722 Brentwood Lane - Inspection Form/ i'
Number
Correctly
Discharged
Incorrectly Unknown
Notes
0t7; 'C'( -» -" F.: 'f ' ` ��p ? ., --
Total
Sump pumps
e
w- ,w
Foundation drains
''
w
.
rs
Roof drains
t-
,_„En
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. 41 , 111 . Y of hap
Residential Sanitary Sewer Service
Compliance Inspection
Date (2 1 (791 ,raid
Alternative MailinAddress . .
4 r
Compliance
Cr No foundation drain connection
0 roof drain connection
{ 4 /Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
, No sump pump
Service Lateral Inspection Findings
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
P J/
•
White Copy: Property Owner
,,/,/ • O am
Time / • O orpm
Name /L, l . /(.*ice; bisk # 0 Ci
Owner /Occupant Signature
i /
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
GTE
PID Number
House Number Z. Street Name _ ''✓v
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
Record Number
Phone ?i
f
/
For information call 651.470.2788
Roots
Poor Pipe joints
Mineral Deposits
Time
inspector Signature
Obstruction
Unable to push past
feet
Entered St at
Final Cleanout:
.4 ""
'0¢
am
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH