4124 Nicols Rd - COCCity of Ea ,all
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
1 City of Eagan
City of Eagan, Minnesota
Property Address: •; ( a- i LL CL(J
COMPLIANCE WIT H INITIAL INSPEC ZION
Ihis 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 required
COMPLIANCE AFTER CORRECIIVE WORK PERFORMED
n 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):
City Approved:
1 City Sanitary Sewer Permit 1 City Plumbing Permit
White Copy: Property Owner
NOTE: Applicable only if box is checked jased on a review of the Sewer Service video inspection /report on file, it is
recommended thatperiodie- cleaxaing or future inspections be performed to minimize a potential blockage due ta:
Grease Build -up 'ootIntrusion i p / S e t t l e m e n t i n P i p e , Other: ( {,L, (e'l. P i -
I A = v u A _ z , s r � , 5 3.'s C {- t , , , , t o - i 'c o t o - 5 ` - - -G 3 -
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Print name
Signature
Yellow Copy: City of Eagan (Parcel F ile)
Date
rev. 2 23.2010