3821 Country Creek Way - COC4 City of Eagan
City Approved:
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
n t
Property Address: 3 -k X
City of hp
COMPLIANCE WITH INITIAL INSPECIION
This is to certify that the property listed above has been inspected by authorized City personnel on , 201 _
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
n 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):
n City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if bo.x is checked: UBased 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 Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
Print name u Signature Date
Yellow Copy: City of Eagan (Parcel File)
rev. 2 23 2010