4839 Richard Lane - Inspection FormCity of Eap,aii
Residential Sanitary Sewer Service
Compliance Inspection
_ � 1�1
/7 f /21
Date p/1_, i _ - ''
Name r2/) ) Disk #
PID Number
House Number' -.� ▪ - I Street Name
Alternative Mailing Address
Owner /Occupant Signature
Compliance
O No foundation drain connection
O ;No roof drain connection
Q Sump pit not connected to
sanitary sewer
,Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time
am
p
Number of stacks
L U -[i7
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
•
Entered S L.at
•
Phone f > a) ..1,-"<"`5 ° . ,5 t iY 7
Obstruction
Unable to push past
feet
O am
0 pm
Inspector Signature ] \ ,A
For information call 651.470.2788
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes 2
c - ✓' j j j. ,
_ �. -` 4. ...;-. F -- --",
Total
Sump pump
Foundation drains
Roof drains
. ._2t�
City of Eap,aii
Residential Sanitary Sewer Service
Compliance Inspection
_ � 1�1
/7 f /21
Date p/1_, i _ - ''
Name r2/) ) Disk #
PID Number
House Number' -.� ▪ - I Street Name
Alternative Mailing Address
Owner /Occupant Signature
Compliance
O No foundation drain connection
O ;No roof drain connection
Q Sump pit not connected to
sanitary sewer
,Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time
am
p
Number of stacks
L U -[i7
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
•
Entered S L.at
•
Phone f > a) ..1,-"<"`5 ° . ,5 t iY 7
Obstruction
Unable to push past
feet
O am
0 pm
Inspector Signature ] \ ,A
For information call 651.470.2788
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH