4055 Blackhawk Rd - COCCity of Edon
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota ..11
Property Address: 4053 5.f} %c7 , x-33
COMPLIANCE WIIH INITIAL INSPEC TION
This is to certify that the property listed above has been inspected by authorized City personnel on
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required.
COMPLIANCE AF TER CORRECIIVE 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 collective repair work under (check all that apply):
n City Sanitary Sewer Permit 1 City Plumbing Permit
!VOTE: Applicable only if box is checked:: UBased 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: iPlrle
White Copy: Property Owner
Signatu e
Yellow Copy: City of Eagan (Parcel File)
41 , 11/II City of Eapn
, 201 1
Date
rev 2 23 2090