3908 Riverton Ave - COCCity of t all
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Propei ty Address; `� 1 C 2 i V C V r`. -e \A_
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on 3 , 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
I ; 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):
City Sanitary Sewer Permit ; 1 City Plumbing Permit
41 City of Eapft
NOTE.. Applicable only if bo.x is checked: I_ (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, Other:
City Approved: - \ w� �- /
�( I f
Print name Signature Date
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel F ile)
a
rev 2.23 2010