3929 Blackhawk Rd - COCCity of Evan
City Approved: \ VA. V`
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: a Q N.CL - -( Vti c 1
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on —9 - , 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 Sanitary Sewer Permit City Plumbing Permit
NOTE: Applicable only if' box is checked [Based on a review of the Sewer Service video inspection /report on file, it is
recommended thatperiadic.rleaning or future inspections be performed to minimize a potential blockage due to:
Grease Build -up trusi n,Dip /Settlement in Pipe, Other. "33 .'
Yellow Copy: City of Eagan (Parcel File)
City of bp
rev 2 23 2010