3941 Palisade Way - COC41 City of EapIl
City Approved:
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: '39,4 \ C>~ �5 C, �
COMPLIANCE WITH INITIAL INSPECTION
Fi This is to certify that the property listed above has been inspected by authorized City personnel on 1 " , 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
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):
City Sanitary Sewer Permit n City Plumbing Permit
NOTE, Applicable only if box is checked, 'used on a review of the Sewer Service video inspection /report on file, it is
recommended that per iad' rng or future inspections be performed to minimize a potential blockage due to
Grease Build -up, R of Intrust /Settlement in Pipe, Other, 63,
i geLLI ( qS )
Signature
Yellow Copy: City of Eagan (Parcel F ile)
City of Evan
/D
Date
rev 2 23 2010