1773 Serpentine Dr - COCCity of Ea Rall
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Ragan, Minnesota
Property Address: ��� 3 S-cv h vu A f t t Nfe-
COMPLIANCE WITH INITIAL INSPEC TION
4 his is to certify that the property listed above has been inspected by authorized City personnel on , 201 J
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
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):
fl City Sanitary Sewer Permit n 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 periodic cleaning or future inspections be perfo ed to minimize a potential blockage due to:
Grease Bu id -up, Root Intrusion, Di /Settlement in Pipe, Other: M �, � k i n - ,7L
S \p-A.4.- ( . Oils - ■ -- S -
City Approved: .� : Wi 0&j("--.
Print name
White Copy: Property Owner
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
City of in
rev 2 23 2010