3924 Palisade Way - COC4 City of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: 3`1 P Cm& t
COMPLIANCE WITH INIIIAL INSPEC IION
r�s is to certify that the property listed above has been inspected by authorized City personnel on , 201
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
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):
City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked: UBased 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 toe
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other r
City Approved: T\ CI-Wt �t I V31 QCs I(
White Copy: Property Owner
Print name Signature Date
Yellow Copy: City of Eagan (Parcel File)
City of Eta]
rev 2.23.2090