4320 Fox Ridge Rd - COCCity of Ear
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
City of Eagan, Minnesota
93R) e eo0_0
COMPLIANCE WITH INITIAL INSPECTION
-This is to certify that the property listed above has been inspected by authorized City personnel on 6 " , 201 )
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AF TER CORRECIIVE WORK PERFORMED
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):
Pi City Sanitary Sewer Permit j I City Plumbing Permit
NOTE: Applicable only if box is checkedr 1 IBased 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.:
City Approved: - \ vv� ��_ /
Signature
Yellow Copy: City of Eagan (Parcel File)
/ 4 °73 Oho
Date
City of Ea as
rev 2 23 2010