1376 Interlachen Dr - COCCity of Eapil
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
4 116 City of hp
City of Eagan, Minnesota
Property Andress: 37 - -4 --a tC fit C�C.�t tvt t� \
COMPLIANCE WITH INITIAL INSPECTION
1- his 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 AFTER CORRECTIVE WORK PERFORMED
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):
n City Sanitary Sewer Permit City PIumbing 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 performed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
City Approved:
t U!2 V\
Print name
White Copy: Property Owner
/
Signature Date
Yellow Copy: City of Eagan (Parcel File)
rev 2 23 2010