3858 Country Creek WayCity of Ea il
City of Eagan, Minnesota
Property Address: a.S''S'
COMPLIANCE WIIH INIIIAL INSPECTION
his 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 corr ective work was required.
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
H 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):
I{
NOTE: Applicable only if box is checked: used 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 pot�gntial blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other: "Slr1. {- (� -• C�
City Approved: i vv L / 11M L� _. .. / — /3 - 6 1
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City Sanitary Sewer Permit j City Plumbing Permit
White Copy: Property Owner
Print name Signature
Date
City of Evan
,201 t
Yellow Copy: City of Eagan (Parcel File) rev 2 23 2010
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA122586
Date Issued:05/13/2014
Permit Category:ePermit
Site Address: 3858 Country Creek Way
Lot:18 Block: 1 Addition: Cedar Grove 11th
PID:10-16711-01-180
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Bryan Backstrom
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Kelly Banasik
3858 Country Creek Way
Eagan MN 55122
(651) 226-6042
Backstrom Remodeling LLC
12780 Vina Lane
Eden Prairie MN 55346
(612) 702-9409
Applicant/Permitee: Signature Issued By: Signature
City of Etall
Mike Maguire
Mayor
Paul Bakken
Cyndee Fields
Gary Hansen
Meg Tilley
Council Members
Thomas Hedges
City Administrator
Municipal Center
3830 Pilot Knob Road
Eagan, MN 55122 -1810
651 675 5000 phone
651 675.5012 fax
651.454.8535 TDD
Maintenance Facility
3501 Coachman Point
Eagan, MN 55122
651 675 5300 phone
651 .675 5360 fax
651 .454.8535 TDD
www.cityofeagan corn
The Lone Oak Tree
The symbol of
strength and growth
in our community
March 2, 2011
Re: Sanitary Sewer System Inspection — Certificate of Compliance
3858 Country Creek Way
Dear Property Owner,
The sanitary sewer service to your property was recently inspected by the City as
part of its City -wide Inflow & Infiltration (III) Program.. I am pleased to inform
you that our inspection indicates that your sewer service system has been found
to be in compliance with Section 3.40 of the City Code,
Your Inflow & Infiltration Certificate of Compliance is enclosed with this letter
This certificate is valuable information to you and for prospective purchasers of
your property and should stay with the compliant property.
Thank you for your cooperation in this inspection program.. If you have any
questions regarding this matter, please contact our Utility Division at (651) 675-
5200
CITY OF EAGAN