4020 Old Sibley Mem Hwy - COCCity of Eao a
COMPLIANCE WITH INITIAL INSPECIION
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for'
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: ! CC U C 1 (t \c3 L ( ' � e Ork �� 1tti
--This is to certify that the property listed above has been inspected by authorized City personnel on (" , 20H
1
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AF TER CORRECIIVE WORK PERFORMED
7 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):
fl City Sanitary Sewer Permit 1 j City Plumbing Permit
NOTE: Applicable only if box i:s checked, I '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 apotential blockage due to:
Grease Buildup, Root Intrusion, Dip /Settlement in Pipe, Other:
\, C', a cAsr
City Approved; ! W■ / �L : _ / ! V
Print name
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
411 City of Egli
rev 2 23 2010