3841 Country Creek Way - COC4 , 11 '' City of Eagan
City Approved: V l_
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE fbr
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: \ C13
COMPLIANCE WITH INIIIAL INSPECTION
This is to certify that the property listed above 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 AFTER CORRECTIVE WORK PERIJORMED
7 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):
City Sanitary Sewer Permit — City Plumbing Permit
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 beperfojned to minimize a potential blockage due to
Grease Build -up, Root Intrusion Dip /Settlement in Pipe, Other: L Gvl. - 90 9
/ ( 61A (SI
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
4 1166 City of Eagan
rev 2 .23 2010