4610 Kingsbury Dr - COC41 City of Eagan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of • Eagan, Minnesota
Property Address:
COMPLIANCE WITH INITIAL INSPECTION J C)
Cit Sanitary Sewer Permit n City Plumbing Permit
City Approved:
Print name
White Copy: Property Owner
Signature Date
Yellow Copy: City of Eagan (Parcel F ile)
41 City of Eapll
Ihis 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 CORREC IIVE 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):
NOTE.; Applicable only if box is checked: L Based 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:
rev 2.23 2010