4834 Eriks Blvd - COC4 1 ! Iii ` b City of Eapil
COMPLIANCE WIll INITIAL INSPECTION
City Approved:
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: °`1� 6 �r
This is to certify that the property listed above has been inspected by authorized City personnel on _ t.~ t , 201
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE All IER 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 cor rective repair work under (check all that apply):
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
Signature Date
Yellow Copy: City of Eagan (Parcel File)
411 City of EaiaIl
rev. 2 23.