3984 Beryl Rd - COCCity of Ea li
City Approved: T ' \) \
Print name
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: {3 eel OD
COMPLIANCE WIIH INITIAL INSPECTION
^- This is to certify that the property listed above has been inspected by authorized City personnel on ' 1 , 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
pi 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 Sanitary Sewer Permit 1 City Plumbing Permit
4 City of Evan
NOTE: Applicable only if box is checked: nBased 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:
White Copy: Property Owner Yellow Copy: City of Eagan {Parcel F ile)
\ ‘:\ ) l ( l i 1 ';-0 i 1
Signature Date
rev 2.23 2010