1881 Gold Tr - COCSANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: aCg Z1 - 1 \
411 City of 6aRan
COMPLIANCE WITH INITIAL INSPECTION
Ihis 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 AF TER CORREC IIVE 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):
77 City Sanitary Sewer Permit E City Plumbing Permit
NOTE:' Applicable only if box is checked: "lased on a review of the Sewer Service video inspection /report on file, it is
recommended thatperiod e- •clean ng or future inspections be performed to minimize a potential blockage due to:
frease Build -up, R of Intrusion,,ip /Settlement in Pipe, Other '4i-1-
City Approved:` v e \A ��. / 'ti � — � / ( i
Signature Date
Print name
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File)
rev 2 23 2010