly
Unknown
0
Record Number
Notes
r •
/ --/ t rc
Time
1
4
o am
o pm
Ph ne (4 K
„/fhspector Signature
For information call 651A70.2788
Obstruction
Unable to push past
feet
No Access
O No one in
Final Cleanout: 4r/4
O Access to service
lateral needed
O Inspection
refused
Service Lateral inspection Findings Number of stacks Entered S.L. at /V*
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
'Transition
F—AT /i •
T?
7
444/ .A/
ipcfW ,
• ,
Yellow Copy: City of Eagan Pink Copy: SEH
641 PI:V 12 A/
CO j i C/ • , °”
vc) Si . /7-.)