1130 Town Centre Dr - COC4 City of Ea as
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Evan
City of Eagan, Minnesota
Property Address: . \ --) 0 — TO C e \ AY-e
C OMPLIANCE WITH INITIAL INSPECTION
8 —This is to certify that the property listed above has been inspected by authorized City personnel on } — S, 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
fl 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 tinder (check all that apply):
n City Sanitary Sewer Permit 1 I City Plumbing Permit
Dy
NOTES Applicable only if box is checked: aced 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: 1 ANL
Print name
White Copy: Property Owner
Signature Bate
Yellow Copy: City of Eagan (Parcel File)
rev 2 23 2010