2073 Shale Lane - COCCity of L,agan, Minnesota
Property Address: r -O 1 S
COMPLIANCE WIIH INITIAL INSPECTION
II
City of EaRall
City Approved: rY c
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Signature Date
Yellow Copy: City of Eagan (Parcel File)
111 ‘0 1 ' City of Ea ll
p ---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 required
COMPLIANCE AF TER CORRECIIVE WORK PERFORMED
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):
n City Sanitary Sewer Permit City Numbing Permit
NOTEE. Applicable only if box is checked ased on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or futureinspectipns be performed to minimize a poten qlal bloc age due to:
Grease Build -up, Root Intrusion, Di /Settlement in Pipe, 0 I (
L. - _l > 73 - D- - 0-6 t
rev 2 23.2010