4807 Richard Lane - COCCity of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
n City Sanitary Sewer Permit City Plumbing Permit
City of hp
City of Eagan, Minnesota
Property Address: ' ` 0 ';. C C L
COMPLIANCE WIIH INITIAL INSPECTION
This is to certify that the property Listed above has been inspected by authorized City personnel on 1 0 201
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 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):
NOTE Applicable only if box is checked: 1 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 minirnize a potential blockage due to:
Grease Buildup, Root Intrusion, Dip /Settlement in Pipe, Other:
City Approved: / �1/� �C L I ( �' 2--0 1
Print name U Signature Date
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel F ile)
rev 2 23 2010