4048 Cinnabar Dr - COC11 City of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City oi Eagan, Minnesota
Property Address: 0 (1,( VLY e“ vi
COMPLIANCE WITH INITIAL INSPEC IION
, 7}1 Ihis 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 0 City Plumbing Permit
NOTE Applicable only if box is checked:1 Based 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: - S V12 17
Print name
White Copy: Property Owner
Signature Date
Yellow Copy: City of Eagan (Parcel File)
City of Evil
rev 2.23 2010