3721 Blackhawk Rd - COC41 City of Eapa
City of Eagan, Minnesota
Property Address: " ? 1 ">\ e O
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on • 2013
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECIIVE WORK PERFORMED
n Ihis 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):
n City Sanitary Sewer Permit n City Plumbing Permit
NOTE, Applicable only if box is checked.; IBased 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 Budd -up, Root Intrusion, Dip /Settlement in Pipe, Other: 'EY-- to ctj e \A/ 0: Q - e._
C v∎ O vn. k S C o S vw
City Approved: .• \` Wv I J Se I
Date
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Print name Signature
Yellow Copy: City of Eagan (Parcel F ile)
11 City of Eapll
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rev. 223 2010