3803 Lodestone Lane - COCCity of EaiaIl
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: 73St
4 , 1/ ' City of hp
COMPLIANCE WITH INITIAL INSPECTION
Fl is to cettify that the property listed above has been inspected by authorized City personnel on , 2011
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
fl 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):
fl City Sanitary Sewer Permit n City Plumbing Permit
NOTE; Applicable only if box is checked: Rased on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections be perfo ed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other.' �� �� {� i v . L 6 -' t t -S
City Approved: iM + i J\.
Print name
White Copy: Property Owner
�L LL,I h l I -1 D"!' CH 1
Signature Date
Yellow Copy: City of Eagan (Parcel F ile)
rev 2 23.