1795 Bluestone Dr E - COC4 0 1 City of Eagan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Pr
operty Addi ess: 1 q B` U -� S ties 0 4 (U e
COMPLIANCE WITH INITIAL INSPEC ZION
R— Ihis 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 PERFORIMED
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 corr ective repair work under (check all that apply):
n City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked, 1 (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 a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
City Approved: -+ C& —
Print name
White Copy: Property Owner
/J / S t
Signature Date
City of Eaal
Yellow Copy: City of Eagan (Parcel x i1e) rev 2 23 2010