4056 Blackhawk Rd - COCCity of kali
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota r,
Property Address: Ll rU 5 L 13 cuc ket„4
COMPLIANCE WITH INITIAL INSPECTION
71- Ihis is to certify that the property listed above has been inspected by authorized City personnel on 3 , 201
and found to be in compliance with Section 3 -40 of the City Code and no corrective work was required.
COMPLIANCE AF TER CORRECTIVE WORK PERFORMED
n Ihis is to certify that the pioperty 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):
1
City Sanitary Sewer Permit ❑ City Plumbing Permit
City Approved: 40,
Print name
City of Eapll
NOTE: Applicable only if box is checked, ased 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 po entia blockage due to.:
Grease Build -up, Root Intrusion, Dip/Settlement in Pipe, Other: �c '�-z C%} 6 h
La e � l < < 41 �� i 1
Signature Date
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File)
rev 2.23 2010