842 Ivy Lane - Inspection Formr City of li L1r
Residential Sanitary Sewer Service
Compliance inspection
Date /';r`l .
Name ` ' - "
PID Number.
House Number 6
Alternative Mailing Address
For information call 651.47
Compliance
O No foundation drain connection
6 . / No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
-No sump pump
Owner /Occupant Signature
Roots
Poor Pipejoints
Mineral Deposits
Service Lateral Inspection Findings
Sag /Pipe Deflection r `
Damaged Pipe /
Transition < / '' > ' a / /4
4" to 6" Transition:
White Copy: Property Owner
i/
a• •
Time. ' •
Disk #
Street Name
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
j;d 7 "" f /c.
o am
pm
Number of stacks Entered S L at /77
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
Phone
t 11
)1
Time
o em
p
Inspector Signature
Final Cleanout: //47
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Notes '!i, -1 - -A
•
// /
AA2 A6 `".r, 1-/Vf C 7.5r )
Pink Copy: SEx
Number
Correctly
Discharged
Incorrect ly
Unknown
Total
Sump pump
.._ ..�
- .,__.._.
Foundation drains
Roof drains
r City of li L1r
Residential Sanitary Sewer Service
Compliance inspection
Date /';r`l .
Name ` ' - "
PID Number.
House Number 6
Alternative Mailing Address
For information call 651.47
Compliance
O No foundation drain connection
6 . / No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
-No sump pump
Owner /Occupant Signature
Roots
Poor Pipejoints
Mineral Deposits
Service Lateral Inspection Findings
Sag /Pipe Deflection r `
Damaged Pipe /
Transition < / '' > ' a / /4
4" to 6" Transition:
White Copy: Property Owner
i/
a• •
Time. ' •
Disk #
Street Name
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
j;d 7 "" f /c.
o am
pm
Number of stacks Entered S L at /77
Length of Ser vice:
Yellow Copy: City of Eagan
Record Number
Phone
t 11
)1
Time
o em
p
Inspector Signature
Final Cleanout: //47
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Notes '!i, -1 - -A
•
// /
AA2 A6 `".r, 1-/Vf C 7.5r )
Pink Copy: SEx