1787 Carnelian Lane - COCCity of Ea .11
City of Fagan, Minnesota
Property Address: 1 c D ` CCTV y -e . i 0,4 G, 1'1 -�
COMPLIANCE WITH INIIIAL INSPECTION
Ihis is to certify that the property listed above has been inspected by authorized City personnel on L S , 201_
and found to be in compliance with Section 3.40 of the City Code and no corr ective work was required
COMPLIANCE Al IER CORRECTIVE WORK PERFORMED
pi 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):
I t
City Sanitary Sewer Permit L City Plumbing Permit
NOTE.: Applicable only if box is checkerkt4Based 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. •n 'al.;Ioc age due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other r I mo- - ` ' V
City Approved: v9
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Signature
Yellow Copy: City of Fagan (Parcel Tile)
Date
4 1°. City of Eapu
rev 2.23 2010