4096 Halite Lane - COCCity of Evan
Property Address:
n City Sanitary Sewer Permit
City Approved: 1 vVt l et:v ---
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
L4Q (1L
COMPLIANCE WIIH INITIAL INSPECTION
T his is to certify that the property listed above has been inspected by authorized City personnel on , 201_(
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 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):
City Plumbing Permit
NOTE: Applicable only if box is checked: [jBased 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 apotential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
C ,t ak
Signature
Yellow Copy: City of Eagan (Parcel F ile)
Date
4 , 1/ City of Eagan
rev 2 23.2010