892 Wescott Square - COCdi City of kali
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of E agan, Minnesota
City of Eapu
COM WIT H INI TIAL INSPECT ION
�lris is to certify that the property listed above has been inspected by authorized City personnel on , 201_ i
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 Sanitary Sewer Permit
Property Address:
City Approved: �� 1 1r1� 140.-
Print name
White Copy: Property Owner
f City Plumbing Permit
NOTE: Applicable only if box is checked.. 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
Signature Date
Yellow Copy: City of Eagan (Parcel F ile)
rev 2 23 2010