4693 Beacon Hill Rd - COC1 City of WE
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
City of hp
er Address: �``
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COMPLIANCE WITH 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 corrective work was r equired
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 corr ective repair work under (check all that apply):
n City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked: nBased 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: l V1ti i ti - 1`
Print name
Signature
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File)
Y3
Date
rev. 2 23.2010