3966 Pumice Lane - COCCity of fla p
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
4111 City of EapIl
City of Eagan, Minnesota
Property Address:
COMPLIANCE WITH INITIAL INSPECTION
'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 AFIER CORRECTIVE WORK PERFORMED
1
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 (cheek all that apply):
i
City Sanitary Sewer Permit C City Plumbing Permit
NOTE: Applicable only if box is checked: I 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 /Settlernent in Pipe, Other:
City Approved: T �' vvN_
Print name
White Copy: Property Owner
, S7 ;./C)
Signature Date
Yellow Copy: City of Eagan (Parcel File)
rev. 2.23 2010