3938 Blackhawk Cir - COC41 City of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: \ C 6 `C3,G o wic Ct
COMPLIANCE WITH INITIAL INSPEC TION
This 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
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 City Plumbing Permit
NOTE Applicable only if boy 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 perfor ed to.minimize a p tential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other.: ( .L>-i 0 Yt -
City Approved: v Aw- 1 1 1
Print name S ignature Date
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File)
4 City of bpi
rev 2.23 2010