4169 Old Sibley Mem Hwy - COCCity of Evan
n City Sanitary Sewer Permit
City Approved: J \ Vv\- L /
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
PYoperty Address: 1..1 9 C \ d S, b 1-e 1
COMPLIANCE WIIH INITIAL INSPECTION
is to certify that the property listed above has been inspected by authorized City personnel on 4 , 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
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):
n City Plumbing Permit
NOTE: Applicable only if box is checked: 1Based 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::
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
-at
City of hp
rev 2 23 2010