4602 Stonecliffe Dr - Inspection Form41. City of Capri
Residential Sanitary Sewer Service
Compliance Inspection
Date i, 1 1
Name
House Number
-- 2. ) b
• 0 a
Time,r • `6 pm
Disk #
PID Number
Street Name
rte.
1
Owner /Occupant Signature
Compliance
O No foundation drain connection
3 'Y
Q No roof dram connection
O Sump pit not connected to
..�
sanitary sewer_�2r,3p
Sump pump properly piped
O No sump pump
-LE-
Alternative Mailing Address
For information calf 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
4" to 6 "Transition:
White Copy: Property Owner
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phone :' >
Obstruction
Unable to push past
feet
Entered 5 L at
• O am
• o pm
'.� 2
Inspector Signature
Final Cleanout:
3 : f •tom' �'
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Total
Notes
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er _"
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yr
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1 J
✓
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i
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. mot'
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Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
41. City of Capri
Residential Sanitary Sewer Service
Compliance Inspection
Date i, 1 1
Name
House Number
-- 2. ) b
• 0 a
Time,r • `6 pm
Disk #
PID Number
Street Name
rte.
1
Owner /Occupant Signature
Compliance
O No foundation drain connection
3 'Y
Q No roof dram connection
O Sump pit not connected to
..�
sanitary sewer_�2r,3p
Sump pump properly piped
O No sump pump
-LE-
Alternative Mailing Address
For information calf 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
4" to 6 "Transition:
White Copy: Property Owner
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phone :' >
Obstruction
Unable to push past
feet
Entered 5 L at
• O am
• o pm
'.� 2
Inspector Signature
Final Cleanout:
3 : f •tom' �'
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH