4640 Kingsbury Dr - COCCity of Eapl
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
4101 City of hp
City of Eagan, Minnesota
Property Address: L `\ L 4 U t 1 51 � y 0 V 1 V
COMPLIANCE WIIH INITIAL INSPECTION
.This is to certify that the property listed above has been inspected by authorized City personnel on , _
201,)
and found to be in compliance with Section 3 40 of the City Code and no corr ective work was required.
COMPLIANCE AF TER CORRECTIVE WORK PERFORMED
This 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):
n City Sanitary Sewer Permit
City Approved: ' v
Print name
White Copy: Property Owner
City Plumbing Permit
NOTE: Applicable only if box is checked: UBased on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning Of future inspections be performed to minimize apotential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
Signature Date
Yellow Copy: City of Eagan (Parcel File)
rev 2 23.2090