1478 Lake Park Cir - Inspection Form\oo
• City al' hallo
Y o
Residential Sanitary Sewer Service
Compliance Inspection
Date H /1 t `)1 /' .:
A
Name .1.. f.
PID Number
House Number
Time
Disk #
Street Name
Alternative Mailing Address
iu
OwnerlOccupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
Q No roof drain connection
O Sump pit not connected to
sanitary sewer r "s % 4'1°' "
ti Sump pump properly piped
O No sump pump
Service Lateral Inspection Fidings
Roots
4" to 6" Transition:
White Copy: Pr operty Owner
• Ol em
• ✓O' pm
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
Number of stacks
t � �
Poor Pipe Joints y ° / / . Z4)
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
L
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
®
Phone ' :°
Obstruction
Unable to push past
feet.
Entered S.L at
Inspector Signature
• O am
• o pm
Final Cleanout:
Pink Copy: SEH
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Total
Notes
l ✓ _
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
s a' j
s
,
Foundation drains
r }
I �-)
„ # mac 3 . ,
Roof drains
n,..
-
\oo
• City al' hallo
Y o
Residential Sanitary Sewer Service
Compliance Inspection
Date H /1 t `)1 /' .:
A
Name .1.. f.
PID Number
House Number
Time
Disk #
Street Name
Alternative Mailing Address
iu
OwnerlOccupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
Q No roof drain connection
O Sump pit not connected to
sanitary sewer r "s % 4'1°' "
ti Sump pump properly piped
O No sump pump
Service Lateral Inspection Fidings
Roots
4" to 6" Transition:
White Copy: Pr operty Owner
• Ol em
• ✓O' pm
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
Number of stacks
t � �
Poor Pipe Joints y ° / / . Z4)
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
L
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
®
Phone ' :°
Obstruction
Unable to push past
feet.
Entered S.L at
Inspector Signature
• O am
• o pm
Final Cleanout:
Pink Copy: SEH
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused