4734 Hazeltine Lane - COC11 City of Eapil
City of Eagan, Minnesota
Property Address: /••73/ e
COMPLIANCE WITH INITIAL INSPEC TION
City Approved:
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Ihis is to certify that the property listed above has been inspected by authorized City personnel on 1t
and found to be in compliance with Section 3 40 of the City Code and no corrective work was €equired.
COMPLIANCE AF IER CORREC LIVE WORK PERFORMER
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):
City Sanitary Sewer Permit City Plumbing Permit
NOTE Applicable only if bo.x 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 performed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other„
Yellow Copy: City of Eagan (Parcel F Ile)
City ofEapll
rev 2 .23 2010