1960 Shale Lane - COC4 City or h
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
10 City of Eagan
City of Eagan, Minnesota
Property Address: 1 9 O
COMPLIANCE WITH INIIIAL INSPECIION
f; is to certify that the property listed above has been inspected by authorized City personnel on 6, 3 , 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
i(
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 corr ective repair work under (check all that apply):
n City Sanitary Sewer Permit n City Plumbing Permit
NOM: 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 be performed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
City Approved: 1 to
Print name
White Copy: Property Owner
Signature
Yellow Copy: City of Eagan (Parcel File)
I (' /`a —q i jam it
Date
rev 2 23 2010