4373 Beaver Dam Rd - COCCity of Eago
City Approved: - '\ (,FLU..
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Proper Addr ess: 1 -3 3 { �, � &w 2 0_6)
COMPLIANCE WIIH INITIAL INSPECIION
'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 CORRECIIVE 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 corrective repair work under (check all that apply):
City Sanitary Sewer Permit ❑ City Plumbing Permit
NOTE, 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:
41 City of Eagan
t - 6-LA- " f I "/316 JJ0 1
Signature . Date
Yellow Copy: City of Eagan (Parcel F ile) rev 2 23 2010