4080 Halite Lane - COCCity of Eagan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of hp
City of Eagan, Minnesota rr
Property Address: C� a L 0 } C, ` � G._ l<u
COMPLIANCE WIIH INITIAL INSPECTION
r '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 AFTER 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 corr ective repair work under (check all that apply):
City Sanitary Sewer Permit L City Plumbing Permit
NOTE; Applicable only if box is checked; ElF ased 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 to:
Grease Build -up, R Intrusio , Dip /Settlement in Pipe, Other[-O
City Approved: L` ,fit— /
Print name
Signature Date
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File)
rev 2. 23 2010