4635 Kingsbury Dr - COCCity of EaQan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
City of Eagan, Minnesota
4 -/C 35 i e004s zu .
City of kap
COMPLIANCE WITH INITIAL INSPECTION
fl This 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 AE TER CORRECTIVE WORK PERFORMED
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): p /I.� ,,,, n t
fl City Sanitary Sewer Permit City Plumbing Permit II �_° `C"
White Copy: Property Owner
NOTE. Applicable only if box is checked: ❑Based on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections beperformed to minimize a potential blockage due for
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
City Approved:iE
Print name Signature
Yellow Copy: City of Eagan (Parcel File)
Date
rev 2 23 2010