1839 Gold Tr - COCCity of Eapll
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: '' 4 t GCS �r{
ity of Eakin
COMPLIANCE WIT H INITIAL INSPECTION
P4. This is to certify that the property listed above has been inspected by authorized City personnel on 1 - , 201
and found to be in compliance with Section 3.40 of the City Code and no corrective wotk was required.
COMPLIANCE AP 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 corrective repair work under (check all that apply):
City Sanitary Sewer Permit n City Plumbing Permit
NOTE. Applicable only if box is checked:' 1 lBased 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: vv. 1A
Print name
White Copy: Property Owner
/ / D /a6 f 1
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
rev 223 2010