4293 Fox Ridge Rd - COCCity of Ea all
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
City of Eagan, Minnesota
c r - '3 cLIC
City Approved: ,(3'k /
Print name \ Signature
City of Eapll
COMPLIANCE WHIT INITIAL INSPEC IION
his is to certify that the property listed above has been inspected by authorized City personnel on - a , 201_'
and found to be in compliance with Section 3 40 of the City Code and no conective work was required
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
n This is to certify that the properly 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
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:
Yellow Copy: City of Eagan (Parcel File)
Date
rev 2 23 2010