4876 Richard Lane - COCCity of Et at
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE foi
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: Lk1 L e'
COMPLIANCE WITH INITIAL INSPECTION
City of Eagan
I Iris is to certify that the property listed above has been inspected by authorized City personnel on 1 — 1, C Z. , 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
i t
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):
City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked; 1 Based on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections beperformed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other
City Approved:
ti
Print name
White Copy: Property Owner
1,c
Signature
Yellow Copy: City of Eagan (Parcel F ile)
■ 3
Date
rev. 2 23 2010