1477 Lake Park Cir - Inspection Form4111. City of la afl
Residential Sanitary Sewer Service
Compliance Inspection
Date u 1 ?. %,/
Name -11.. _ I r'
PID Number
•
4" to 6" Transition:
. 1
-6` Owner /Occupant Signature
Compliance
O No foundation drain connection
o ' No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
White Copy: Property Owner
Time _ .; t — • c ` = am
pm
Disk #
mimim
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 Entered S L. at
Length of Service:
Yellow Copy: City of Eagan
-P
Record Number.
Time
Obstruction
Unable to push past
feet
O am
•
• O pm
House Number ;f 2 77 Street Name
Alternative Mailing Address Phone
Final Cleanout:
inspector Signature
For information call 651.470.2788
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
Notes
. ' - °: � f : 'J 1 � '
"- -- 1,.� %' 2.yf ; i ;
i I [ ,., r /
' ' ) �' � ' A
I/ -ill -, eft / ? I
�.
Total
Sump pumps
; . ��_
r � ,
.- , -
Foundation drains
Roof drains
t' ^1
/
4111. City of la afl
Residential Sanitary Sewer Service
Compliance Inspection
Date u 1 ?. %,/
Name -11.. _ I r'
PID Number
•
4" to 6" Transition:
. 1
-6` Owner /Occupant Signature
Compliance
O No foundation drain connection
o ' No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
White Copy: Property Owner
Time _ .; t — • c ` = am
pm
Disk #
mimim
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 Entered S L. at
Length of Service:
Yellow Copy: City of Eagan
-P
Record Number.
Time
Obstruction
Unable to push past
feet
O am
•
• O pm
House Number ;f 2 77 Street Name
Alternative Mailing Address Phone
Final Cleanout:
inspector Signature
For information call 651.470.2788
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