4381 Beaver Dam Rd - COCCity of hp
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
4 City of Eagan
City of Eagan, Minnesota
Property Address: 3S cLie
COMPLIANCE WIIH INITIAL INSPEC TION
is 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 woz was required
COMPLIANCE AFTER 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):
City Sanitary Sewer Permit n 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 apotential blockage due to
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
City Approved: rt l V ,t AAA-- - L ,rtJ4.. I �' l � 7g.6 i
Print name Signature Date
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File)
rev 2.232010