3575 Lexington Ave - COC41 City of Etao
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
City of Eafall
Property Address: �5 �S �`�� -'� V kQ
COMPLIANCE WITH INITIAL INSPECTION
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
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):
fn City Sanitary Sewer Permit Li 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:
City Approved: \ . tiAtt_
Print name
White Copy: Property Owner
Signature Date
Yellow Copy: City of Eagan (Parcel File) rev 2.23 2010