2225 Liberty Lane - COCI
City of E gli
City Approved: \ vV�
City of Eagan, Minnesota
Property Address: C� � �� b -C Le
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Signature
COMPLIANCE WITH INITIAL INSPEC IION
.phis is to certify that the proper listed above has been inspected by authorized City personnel on _ , 20I
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
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 Sanitaiy Sewer Permit City Plumbing Permit
NOTE, Applicable only if box is checked: I !Based on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or fixture inspections be performed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
Yellow Copy: City of Eagan (Parcel Tile)
4 City of Earn
al I
Date
rev 2 23 2010