3737 Blackhawk Rd - COCCity of Eapil
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: 3 3 I 0. CL'ly Cs C+-4
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed abor,'e has been inspected by authorized City personnel on , 201 t
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required.
COMPLIANCE AF TER 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):
n City Sanitary Sewer Permit n City Plumbing Permit
NOTE; Applicable only if box is checked.. -eased on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections beperf med to minimize a potential blockage due to:
Grease Build -up, Root intrusion, Dip /Settlement in Pipe, Other: � L Q 1 i M
City Approved: 4 tli / - \.r -
Print name Signature
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File)
Date
City of Eagp.11
rev 2 23 2010