1794 Bluestone Dr E - COCCity of Eaaall
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: r 4 61 0 \iN-
COMPLIANCE WIIH INIIIAL INSPECIION
City of Eagan
Ibis is to certify that the property listed above has been inspected by authorized City personnel on , 201_J
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required.
COMPLIANCE AFIER CORRECIIVE 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):
NOTE: Applicable only if box 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 Sanitary Sewer Permit City Plumbing Permit
City Approved: 61\A- � � / � / t3
Print name Signature Date
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File)
rev. 2.23 2010