1775 Kyllo Lane - COC1 , 1 ` . City of Eagall
City Approved: 1 VVx
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: 1-1 , ' 1 . ( 3 Laii - - --
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on , 20
and found to be in compliance with Section 3 40 of the City Code and no corrective work was r equired
COMPLIANCE AP TER CORRECIIVE WORK PERFORMED
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 requited corrective repair work under (check all that apply):
n City Sanitary Sewer Permit n City Plumbing Permit
NOTE, Applicable only if box is checked. ased on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic.cle awning or future inspections be performed to min "mize a potential lockage due to:
o
Grease Build -up, ot In trusinn_ ip /Settlement in Pipe, Other: 5 `7 1 P6SS l qr9 L.
elkAL / , 12 -6-6
Signature Date
Yellow Copy: City of Eagan (Parcel File)
11 City of EapIl
rev. 2 23 2010