4301 Fox Ridge Rd - COCCity of Ea as
City Approved: - -6,K,r
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
n City Sanitary Sewer Permit i City Plumbing Permit
Yellow Copy: City of Eagan (Parcel File)
City of Emil
City ofEagan, Minnesota
Property Address: ' 4 °t- `
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on ` , 201 f
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AFIER CORREC IIVE WORK PERFORMED
n Ibis 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):
NOTE.: Applicable only if box is checked: 1 lBased 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:•
te I C'731 Q.6 1 (
Signature Date
rev 2.23 2010