4237 Sunrise Rd - COCCity of bp
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Fagan, Minnesota
Property Address: �° ? '1 S 1 S1 eb 0-0
COMPLIANCE WITH INITIAL INSPEC TION
._,This is to certify that the property Listed above has been inspected by authorized City personnel on 6v" , 201 1
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AF TER 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 corrective repair work under (check all that apply):
n City Sanitary Sewer Permit n City Plumbing Permit
4,11i' City of Eap,all
NOTE:. Applicable only if box is checked: UBased 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: yf
Print name
White Copy: Property Owner
Signature
Yellow Copy: City of Eagan (Parcel File)
(-7-3o1 rr
Date
rev 2 23 2010