4622 Kingsbury Dr - COCCity of Eapall
Property Address: 1/
City Approved:
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
COMPLIANCE WYIH INITIAL INSPECTION
Ihis 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 AF IER CORREC TIVE WORK PERFORMED
Ft/This is to certify that the property listed above has been found to be in compliance with Section 340 of the City Code
after satisfactorily completing the required corrective repair work under (check all that apply):
n City Sanitary Sewer Permit City 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 OF future inspections be performed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
( Mt' < r r
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Sign Date
Yellow Copy: City of Eagan (Parcel File)
City of Eaaall
rev. 2 23.2010