4715 Beacon Hill Rd - COCi
City of Ea aft
City Approved:
0-1
Print name
White Copy: Property Owner
SANITARY. SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Ptopetty Address: c -- / , -'F'-::) / /f.),7 l l ! /
COMPLIANCE WIIH INITIAL INSPEC ZION
This 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 work was required..
COMPLIANCE AFIER: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):
n City Sanitary Sewer Permit FKity Plumbing Permit
NOTE.. Applicable only if box is checked :1 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 a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other..
I
i Signature Date
Yellow Copy: City of Eagan (Parcel File)
City of Eagan
rev. 2 23 2010