4253 Jasper Dr - Inspection FormResidential .Sanitary Sewer Service
Compliance Inspection
Date .4 7 /7 l /)
i
Name / 1 y!) J Disk #
I
PID Number
/
House Number Street Name
Alternative Mailing Address
For information call 651! A70.2788
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitar y sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings Number of stacks Entered S.L at !
Roots !1 f 3
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
°r i
/Owner /Occupant Signature
Time
//: S G' rf pm
0
il-
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:
Yellow Copy: City of Eagan
Record Number
0
Phone `
, /'
,Inspector Signature
Obstruction
Unable to push past
7
Time'
Final Cleanout: !t
o am
o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
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Number.
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
� y
Foundation drains
Roof drains
..-
.�.._._
._ .-
--
Residential .Sanitary Sewer Service
Compliance Inspection
Date .4 7 /7 l /)
i
Name / 1 y!) J Disk #
I
PID Number
/
House Number Street Name
Alternative Mailing Address
For information call 651! A70.2788
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitar y sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings Number of stacks Entered S.L at !
Roots !1 f 3
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
°r i
/Owner /Occupant Signature
Time
//: S G' rf pm
0
il-
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:
Yellow Copy: City of Eagan
Record Number
0
Phone `
, /'
,Inspector Signature
Obstruction
Unable to push past
7
Time'
Final Cleanout: !t
o am
o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH