4141 Old Sibley Mem Hwy - COC4 4 * City of Eagan
City of Eagan, Minnesota 4 �
Property Address: L t 1 4 k � C!k � + t'� � l 4 _ vv 0 - W y
COMPLIANCE WITH INITIAL INSPECTION
S -"This is to certify that the property fisted above has been inspected by authorized City personnel on
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
1 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):
it
City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked: UBased on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections be perfor d to inimi a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Others i -E f r6,
City Approved: 1NL
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
City of Eapil
— I a l, 2 0 1 1
rev. 2 23.2010