1923 Gold Tr - COC1
City of Ea al
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTR_4TION
City of'E,agan, Minnesota
Property Address:
COMPLIANCE WI I II INITIAL INSPECTION
7rThis is to certify that the property listed above has been inspected by authorized City personnel on 3 `} , 201 ti
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 Plumbing Permit
City of Evan
NOTE: Applicable only if box is checked, u on a review of the Sewer Set vice video inspectionheport on file, it is
recommended that periodic cleaning or future inspections be perfo ed to minimize apotential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:. V5N—
City Approved: '77'3 L �
Print name Signature Date
Yellow Copy: City of Eagan (Parcel pile)
rev 2 23.2010