3966 Palisade Way - COCCity of Eapil
City Approved: _.. \
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: 3 ° 4 LO SC C`..t
COMPLIANCE WIIH INITIAL INSPECTION
Z/1„--This is to certify that the property listed above has been inspected by authorized City personnel on 3 , 201_1
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 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 City Plumbing Permit
Print name
White Copy: Property Owner
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 Buildup, Root Intrusion, Dip /Settlement in Pipe, Other.:
Signature
Yellow Copy: City of Eagan (Parcel File)
1
Date
4 City of Eagan
rev 2.23 2010