1746 Davenport Ave - COCCity of Eap
City Approved:
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Lagan,Minnesota
Property Address: 11 'F to
COMPLIANCE WIT H INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on Lt , _ , 201
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AF TER 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):
City Sanitary Sewer Permit J City Plumbing Permit
NOTE: Applicable only if box is checked: Based on a r eview 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:
; o 1
Signature Date
Yellow Copy: City of Eagan (Parcel File)
411 City of EapIl
rev 2,23 2010