3720 Blackhawk Rd - COC41 City of Baran
City of Eagan, Minnesota /�
Property Address: 3 i - O 1Ct_C AA 1 C-LL . e 0 ‘I-A0
COMPLIANCE WIIII INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on S , 2011
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AF TER CORREC IIVE 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 corrective repair work under (check all that apply):
n City Sanitary Sewer Permit
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
n City Plumbing Permit
41 City of Eagan
NOTE: Applicable only if box is checked :1 IBased 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: HIV\ / / �'! j Z 1 D + j
Date
Signature
Yellow Copy: City of Eagan (Parcel File)
rev 2 23 2010