4791 Beacon Hill Rd - COCCity of Eaaaa
City Approved: L Vv"--
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for City of �a all
INFLOW & INFILTRATION J
City of Eagan, Minnesota
Property Address: ' £ C� LCD 4�_ 12.0 { f� 4C'�
COMPLIANCE WITH INITIAL INSPEC TION
This is to certify that the property listed above has been inspected by authorized City personnel on 6 - } , 204
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AFIER 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 n City Plumbing Permit
NOTE.: Applicable only if box is 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 a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other..
Print name
[a-0 ((
Signature Date
Yellow Copy: City of Eagan (Parcel File)
rev 2.