4761 Westminster Cir - Inspection FormCity of F ate
Residential Sanitary Sewer Service
Compliance Inspection
Date / /
Name /1/4 A f 1
PID Number
House Number / Street Name ° lam r;
Alternative Mailing Address
ai
Owner /Occupant Signature
Compliance
O No foundation drain connection
�1
15 No roof drain connection
Sump pit not connected to
!! " sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
•.-- O) am
Time.. -� Rm
Disk # —LE
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
Length of Service:
Yellow Copy: City of Eagan
W
Record Number
Time
Phone - ) C7
Inspector Signature )\ , A . /) 6. „
Obstruction
Unable to push past
feet.
For information call 651.470.2788
Entered S L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
O am
•
• o Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
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Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
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Foundation drains
Roof drains
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City of F ate
Residential Sanitary Sewer Service
Compliance Inspection
Date / /
Name /1/4 A f 1
PID Number
House Number / Street Name ° lam r;
Alternative Mailing Address
ai
Owner /Occupant Signature
Compliance
O No foundation drain connection
�1
15 No roof drain connection
Sump pit not connected to
!! " sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
•.-- O) am
Time.. -� Rm
Disk # —LE
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
Length of Service:
Yellow Copy: City of Eagan
W
Record Number
Time
Phone - ) C7
Inspector Signature )\ , A . /) 6. „
Obstruction
Unable to push past
feet.
For information call 651.470.2788
Entered S L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
O am
•
• o Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH