1858 Jade Lane - COCCity of Roil
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address:
COMPLIANCE WITH INITIAL INSPEC ZION
This is to certify that the property listed above has been inspected by authorized City personnel on , 201 l
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AI TER 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):
White Copy: Property Owner
City Sanitary Sewer Permit 1 City Plumbing Permit
411 City of h pp
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,
City Approved: ■r•-• 1L1 / 1/v\r - 4 (O 'l � { c t
Print name Signature Date
Yellow Copy: City of Eagan (Parcel File)
rev 2 23 2010