4092 Halite Lane - COC1 City of kali
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Pr oper ty Address: �} C A � 4 i Tom_ ` 0, vL�
COMPLIANCE WITH INITIAL INSPECTION
--Ihis is to certify that thepropetty listed above has been inspected by authorized City personnel on Lc , 201_
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECIIVE 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 n City Plumbing Permit
NOTE.; Applicable only if box is checker1er_ 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 poten 'al blo *age due for
Grease Build-up, Root Intrusion, Dip /Settlement in Pipe, Other:
(.1
City Approved:
Print name
White Copy: Property Owner
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
4 City of Evan
Pt
rev 2 232010