1741 Palisade Cir - COC411 City of EagaIl
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
41 City of EaRall
City of Eagan, Minnesota
11
Pr Address: 1'1'4 1 0._1 1 i S 'L
COMPLIANCE WITH WITH INIIIAL INSPECTION
lfr This is to certify that the property listed above has been inspected by authorized City personnel on , 2011
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 Ihis 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
n City Plumbing Permit
NOTE: 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: -t 1
Print name
White Copy: Property Owner
Signature Date 7 1 ' 1 1
Yellow Copy: City of Eagan (Parcel F ile)
rev. 2 23.2010