3813 Country Creek Way - COCCity of Evan
1i
White Copy: Propetty Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Ptoperty Addle ess:
Print name
City of Eagan, Minnesota
COMPLIANCE WITH INIILAL INSPECTION
,This is to certify that the property listed above has been inspected by authorized City personnel on j - 201_1
and found to be in compliance with Section 3. 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 I 1 City Plumbing Permit
NOTE Applicable only if box is checked; c- 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 p ten t l blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other: I , 4 0 ,
y - tSvn 9 -i00 C
City Approved: \ k4-L_
3 Co w v L ' N C te IC c 1.
Signature
Date
City of Eapll
Yellow Copy: City of Eagan (Parcel File) rev. 2 . 23 2010