4847 Richard Lane - Inspection FormciA) JO (91-
City ar hp
Residential Sanitary Sewer Service
Compliance Inspection
Date / i 1 i 2 / ) Time
Name ! - Disk #
PID Number
House Number - ° , '` Street Name
Alternative Mailing Address Phone-
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
• Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Service Lateral Inspection Findings
am
/O pm
L_LJ-
I
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Flexible sump pump piping
i
Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection jp
Damaged Pipe
Jj
Transition . .�1
l
i
i
Length of Service:
Yellow Copy: City of Eagan
f
Record Number
f
Time
Inspector Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
0 a
•
• O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.
Pink Copy: SEH
Tota , ,
Number
i Correctly
Discharged
Incorrectly Unknown
Notes
%' 7?--5,--. `.. &;_ .. --' , : 4f ? n `?` c::: : x
1 # ✓
Sump pumps
/
3 r r°`' i.
:7
Foundation drains
f
!r
Roof drains
...' _L_
/
A.
ciA) JO (91-
City ar hp
Residential Sanitary Sewer Service
Compliance Inspection
Date / i 1 i 2 / ) Time
Name ! - Disk #
PID Number
House Number - ° , '` Street Name
Alternative Mailing Address Phone-
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
• Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Service Lateral Inspection Findings
am
/O pm
L_LJ-
I
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Flexible sump pump piping
i
Number of stacks
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection jp
Damaged Pipe
Jj
Transition . .�1
l
i
i
Length of Service:
Yellow Copy: City of Eagan
f
Record Number
f
Time
Inspector Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
0 a
•
• O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S.
Pink Copy: SEH