1729 Walnut Cir - COCd e * City of Emu
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: � `i o C A J C19—
COMPLIANCE WIIH INITIAL INSPECTION
-This 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 AF IER 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):
City Approved:
Print name
White Copy: Property Owner
j1 City Sanitary Sewer Permit 1 City Plumbing Permit
NOTE: Applicable only if box is checked: 1Based 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, Others
Signature
Yellow Copy: City of Eagan (Parcel File)
4,01. City of a ,art
(-1 1a4 c
Date
rev. 2 23. 2010