850 Ivy Lane - Inspection FormSump pumps
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Foundation drains
0
Roof drains
0
City of faun
Residential Sanitary Sewer Service
Compliance Inspection
Date l0 1 1
Name `j y i C LiNv N
PID Number.
'85 0
House Number
Alternative MaiilliingAddress
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White Copy: Property Owner
1
For information call 651.470.2788
Compliance
A No foundation drain connection
�� No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
Owner /Occupant Signature
Service Lateral Inspection Findings Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits 3°
Sag /Pipe Deflection
Damaged Pipe
Transition
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4" to 6 "Transition: Li 01 AM.4v(,q
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Total
•
Time • O Kern
• o pm
Disk #
Street Name
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Non - Compliance
O Clear water connections to
sanitary sewer
O Ser vice lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
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Length_ of Service:
Correctly
Incorrectly
Unknown
Record Number
A
Phone
Time
Obstruction
Unable to push past
feet
1
8 •
• —
Inspe4to Signature
Final Cleanout:
am
0 pm
5 - 3o �i'Lf
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.L at T}• . '< C r f3
1.}.)1/41M Gocu
Notes
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Yellow Copy: City of Eagan Pink Copy: SEH