4007 Blackhawk Rd - COCCity of Eagan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan
City of Eagan, (' Minnesota
1 43
Property Address: L O C k_Cr„` L
COMPLIANCE WITH INITIAL INSPECTION
T his 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 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 corrective repair work under (check all that apply):
n City Sanitary Sewer Permit City Numbing Permit
NOTE: Applicable only if box is checkea gased on a review of the Sewer Service video inspection /report on file, it is
recommended thatperio leaning or future inspections be performed to minimize a potential blockage due to:
Grease Build -up ootIntrusion I • _ lement in Pipe, Other:
City Approved:
\` wA.- 06..1 L i -- [ / S-13/3-6
Print name Signature Date
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel F ile)
rev 2 23. 2010