1762 Hickory Hill Dr - COC4 , 11IP ' City of Eapa
City of Eagan, Minnesota
Property Address: +r c t 011 N/ ( e.---
COMPLIANCE WITH 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
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):
7 City Sanitary Sewer Permit
City Approved: J \\OWSL
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
ri City Plumbing Permit
411 City of EagaIl
NOTE: Applicable only if box is checked: UBased 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:
/co (--/N126 i
Signature Date
Yellow Copy: City of Eagan (Parcel File)
rev 2 23 2010