4049 Halite Lane - COCCity of hp
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: 4 C3 0 i ' ±L LOL K
COMPLIANCE WIIII INITIAL INSPECTION
his is to certify that the property listed above has been inspected by authorized City personnel on
and found to be in compliance with Section 3 40 of the City Code and no corr ective work was required.
COMPLIANCE AFTER CORRECIIVE WORK PERFORMED
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 n City Plumbing Permit
NOTE: Applicable only if box is checke Based on a review of the Sewer Service video inspection /report on file, it is
recommended thatper iodic cleaning or future inspections be performed to minimize a potential blockage due to:
Grease Build -up, Of Intrust n, Dip /Settlement in Pipe, Other.: (_ p OSS; V- a
City Approved:
Print name
White Copy: Property Owner
4 /11 City of BaRau
201t
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
rev. 2 23.2010