3745 Blackhawk Rd - COCCity of Eta!'
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: j ( alczC � n W- .. e0
COMPLIANCE WIIH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on , 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
This is to certify that the property listed above has been found to be h compliance with Section 3.40 of the City Code
after satisfactorily completing the required corrective repair work under (check all that apply):
H City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked °:}Based on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic' cleaning otfuture inspections beperformed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other.: `j F+'
0 y"
City Approved l L i��L. - 1
Print name Signature Date
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel F ile)
4 City of Evan
rev 2 23 2010