1838 Kathryn Cir - COCCity of pp
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: 175 C "f V�. C. J C
COMPLIANCE WITH INIIIAL INSPECTION
frl--.This 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 AF IER CORRECIIVE WORK PERFORMED
fl City Sanitary Sewer Permit
White Copy: Property Owner
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 Plumbing Permit
NOTE: Applicable only if box is checked: Eased on a review of the Sewer Service video inspection /report on file, it is
recommended that per i - ;leaning or future inspections be performed to minimize a otential blockage due to:
Gr se Build -up, ootTntrusio ip /Settlement in Pipe, Other:: r 43 V} "
1 - 4�
City Approved: 1 1, / � — .A- J
Print name Signature
Yellow Copy: City of Eagan (Parcel File)
Date
41 City of Eagan
5
/ -o I
rev 2.23 2010