1863 Gold Tr - COC4111 City of Baran
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: 1 c - C A,c T ,
COMPLIANCE WIT IIINIIIAL , l
FA—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 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 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 be perforated to miAirnizy a potential bloc /age due to
Grease Build-up,/Settlement in Pipe, Other: V 1 Q 6 �s
City Approved: 1 VAN. `AI.
Print name
White Copy; Property Owner
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
City of Eapll
rev 2 23 2010