1361 Grace Dr - COCCity of Eapa
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Pi ()petty Address: , ` C L. C `v \ V
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on 1 , 201_
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required,
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
n Ihis is to certify that the property listed above has been found to be in compliance with Section 3.40 of the City Code
after satisfactorily completing the required corrective repair work under (check all that apply):
I City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked:1 lBased on a review of the Sewer. Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections be performed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
City Approved:
■AA- ■ ,,r. ( a Y311rD(3
Print name
White Copy: Property Owner
Signature Date
Yellow Copy: City of Eagan (Parcel File)
4111 City of
rev 2 23 2010