4682 Beacon Hill Rd - COCCity of Eaaii
I
City Approved"" �''- L 9e4 - ' (5 o
Print name
Signature
Date
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File)
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Propexty Address:
COMPLIANCE WITH INITIAL INSPEC'HON 201
This is to certify that the property listed above has been inspected by authorized City personnel on
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AF TER CORREC IIVE 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):
City Sanitary Sewer Permit ® 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 a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
I �
City of Eapt
rev 2 23 2010