1844 Gold Tr - COCCity of bp
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Pt operty Address: ; ' "4 CO tcS cQ
COMPLIANCE WITH INITIAL INSPECTION
Ihis is to certify that the property listed above has been inspected by authorized City personnel on
and found to be in compliance with Section 3 40 of the City Code and no corrective work was r equired
COMPLIANCE Air IER CORREC IIVE 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 corr ective repair work under (check all that apply):
City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if bo.x is checked: 1 !Based on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning orfirture inspections beperformed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other,
City Approved:
Print name
White Copy: Property Owner
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
4 , 6 ' City of Evan
,2011
rev 2 23 2010