3897 Blackhawk Rd - COC4 City of EaRall
City of Eagan, Minnesota
Property Address: ' 1_
COMPLIANCE WIIH INIIIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on 3 , 200
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
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 City Plumbing Permit
City Approved:
Print name
White Copy: Property Ownci
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
NOTE: Applicable only if box is checked:1 Based 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, Others
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
411 City of Emil
igEt D6 1(
rev 2 23 2010