1855 Jade Lane - COCCity of Eapil
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: 1$ - cS
COMPLIANCE WITI1 INITIAL INSPECTION
1.—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 conective work was required.
COMPLIANCE AFTER 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):
White Copy: Property Owner
City Sanitary Sewer Permit ' City Plumbing Permit
NOTE Applicable only if box is checked: sed on a review of the Sewer Service video inspection /report on file, it is
recommended that peril ' ' eaning or' future inspections be performed to minimize a potential blockage due to:
Grease Build -up, 'oot Intrusion : I 'r /Settlement in Pipe, Other,: —
City Approved: l v t / l
Print name Signature
Yellow Copy: City of Eagan (Parcel File)
4 1 ,0 1F City of Eall
S 1
Date
rev 2 23. 2010