4670 Kingsbury Dr - COCCity of Eaall
COMPLIANCE WITH INITIAL INSPECTION
I
City Approved: ,
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
City of Eagan, Minnesota
fi - 7 0
This is to certify that the property listed above has been inspected by authorized City personnel on et-'t, f , 201 o
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required.
COMPLIANCE AF TER CORRECTIVE WORK PERFORMED
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 fl City Plumbing Permit
NOTE: Applicable only if box is checked: Based on a r eview 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:
Signature Date
411 City of Etall
Yellow Copy: City of Pagan (Parcel File) rev 2 23.2010