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4157 Rahn Rd - Inspection FormAccount # 260536 City of Eagan/City Dept at: Wayne Schwanz 3419 Coachman Pt Eagan MN 55122 Service At: Karen Coggins 4157 Rahn Rd Eagan MN 55122 Service Date 08/11/10 PO # Camera inspection of sewer line. Description Of Service Camera inspection of sewer line Remit Io: 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 F1D #27- 1025956 Job it 214893 Quantity 1 Please Detach and Return with Remittance Check Enclosed [ ] Method of Payment Master Card [ ] Visa [ ] AmExp [ ] Discover [ ] Acct # Exp Date Name on Card Signature Invoice # Date: Page # A65395 08/11/10 1 of' 1 Unit Price Extended Price Tx Amount Due Amount Paid $215.00 $215.00 Balance Due $215..00 DUNS #02731489.3 I erms: Due 9/10/2010 Please pay from this Invoice, Thank You Invoice # Date : A65395 08/11/10 Account # 260536 City of Eagan/City Dept at: $215..00 es cIe tia! Sanitary Sewer Service , city �d o p c inspect s Date Name PID Number House Number • f Owner /Occupant Signature Compliance t<<_ /Th Time b Sump pit not connected to sanitary sewer 0 Sump Pump properly piped V No sump pump No foundation drain connection No roof drain connection }I� °7 Service Lateral Inspection Findings 4" to 6" Transition: White Copy: Property Owner Disk tt 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 o am O pm Street Name Number of stacks Obstruction Length of Service: q1'9 Yellow Copy: City of Eagan Record Number �' 1 3 Time Alternate Mailing Address Phone Unable to push past feet inspector Signature Entered S.L. at — ¶ ! 3 Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection 7 tj ;--) Damaged Pipe Transition o am o pm For Information call 651.470.2788 No Access o No one in O Access to service lateral needed O Inspection refused Final Cleanout: Number Discharged Sump Pumps Foundation Drains Roof Drains Total Correctly Incorrectly Unknown Notes Pink Copy: Benjamin Franklin Plumbing 651 - 222 -1551