3762 Windtree Dr - Inspection FormCity a1' Wn
Residential Sanitary Sewer Service
Compliance Inspection
Name
PID Number
House Number !r`;i Street Name
Alternative Mailing Address
Roots
PockPipeJ nts
Min tal eposits
Sag/4e Deflection
Damaged Pipe
Transition 2 ^,
4" to 6" Tr
White Copy: Property Owner
<) /.) Disk #
(V 4 am
Time r p pm
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
A No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings Number of stacks '
-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
r � ,
Length of Service:
/I
1
Yellow Copy: City of Eagan
Record Number '.
Phone D i - > ' ) � •r , _...
Obstruction
Unable to push past
feet
Entered S.,L at °r'1?, ! �. , d r
/i
.' • ✓dam
Time , '� • _ p pm
Inspector Signature
No Access
2
'o one in
AFEdii;f&service-
..later
0 Inspection • 'f'
refused
x r i
Final Cleanout• � ``"° • -
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
p , '
' ''''' ",- ". I ' z " " ,,,-, : O 1
/
, /;/L?) : 1 i r ,---: , , s ,
'^) ., m, ,
Total
Sump pumps
/ ' by.
�.,
�,,"1 ,
� I i
-1 ')f.-
%
Foundation drains
Roof drains
t J?
City a1' Wn
Residential Sanitary Sewer Service
Compliance Inspection
Name
PID Number
House Number !r`;i Street Name
Alternative Mailing Address
Roots
PockPipeJ nts
Min tal eposits
Sag/4e Deflection
Damaged Pipe
Transition 2 ^,
4" to 6" Tr
White Copy: Property Owner
<) /.) Disk #
(V 4 am
Time r p pm
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
A No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings Number of stacks '
-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
r � ,
Length of Service:
/I
1
Yellow Copy: City of Eagan
Record Number '.
Phone D i - > ' ) � •r , _...
Obstruction
Unable to push past
feet
Entered S.,L at °r'1?, ! �. , d r
/i
.' • ✓dam
Time , '� • _ p pm
Inspector Signature
No Access
2
'o one in
AFEdii;f&service-
..later
0 Inspection • 'f'
refused
x r i
Final Cleanout• � ``"° • -
Pink Copy: SEH