3750 Blackhawk Rd - COC4 City of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Pt operty Address: `�[�V�GL��' Qo CJ
d e lb ' City of Evan
COMPLIANCE WITH INITIAL INSPECTION
his is to certify that the property listed above has been inspected by authorized City personnel on , 201_1
and found to be in compliance with Section 3 40 of the City Code and no corrective wor 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):
City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked..ised on a r eview of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections be performed to minimize a ote ' 1 blo kage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other .: -,r-i p 1 r - h
15 35 E4- 3 - IA , gb Sg C- 4- \ at- (SO c 1-t l ` `i 161- lgL i.
City Approved: t.t - - „, '\'r).--t-J.t — ( / / 6 1/
White Copy: Property Owner
Print name Signature Date
Yellow Copy: City of Eagan (Parcel File) rev 2 2.3 2010