4562 Lake Park Ct - Inspection Form4 11. City of Etat'
Residential Sanitary Sewer Service
Compliance Inspection
7-) (2 A
Date jr2/.4 )( / am
Time - • Pm
Name
Disk
PID Number
House Number - ,„:7)(::::44 Street Name
Alternative Mailing Address
Owner/Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O: pump properly piped
0 No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Non-Compliance
0
)
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Roots
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
LU
Record Number
Time
Phone,/ - ; 1-
;
•
Obstruction
Unable to push past
feet
inspector Signature
Entered S.L. at
Final Cleanout:
• • clam
o ccess
No one in
Access to service
lateral needed
0 Inspection
refused
Pink Copy: SE H
Number
Correctly
Discharged
Incorrectly ectly Unknown
Notes
Total
Sump pumps
IIII
IIIII
Foundation drains
111011111111
-,-'
Roof drains
4 11. City of Etat'
Residential Sanitary Sewer Service
Compliance Inspection
7-) (2 A
Date jr2/.4 )( / am
Time - • Pm
Name
Disk
PID Number
House Number - ,„:7)(::::44 Street Name
Alternative Mailing Address
Owner/Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O: pump properly piped
0 No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Non-Compliance
0
)
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Roots
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
LU
Record Number
Time
Phone,/ - ; 1-
;
•
Obstruction
Unable to push past
feet
inspector Signature
Entered S.L. at
Final Cleanout:
• • clam
o ccess
No one in
Access to service
lateral needed
0 Inspection
refused
Pink Copy: SE H
City fit ha a i
p
Residential Sanitary Sewer Service
Compliance Inspection
) /2 )
Date i /I / //
Name t � �fi�3 J� Disk #
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings Number of stacks
4 to b "Transition:
White Copy: Property Owner
7/3) o am
Time i- •
OwnerlOccupant Signature
t 1 pm
2_,L i- ! : Street Name
LL]
Length of Service:
Yellow Copy: City of Eagan
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
Time
Phone
,
Obstruction
Unable to push past
feet,
Entered S L at
•
Final Cleanout:
' l-
f
O am
O pm
Inspector Signature \) /A/ i r2 v
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Total
Notes
Number
Discharged
Correctly
Incorrectly
Unknown
Sump um 5
frame
•
/;�) "2-''
Foundation drains
Roof drains
.�- , .../....
f 1
City fit ha a i
p
Residential Sanitary Sewer Service
Compliance Inspection
) /2 )
Date i /I / //
Name t � �fi�3 J� Disk #
PID Number
House Number
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings Number of stacks
4 to b "Transition:
White Copy: Property Owner
7/3) o am
Time i- •
OwnerlOccupant Signature
t 1 pm
2_,L i- ! : Street Name
LL]
Length of Service:
Yellow Copy: City of Eagan
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
Time
Phone
,
Obstruction
Unable to push past
feet,
Entered S L at
•
Final Cleanout:
' l-
f
O am
O pm
Inspector Signature \) /A/ i r2 v
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH