1900 Gold Tr - COCCity of hp
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
411 City of Eaftall
City of Eagan, Minnesota
Property Address: f ° i O 0 C c)1 - T c
COMPLIANCE WITH INITIAL INSPECTION
This 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 work was required
COMPLIANCE AF TER CORREC I IV E WORK PERFORMED
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 r equired corrective repair work under (check all that apply):
n City Sanitary Sewer Permit
Print name
White Copy: Property Owner
n City Plumbing Permit
!VOTE„ Applicable only if box is checked Based 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 inimize a po "ntial lac ge due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other :' ti A .. U V1
City Approved: l
Signature
Yellow Copy: City of Eagan (Parcel File)
I -1 3
Date
r #�
rev 2 23.2010