4241 Sandstone Dr - COC4, 11/16 City of Ea
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
1 1
City of Eagan, Minnesota
Property Address: L}'�L-V 1 S r1rt3NN.e_ V'
111 City of Evan
COMPLIANCE WITH INITIAL INSPECTION
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 AFIER 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):
n City Sanitary Sewer Permit City Plumbing Permit
NOTES Applicable only if box is checked: c 'Based on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections beperfoed to minimize a potential blockage due to:
Grease Build-up, Root Intrusion, Dip /Settlement in Pipe, Other: r o'r 9 c ' r 3 M7
6 nC� (0 1 -
City Approved:
Print name
White Copy: Property Owner
Signature
Yellow Copy: City of Eagan (Parcel F ile)
Date
rev. 2 23.2010