4059 Amethyst Lane - COC4 City of Eagan
II
City Approved: �,'A" � 4 -.--
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, i Minnesota
Property Atltlress:
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on V- _ , 2011
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
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):
City Sanitary Sewer Permit City Plumbing Permit
NOM: Applicable only if box is checked: Based 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 apotential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other 7
Signature Date
Yellow Copy: City of Eagan (Parcel F ile)
41 City of Eapll
rev 2 23 2010