1986 Shale Lane - COCCity of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: l 9, o to C . ( 0 - -KJ--
COMPLIANCE WITH INITIAL INSPEC TION
7‘f This is to certify that the property listed above has been inspected by authorized City personnel on ' , 201 t
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 Ihis is to certi fy that the property listed above has been found to be in compliance with Section 3 40 of the City Code
after satisfactorily completing the requited corrective repair work under (check all that apply):
City Sanitary Sewer Permit n City Plumbing Permit
City of Ea ll
NOTE: Applicable only if box is checked: used 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 apotential blockage due to
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
City Approved:
Print name
White Copy: Property Owner
Signature
Date
Yellow Copy: City of Eagan (Parcel File) rev. 2.23 2010