3905 Blackhawk Rd - COCCity of Ea pll
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota �}
Property Address: 75 O`S \QL Q L , Vtt L �3_
41 City of Eagan
COMPLIANCE WITH INITIAL INSPECIION
['this is to certify that the property listed above has been inspected by authorized City personnel on t U , 201
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required.
COMPLIANCE AFIER CORRECTIVE WORK PERFORMED
n This 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 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 periodie-cleaning or future inspections be performed to minimize a potential blockage due to
Grease Buildup, Il O Intrusi ', Dip /Settlement in Pipe, Other 3 Pr
City Approved: 1 Vyt�
Print name
White Copy: Property Owner
Signature Date
Yellow Copy: City of Eagan (Parcel F ile)
? Vg-1D-6 (i
rev 2 23.2010