4521 Lake Park Dr - Inspection FormSump pumps
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Foundation drains
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Roof drains
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41* Residential Sanitary Sewer Service
4._ City of E 13R Compliance Inspection
Date f f h./ .. / /(
Name , . . f /' ° " Disk #
PID Number
House Number
Alternative Mailing Address
Street Name
Owner /Occupant Signature
For information call 651.470.2788
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
4" to 6 " Transition:
Total
Time.- •
Correctly
am
pm
Phone& !, '
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
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Number Discharged
Incorrectly
Unknown
White Copy: Property Owner
LJIJ
Record Number
Time
Obstruction
Unable to push past
feet
Entered St at
Final Cleanout:
Notes
Oam
•
• O pm
InsFector Signature � i f v
No Access
O No one in
O Access to service
lateral needed
o Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH