4280 Sunrise Rd - COC4 116 City of Evan
COMPLIANCE WITH INITIAL INSPEC T ION
Ihis is to certify that the property fisted 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 TER CORRECIIVE 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 cor rective repair work under (check all that apply):
7 City Sanitary Sewer Permit n City Plumbing Permit
NOTE Applicable only if box is checked: UBased 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: l in \Ac i r - rte.
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota nn
Property Address: i A - n0 SW, k 1
( J
Signature
Yellow Copy: City of Eagan (Parcel F ile)
4 1114 City of Evan
Date
rev 2 23 2010