3901 Riverton Ave - COCCity of Evan
City Sanitary Sewer Permit
City Approved: -,
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Pt ()petty Address: '19 ti i
COMPLIANCE WIT H INITIAL INSPEC I ION
- is to certify that the property listed above has been inspected by authorized City personnel on c� ` , 201
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 Plumbing Permit
NOTE: Applicable only if box is checked: eased on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections be performed t minimize apotential blockage due to:
Grease Build -up, oot Intrusion ip /Settlement in Pipe, Other: "-
\j\ (s6)
Signature
Yellow Copy: City of Eagan (Parcel F ile)
t /,
Date
City of Evan
a-(J rt
rev. 2.2.3 2010