1776 Serpentine Dr - COCCity of Emil
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
1 City of Earn
City of Eagan, Minnesota
Pr operly Address: 1 �� (.7
C OMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on J - , 20l I
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):
II
City Sanitary Sewer Permit n City Plumbing Permit
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 potential blockage due to:
Grease Build-up, Root Intrusion, Dip /Settlement in Pipe, Other:
•
City Approved: v'
Print name
White Copy: Property Owner
1/44 c
Date
Signature
Yellow Copy: City of Eagan (Parcel File)
rev 2,23.2010