3826 Country Creek Way - COC411 City of Evan
City Approved:
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: � L CO io. Y\s-1 Y � (L- C,-1
City Sanitary Sewer Permit City Plumbing Permit
Yellow Copy: City of Eagan (Parcel F ile)
City of Flap
COMPLIANCE WITH INITIAL INSPECTION
. This 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
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):
NOTE:. Applicable only if box is checked: tBased on a review of the Sewer Ser vice video inspection /repot t 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:
Print name Signature Date
rev 2 23.2010