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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