4286 Sunrise Rd - COCCity of hp
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of i3aian
City of Eagan, Minnesota
PxopextyAddress: k kg - S 1, 0 �.
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COMPLIANCE WIT El INITIAL INSPEC IION
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 AFTER CORRECTIVE WORK PERFORMED
n 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 corr ective repair work under (check all that apply):
City Approved: `
OA—
Print name
White Copy: Property Owner
City Sanitary Sewer Permit j City Plumbing Permit
NOTE; Applicable only if box is checked: 1 [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:
Signature
Yellow Copy: City of Eagan (Parcel File)
C
Date
rev 2 23. 2010