4842 Shevlin Ct - Inspection FormA l ' City l Cagan
Y p
Residential Sanitary Sewer Service
Compliance Inspection
Date ))l / lr'
Name
PID Number
'
House Number Street Name
♦ `' 2— ) `:
Alternative Mailing Address Phone Z--<
4" to 6" Transition:
White Copy: Property Owner
Time •_) •
Disk #
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
f ' sanitary sewer
Sump pump properly piped
O No sump pump
am
pm
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks Entered S . at
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
• 0 am
Time • o pm
Obstruction
Unable to push past
feet
e y i
Final Cleanout:
lnspctor Signature 1%) - >F' / V/
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Notes
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♦
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f ♦
J A..2
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a
t
Number Discharged
Total Correctly Incorrectly
KIM=
M ill=
Unknown
Sump pumps
Foundation drains
Roof drains
A l ' City l Cagan
Y p
Residential Sanitary Sewer Service
Compliance Inspection
Date ))l / lr'
Name
PID Number
'
House Number Street Name
♦ `' 2— ) `:
Alternative Mailing Address Phone Z--<
4" to 6" Transition:
White Copy: Property Owner
Time •_) •
Disk #
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
f ' sanitary sewer
Sump pump properly piped
O No sump pump
am
pm
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks Entered S . at
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
• 0 am
Time • o pm
Obstruction
Unable to push past
feet
e y i
Final Cleanout:
lnspctor Signature 1%) - >F' / V/
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH