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Inspection Form
Name:_ ~y~~~~,ar~'~ ~t~, ~~~v~d- ~''~r,~~
T" 6 ~~ ~
Address: ] ~ Q ~ ~. `P ~
Prior Lake, MN 55 ?, 7~. Phone: ~~ ~~ 7~~~ ? d
Date: ~'-~~ - 99 Time: I~U a.m./p.m.
First Inspection L~ Second C7
Own: C~'' Rent: ~ Age of Home: ~
Residential: i~"'
Non-Residential: ~
~/~~.tkdK-r
A. BASEMENT C-~''Yes ~ No 5iJMP BASKET Q 0 ~~ 2 O 3 a
WATER IN BASKET A'4~es ~ No SiJMP PUMP Ll'0 ~ 1 ~ 2 d 3 O
WATER IN BASEMENT (flow over floor) ~ Yes C~o CISTERN ~ Yes C3-~d'b
(If no pump, place sticker across edge of sump cover and basement floor so any removal of cover will
break seal. Skip to Part B of this form. )
Discharge Point ~ Laundry tub ~ Sanitary sewer I~ Outside
at Inspection: ~ Floor drain ~ Other
Prior to Inspection:
When was systenn installed, or most recently modi~ed? (Date) and why
17 Home came with system
~ Water in basement
B. ROOF LEADERS:
C. YARD DRAINS
BEAVER SYSTEM
~ Response to inspection program d Other
~ Previous system failed
~s ~ No DISCHARGE: ~ Near L~'~way
~ Yes 'f'7""~No WINDOW WELLS Q Yes C#"No
~ Yes f~'~
D. PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer
(check all that apply) How often does pump run?
V~here does pump discharge to outside? ~ Front
NOTES:
~ Spring ~ Winter
~ Back ~ Side
SUMP PUMP SYSTEM: ~'PASS t7 FAIL You have 30 days to bring your system into compliance with current
regulations. When you are ready for reinspection, call 651 /644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes C3~To
Where is this location?
This area will need to be fixed so the clear water discharges to the storm sewer system.
I Inspector: ~`~"'~~K~L~---~' Date: ~'".1„?- 9 9 I
Resident: `~ ~ ,.,% ",,~, ~~ Date: S"'- ~.,1 ~ 9y
Disclaimer: This visual inspection is done with due diligence to find obvious clear water cross-connections
and does not imply the structure meets all Cit.y Codes.
City of Prior Lake
Sump Pump and I/I Reduction
White: Homeowner Yellow: City Pink: HRG