3879 Dolomite Dr - COCCity of EaiaIl
City of Eagan, Minnesota
Property Addtess: s �. UYY\ t ci)"(
COMPLIANCE WITH INITIAL INSPEC TION
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
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):
City Sanitary Sewer Permit
City Approved: " 1 vA,ti_ L 1�
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
n City Plumbing Permit
NOTE„ Applicable only if box is checked. sed on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections heperfo (ned to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Di /Settlement in Pipe, Other:
Yellow Copy: City of Eagan (Parcel File)
a b
/ / M bar i
Signature Date
City of Eat ll
rev 2 23 2010
1