1602 Norwood Cir - Inspection Form`Cit of hra p
City �
Residential Sanitary Sewer Service
Compliance Inspection
Date ) ) 1 (.. 1 , V1
, -�
Name }� -, - -� i ,:3� ' )1 /`Dis #
PID Number
House Number J i ; i J / Street Name
Alternative Mailing Address Phone :-'
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
, sanitary sewer
Sump pump properly piped
'O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
Time `/ f ; p pm
. e
Own`lOccupant Signature
m-
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
Length of Service:
White Copy: Pr operty Owner
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet.
Entered S.L.at
•
Final Cleanout:
ID am
p pm
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
1- '_\ -
� ,
'
} 9
/ --,
/
-;__
fi
/
i /
]
✓
Nuraber
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
V
_
`Cit of hra p
City �
Residential Sanitary Sewer Service
Compliance Inspection
Date ) ) 1 (.. 1 , V1
, -�
Name }� -, - -� i ,:3� ' )1 /`Dis #
PID Number
House Number J i ; i J / Street Name
Alternative Mailing Address Phone :-'
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
, sanitary sewer
Sump pump properly piped
'O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
Time `/ f ; p pm
. e
Own`lOccupant Signature
m-
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
Length of Service:
White Copy: Pr operty Owner
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet.
Entered S.L.at
•
Final Cleanout:
ID am
p pm
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Residential Sanitary Sewer Serv'
Compliance Inspection
Date V
r 1 /` ;
Name 1 — l�f
•� . am
Time m •. p
�t
'2Disk #
PID Number
House Number
Street Name
Cr]
Alternative Mailing Address
4" to 6" Transition:
White Copy: Property Owner
Owner/Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Non - Compliance
0
O
O
O
0
Number of stacks
Length of Service:
IT
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Notes
Time
Record Number ) )
Phone < 4- ��"
For information call 651.470.2788
Obstruction
Unable to push past
feet
inspector Signature
Entered S. L,at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
o am
• O pm
No Access
No one in
0 Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Serv'
Compliance Inspection
Date V
r 1 /` ;
Name 1 — l�f
•� . am
Time m •. p
�t
'2Disk #
PID Number
House Number
Street Name
Cr]
Alternative Mailing Address
4" to 6" Transition:
White Copy: Property Owner
Owner/Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Non - Compliance
0
O
O
O
0
Number of stacks
Length of Service:
IT
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Notes
Time
Record Number ) )
Phone < 4- ��"
For information call 651.470.2788
Obstruction
Unable to push past
feet
inspector Signature
Entered S. L,at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
o am
• O pm
No Access
No one in
0 Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH