1475 Lake Park Cir - Inspection FormDate
Name r
PID Number
House Number
Alternative Mailing Address
4" to 6 "Transition:
4 11. City or Ea aii
Residential Sanitary Sewer Service
Compliance Inspection
`e a =~, Disk #
Compliance
O No foundation drain connection
O No roof drain connection
0 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
)f % �h �
q ' am
Time .t /� /06 pm
r " I Street Name
Owner /Occupant Signature
LL-W
)
Phone f '`a
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.L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
Inspector Signature
Final Cleanout:
o am
•
• O pm
3
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged_,
Incorrectly Unknown
N tes
). } ✓ yv ' .
:: : _...
C:1" t '!r
i
� _� ., _ ,
Total
Sump pumps
a
a i
' '
Foundation drains
I
Roof drains
0 H*;.,
Date
Name r
PID Number
House Number
Alternative Mailing Address
4" to 6 "Transition:
4 11. City or Ea aii
Residential Sanitary Sewer Service
Compliance Inspection
`e a =~, Disk #
Compliance
O No foundation drain connection
O No roof drain connection
0 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
)f % �h �
q ' am
Time .t /� /06 pm
r " I Street Name
Owner /Occupant Signature
LL-W
)
Phone f '`a
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.L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
Inspector Signature
Final Cleanout:
o am
•
• O pm
3
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH