4238 Beaver Dam Rd - COCSANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Properfy Address: `'°i•2- > B e_0„Q f 6-et, WI- cl
COMPLIANCE WITH INITIAL INSPEC PION
This is to certify that the property listed above has been inspected by authorized City personnel on L, v' 3 201J
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required.
COMPLIANCE AFTER CORRECIIVE WORK PERFORMED
H 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):
n City Sanitary Sewer Permit n City Plumbing Permit
City of km
NOTE Applicable only if box is checked: Based on a review of the Sewer Service video inspection /report on file, it is
recommended that per iodic 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: _ ' trlA-. -_
Print name
White Copy: Property Owner
1 1
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
City of Ea a
rev 2232010