3713 Blackhawk Rd - COC41 City of Evan
City of Eagan, Minnesota 11
Property Address: .31 `� eo .
COMPLIANCE WITH INITIAL INSPEC TION
11 is to certify that the property listed above has been inspected by authorized City personnel on — , 201_
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
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):
7 City Sanitary Sewer Permit n 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 be performed to minimize a potential blockage due to :'
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
City Approved: � VV\ I I"C2.
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Signature
Yellow Copy: City of Eagan (Parcel F ile)
1
Date
City of Eat ll
rev 2 23 2090