3816 Country Creek Way - COCCity of Etat
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
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Property Address: Cc N K_
COMPLIANCE WIT INITIAL INSPECTION
his is to certify that the property listed above has been inspected by authorized City personnel on
and found to be in compliance with Section 3 40 of the City Code and no corr ective work was required
COMPLIANCE AF IER CORRECTIVE WORK PERFORMED
T 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 1 City Plumbing Permit
NOTE: Applicable only if box is checkedased 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 potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:: cYi\ G `7 CO
City Approved: i v�� "�.1 +� / ' '= NL./ v
Print name Signature Date
Yellow Copy: City of Eagan (Parcel File)
111 City of EtaIl
rev 2 23 2010