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4875 Windsor Ct - Inspection FormAccount # 260536 City of Eagan/City Dept at: Wayne Schwanz 3419 Coachman Pt Eagan MN 55122 Service At: Bill Bierman 4875 Windsor Ct Eagan MN 55122 Service Date 08/09/10 Description Of Service PO # Camera inspection of sewer line. Camera inspection of sewer line Check Enclosed [ ] Method of Payment Master Card [ ] Visa [ ] ArnExp [ ] Discover [ ] Acct # Exp Date Name on Catd Signature Remit T o: 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 # 213283 Quantity 1 Please Detach and Return with Remittance Invoice # Date: Page if B50853 08/09/10 I of 1 Unit Price Extended Price Tx $215.00 $215.00 Balance Due $215.00 DUNS #027314893 Ier ms: Due 9/8/2010 Please pay fr om this Invoice, Thank You Amount Due Amount Paid Invoice # B50853 Date : 08/09/10 Account # 260536 City of Eagan /City Dept at: $215.00 Residential Sanitary Sewer r is Compliance Inspection it Date Name PID Number , I t (7) House Number f Alternate Majling Address Compliance a No foundation drain connection No roof drain connection 'y' Sump pit not connected to sanitary sewer 0 Sump Pump properly piped No sump pump Transition White Copy: Property Owner Time 1 ✓S /.0 Yff d" Owner /Occupant Signature Service Lateral Inspection Findings Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection Damaged Pipe 4" to 6" Transition: Disk # /F; 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 ` 71 Length of Service: Yellow Copy: City of Eagan Record Number For Information call 651.470.2788 Obstruction Phone Unable to push past feet Entered S L at Time Inspector Signature No Access o No one in o Access to service lateral needed o Inspection refused Final Cleanout: , o am o pm 1 ,I Number Discharged Sump Pumps Foundation Drains Roof Drains =MIMI Total Correctly Incorrectly Unknown Notes • Pink Copy: Benjamin Franklin Plumbing 651- 222 -1551