3665 Blackhawk Rd - COCCity of EaRall
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
4 City of Eaaan
City of Eagan, Minnesota
2 c )
Pr �
Property �(�� >5 ‘ 0 C� Ift('-� ,
COMPLIANCE WITH INIIIAL INSPECIION
his is to certify that the property listed above has been inspected by authorized City personnel on a- , 201
and found to be in compliance with Section 3 40 of the City Code and no collective work was required
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
n 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):
n City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked: a: ased 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 -r {p, oot ln }4etttement in Pipe, Other : 31. 3 5. j � C,� - � - S "D.- 5
g
City Approved: t W� t C� I t n� � 1� � 3 f I
Print name Signature Date
Yellow Copy: City of Eagan (Parcel File) rev 2.23 2010