3881 Palisade Way - COC411 City of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Addr ess:
City of Eagan, Minnesota
City of Earn
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on 4 - , 201(
and found to be in compliance with Section 3 40 of the City Code and no corre ctive 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 corr ective repair work under (check all that apply):
City Sanitary Sewer Permit n City Plumbing Permit
NOTE, Applicable only if box is checked: aged 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, Ro n(rusa , Dip /Settlement in Pipe, Other:
White Copy: Property Owner
City Approved: - / �
Print name Signature
Yellow Copy: City of Eagan (Parcel File)
Date
rev 2 23 2010